The impact of a neurological emergency 'crash cart' on high-risk medication delivery in a general medical-surgical intensive care unit
CCCF ePoster library. Ajzenberg H. Nov 1, 2016; 150998; 52
Mr. Henry Ajzenberg
Mr. Henry Ajzenberg
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Abstract
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Topic: Quality Assurance & Improvement

The impact of a neurological emergency 'crash cart' on high-risk medication delivery in a general medical-surgical intensive care unit


Ajzenberg, Henry1; Newman, Paula;Harris, Gail-Anne3; Cranston, Marnie3; Boyd, J. Gordon 3
 
1School of Medicine, Queen’s University, Kingston, Canada; 2North West Telepharmacy, ON, Canada; 3Dept. of Critical Care Medicine, Queen’s University, Kingston, Canada


Grant acknowledgements:
Salary support was provided to HA from the Thomas M. and Louise A. Brown Research Studentship Fund via the Queen’s University School of Medicine

Abstract:

Introduction
Patients hospitalized in the intensive care unit (ICU) are at high risk for developing neurological complications, many of which require prompt treatment with specific medications. In an effort to reduce medication turnaround times during neurological emergencies, we developed a neurological emergency crash cart in our ICU in 2012. This cart includes phenytoin, hypertonic saline, and mannitol and other equipment. We hypothesized that turnaround times for these medications would be reduced by implementing this cart.

Methods
This was a retrospective cohort study. We compared medication turnaround times (duration between medication being ordered and administered) for 2-year epochs before- and after its implementation. Eligible patients were identified from ICU screening log by looking for patients whose admitting diagnosis carried a high likelihood of requiring emergent medications. We included adults who required emergent use of phenytoin, hypertonic saline, or mannitol while in the ICU. Nonparametric analyses were used to compare groups.

Results
In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events.  The median medication turnaround time was significantly reduced after implementation of the neurological emergency cart (25 vs. 10 minutes, p=0.003). See Figure 1.  There was no statistically significant difference in ICU or 30-day survival between the two cohorts.

Conclusion
The implementation of a novel neurological emergency crash cart as the standard of care in our ICU resulted in a statistically and clinically significant reduction in medication turnaround times. 
 


References:

No references. 



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