title: Saving Time Under Pressure: Effectiveness of Standardizing Pediatric Resuscitation Carts.
abstract: BACKGROUND
  Resuscitation situations are high risk and high stress, and delays in care can have significant influences on outcomes. Standardization of care protocols and equipment is postulated to decrease some of the stress and risk. The objective of this study was to document increased efficiency in finding resuscitation equipment in a standardized resuscitation cart.
  
  
  METHODS
  A new standardized resuscitation cart design was created, and a multimedia education program addressing the new design was launched. A goal was set to find required equipment in <15 seconds. Five cohorts of 10 nurses were timed at finding randomly chosen items 1, 12, 49, 152, and 351 days after new cart launch. t tests were used to compare estimated acquisition times of requested items using the new cart system to the old cart system (baseline), and a separate regression analysis was used to model skill degradation.
  
  
  RESULTS
  All pairwise comparisons showed significant decreases in mean acquisition time compared with baseline. One day after launch, the mean time to find items was reduced by 46%. Mean time to find requested items was below the goal of 15 seconds 12, 49, and 152 days after launch. This effect was lost by 351 days from launch. Regression analysis predicted the time to find items would exceed 15 seconds 287 days after launch.
  
  
  CONCLUSIONS
  Standardizing the resuscitation cart design greatly reduced time to find items and was accomplished with reduced financial cost. Skill degradation did occur over time, and refresher training was required.
authors.affiliation: Division of Hospital Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky; ecmaul2@uky.edu.
authors.forename: Erich
authors.initials: E
authors.lastname: Maul
authors.affiliation: Office of Enterprise Quality and Safety, UK HealthCare, Lexington, Kentucky; and.
authors.forename: Barbara
authors.initials: B
authors.lastname: Latham
authors.affiliation: Department of Biostatistics, University of Kentucky College of Public Health, Lexington, Kentucky.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Westgate
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000523:psychology / Q000592:standards; D002648:Child; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004865:Equipment and Supplies, Hospital / Q000592:standards*; D006801:Humans; D008421:Materials Management, Hospital / Q000379:methods / Q000592:standards; D010348:Patient Care Team; D010372:Pediatrics; D060805:Performance Anxiety / Q000517:prevention & control; D012015:Reference Standards; D013647:Task Performance and Analysis; D013997:Time Factors; D000066477:Work Performance / Q000592:standards