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					                                                                                                                                                                                                VHA Central Survey #225 Crash Cart Procedures
                                                                                                                                                                                                                                   April, 2008

                                                                                                                                           How do you ensure
                                                                                                                                           that drugs are safe    Is there a
                                                                                                                                          during transportation  designated
                                    What is your process         Who is responsible for                                                                                       Do you have special         Are two people
                                                                                                Does cleaning happen before cart           of the used cart to   person for
     Organization          State   for the crash cart after      cleaning the crash cart                                                                                     training for those who required to sign off on                          Additional comments
                                                                                               goes to pharmacy to be restocked?              pharmacy for      documentati
                                           a code?                    after a code?                                                                                          document code notes?          code notes?
                                                                                                                                         restocking? (Are there on of code
                                                                                                                                              some kind of          notes?
                                                                                                                                           temporary locks?)
                                                                                               Material Serivces after a code take the
                                                                                               cart to Pharmacy. The used medication
                                                                                               drawer tray is removed by pharmacy for
                                                                                               restocking. Materials Serivces then takes
                                   The medication drawer is
                                                                 Materials Services and they   the cart to MS area for cleaning and
                                   locked by RN. The
Trinity Health System      Ohio                                  also restock everything but   restocking of supplies. They then take it Temporary lock.        Yes.         We review in Mock codes. No.
                                   department calls Material
                                                                 medications.                  back to Pharmacy and Pharmacy
                                   Services for replacement.
                                                                                               personnel replace the medication
                                                                                               drawer and lock the drawer. MS then
                                                                                               take the cart back to the MS storage
                                                                                               area.
                                   The cart is locked with a
                                   different color break away
                                   lock to secure and taken to   the department staff is
                                                                                                                                                                                                                      the RN and the physician
                                   Pharmacy or Central           responsible to wipe the                                                 that was described above -
Grady Memorial Hospital    Ohio                                                                yes                                                                  No                   annual review for all RN's   since that is only place the
                                   Supply for restocking and     cart down prior to taking                                               yes a temporary lock
                                                                                                                                                                                                                      orders are written
                                   a replacement cart is         for restocking.
                                   obtained from the utility
                                   room of our ICU

                                   we have a temporary lock
                                   inside the medication
                                   drawer to relock the crash
                                   cart and call materials
                                   service to exchange cart,
                                   clean blade and place into                                                                                                           yes, the nurse   no, however we do have a
                                   biohazard bag, place a 2                                                                                                             on the unit or   nurse who reviews all code the code team is to sign
Trinity Helath System      Ohio    cards with patient sticker materials service                yes                                       temporary lock                 designated       documentation and we       their names onto the code
                                   to charge in material                                                                                                                code team        reinforce proper           record
                                   service and pharmacy. the                                                                                                            member           documentation
                                   cart is taken by materials
                                   service to restock then to
                                   pharmacy to charge and
                                   replace medication drawer
                                   and relock


                                                                                                                                         They are placed in sealed
                                                                                                                                         bags- a clear tamper proof
                                                                                                                                         one from pharmacy and
                                                                                               We have a locked tray on top of the cart
                                                                                                                                         then placed in a bag once
                                                                                               that is in a tamper proof bag, the used
                                   The medication tray goes                                                                              the code occurs that is a      Whomever is
                                                                                               tray is placed in another bag and sent to                                                 It is routinely covered in   Nurse transcribing and the
                                   back to pharmacy and the                                                                              different color along with     assigned
Greene Memorial Hospital   Ohio                             Central processing                 pharmacy before the cart goes to                                                          yearly nursing               physician who ran the
                                   cart goes to central                                                                                  the list of medications that   during the
                                                                                               central. Central returns a clean cart to                                                  competencies.                code.
                                   processing for cleaning.                                                                              were used in the code and      code.
                                                                                               the unit and pharmacy places a clean
                                                                                                                                         the code sheet. This
                                                                                               tray and lock on the cart at that time.
                                                                                                                                         ensures all medications are
                                                                                                                                         accounted for that are on
                                                                                                                                         the tray.



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                                                                                                                                 How do you ensure
                                                                                                                                 that drugs are safe     Is there a
                                                                                                                                during transportation   designated
                                      What is your process       Who is responsible for                                                                               Do you have special                         Are two people
                                                                                         Does cleaning happen before cart        of the used cart to    person for
      Organization          State    for the crash cart after cleaning the crash cart                                                                                training for those who                    required to sign off on         Additional comments
                                                                                        goes to pharmacy to be restocked?            pharmacy for      documentati
                                              a code?                 after a code?                                                                                  document code notes?                           code notes?
                                                                                                                               restocking? (Are there on of code
                                                                                                                                     some kind of          notes?
                                                                                                                                 temporary locks?)
                                    Pharmacy replaces items                                                                   No temporary locks are
                                    inside the locked area of                                                                 used - however any                                                               Not two staff people, the
                                    the crash cart; nursing and                         Pharmacy comes to the unit to replace drawer that has not been              No special training, but                   physician and professionals
Pikeville Medical Center   Kentucky                             Nursing                                                                                Yes
                                    respiratory therapy                                 needed items                          broken into during the                part of code blue training                 who participated in the
                                    replaces items on top of                                                                  code is still sealed                                                             code are required to sign
                                    the crash cart                                                                            individually
                                                                                                                                                                                                                                             We also send a copy to our
                                    We have all drugs in a tray
                                                                                                                                                                                                                                             Critical Care Educator and
                                    in the top drawer. This
                                                                                                                                                                                                                                             she reviews the sheet for
                                    tray is removed after the                                                                                                    It is generally   Yes, we have a video of a
                                                                                                                                                                                                               No but since there are        documentation issues and
                                    code and must be taken to                              Css restocks the supplies. Pharmacy                                   the nurse that    code that and staff
                                                                                                                                                                                                               drugs and physician           gives feedback as
                                    the pharmacy by a nurse.                               then returns the restocked tray to the                                has the patient   practice documentation of
Fort Hamilton Hosp           Ohio                               Central Sterile Supply                                              See above.                                                                 orders, we require a          appropriate for learning
                                    The pharmacy also gets a                               cart and locks the cart with a break                                  or another        the code. It is covered
                                                                                                                                                                                                               physician to sign the         opportunities. She also
                                    copy of the code blue                                  away lock that is numbered.                                           nurse on the      during new hire
                                                                                                                                                                                                               sheet.                        prepares a report of
                                    sheet that has the drugs                                                                                                     unit.             orientation.
                                                                                                                                                                                                                                             outcomes that is presented
                                    used during the code to
                                                                                                                                                                                                                                             quarterly at our Critical Care
                                    reconcile the tray.
                                                                                                                                                                                                                                             comm.
                                                                                                                                    no lockes, unit staff are
                                                                                                                                                                 A person in the
                                   the crash cart is taken by   pharmacy sends the cart                                             reponsible to get the used
                                                                                                                                                                 room is
Genesis Healthcare         Indiana unit staff to pharmacy for   to central proceesing to   yes                                      cart to the pharmacy, the                    No                            No
                                                                                                                                                                 designated to
                                   drug removal                 clean and restock                                                   cart is not to be left
                                                                                                                                                                 documnent
                                                                                                                                    unattended.




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posted:3/31/2012
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