G421(P)\u2005Seconds count: a quality improvement project to reduce the time taken for frontline paediatric staff to find essential emergency equipment at a district hospital in myanmar

Abstract

Aims Paediatric standards suggest resuscitation equipment should be immediately accessible. This study aimed to determine whether time taken for paediatric staff to find emergency equipment, in a Myanmar district hospital, could be reduced with re-organisation and improved staff awareness. It was hoped that having more accessible equipment would improve morbidity and mortality rates in children requiring emergency treatment. Method Randomly selected nurses and doctors of all seniority in the paediatric ward, were asked to find items of emergency equipment while timed. Following this, a set of emergency drawers was created in the resuscitation area, and a spare suction machine placed adjacent. The drawers were each labelled (Airway, Breathing, Circulation, Drugs, ‘Everything else’), and an inventory and checklist added to enable staff to maintain stock. Teaching was given on equipment location and use, and announcements made at departmental meetings. A similar group of staff were timed to find equipment post-interventions, and results compared. Results Prior to the emergency drawers and teaching, staff members took up to 5\u2009min to find specific equipment, and some items, e.g. oropharyngeal airways, could not be found by 80% of staff tested. 20% of staff tested could not find a needle for intraosseous access, and 10% were unable to find adrenaline, a glucometer or a thermometer. Following the interventions, there was a noticeable improvement in results; all emergency equipment was found by all staff within 30\u2009s, 90% found within 10\u2009s, and 72.3% of equipment found within 5\u2009s. Conclusions This study suggests it is possible to improve the time taken for frontline staff to find emergency equipment with simple re-organisation and teaching. Despite difficulties associated with providing rapid emergency care to paediatric patients in district hospitals in Myanmar, not being able to find a piece of emergency equipment could have a huge impact on a child’s prognosis. Making equipment more accessible has the potential to reduce the high morbidity and mortality rates in this area.