Authors (including presenting author) :
Chan HTI
Affiliation :
Labour Ward and Operation Theatre, Department of Obstetrics and Genecology, Queen Mary Hospital
Introduction :
A randomized controlled trail was carried out by Chan et al at 2015, to compare user preference and lengths of time required to retrieve standard resuscitation equipment from an NRP Cart versus a generic storage drawer. The generic drawer is organized in the airway–breathing–circulation approach in two large drawers. The organization of the drawer is similar to those used currently in some delivery rooms and NICU in Hong Kong, including Queen Mary Hospital. The study concluded that the mean length of time required for equipment retrieval from the NRP Cart was significantly less than that from the generic drawer. NRP Cart was 32% faster than the drawer when extensive resuscitation equipment was required. All the participants rated the NRP Cart as easier to use than the drawer.
Objectives :
To assess the feasibility and effectiveness of using the newly designed neonatal resuscitation trolley, Rainbow Cart
Methodology :
The design and setting of Rainbow-Cart
The equipment in the Rainbow-Cart was organized according to NRP recommendation and algorithm. However, the aim of Rainbow-Cart use is to cooperate with the existing resuscitaires in labour ward, and to support advance neonatal resuscitation. Thus, some of the basic NRP items which as available in resuscitaires for initial steps, such as suction catheter, T-piece circuit, are excluded in Rainbow-Cart.
The design of cart also is also based on a simulation study, which suggested some improvements to ‘code-cart’ according to simulation performance (Chen & Law, 2023). These included the use of visual prompts and cues like color coding, prominent labelling, grouping items by task, reducing amount of equipment.
Performance tests were done in labour ward by convenience sampling to compare the time use for preparing umbilical vein catheter (UVC) set and ready-to-use syringe of adrenaline 1:10000, retrieving from Rainbow-Cart and resuscitaire.
Result & Outcome :
1.To enhance a smooth teamwork of midwife and neonatal team during advance neonatal resuscitation.
2.To reinforce the quality of NRP, hence to promote the neonatal resuscitation
3.To reduce the equipment storage in individual labour room, thus reduce expiry date check, workload and medical wastage 7 midwives staff were recruited in this study. Experience ranged from 0-10 years in midwifery.
The average time used to open all UVC material were 64 seconds and 34 seconds, from the resuscitaire and Rainbow-Cart respectively.
And the average time used to prepare a ready-to-use syringe of Adrenaline 1:10000 were 12.4 seconds and 9.4 seconds, from the resuscitaire and Rainbow-Cart respectively.
Some comments were collected from the participants. When asked if they found it easy to access the materials, the average score of resuscitaire was 2.14 (5 was highest). They commented the materials were too pack in the generic drawer and they found it quite difficult to access during emergency resuscitation. And the average score of Rainbow-Cart was 4.7. They found it was easy to access and identify the materials and equipment inside the cart.
Time spent on checking 2 Rainbow Carts was 240 minutes per month (4 times a month), while time spent on checking 11 resuscitaires was 330 minutes.
