Use of Bedside Supply Carts

Hey there, I was involved years ago with a project to utilize supply carts outside of our ICU rooms. I had to do a cost analysis to determine if supply cart utilization made financial sense, after the study we determined that the amount of waste was greater than the cost of the carts. We used to have to toss supplies after every patient, which is why we wanted to have carts right outside the room.

We also had to break up the cost of the carts over 2 years, so we bought half the carts one year and the other half the second year.

Interesting! Was there any particular reason why your carts had to be outside of the room vs. inside? Thank you for the info, that helps!

41 minutes ago, NCline9 said:

Interesting! Was there any particular reason why your carts had to be outside of the room vs. inside? Thank you for the info, that helps!

If it's kept in the room, in some environments, it's considered contaminated, regardless of being locked in a drawer or closet, open or closed, etc. In that case, it must be disposed of after each patient, adding to cost and increasing waste of resources

Just like Hoosier said, if the cart is kept inside the room it is considered contaminated, we place ours right outside the room. It is a six drawer cart where we keep IV primary/secondary tubing, blood tubing, central dressing kits, pads, IV/blood work supplies, and other misc. things that we utilize frequently.

We did this in the last NICU I worked at. Carts were right next to the isolette/crib but were considered clean, so you had to take what you needed out before touching the baby. If you touched the baby and realized you needed something you had to unglove, clean hands, get it, reglove. We had someone come in each morning to restock. It was great.

Due to the size of our hallways, I think the only way this design would work for us is if the carts were inside the room. However, it seems like there are varying schools of thought regarding the contamination of the cart's contents if placed inside the room: Either all contents are automatically contaminated with, or not contaminated so long as proper HH is always performed prior to opening the cart. Both are reasonable; the former eliminates any doubt that the cart's contents are sanitary, and the latter incorporates trust in the RN that he/she will perform appropriate HH prior to using the cart.

Hopefully our facility sides with the latter, especially considering our ER rooms and CVICU bay already utilize a bedside "C-locker" storing supplies that are not discarded in-between patients, and are actually more exposed than they would be if stored inside a cart.

Thank you guys again for your input!

2 hours ago, NCline9 said:

Due to the size of our hallways, I think the only way this design would work for us is if the carts were inside the room. However, it seems like there are varying schools of thought regarding the contamination of the cart's contents if placed inside the room: Either all contents are automatically contaminated with, or not contaminated so long as proper HH is always performed prior to opening the cart. Both are reasonable; the former eliminates any doubt that the cart's contents are sanitary, and the latter incorporates trust in the RN that he/she will perform appropriate HH prior to using the cart.

To some degree, state or JC or whoever the governing body for your facility, determines the course of action

Do you not keep supplies in the room? Is each room devoid of basic supplies?

6 hours ago, Hoosier_RN said:

If it's kept in the room, in some environments, it's considered contaminated, regardless of being locked in a drawer or closet, open or closed, etc. In that case, it must be disposed of after each patient, adding to cost and increasing waste of resources

Yeah, that was tried with us. Telling us we had to get rid of all supplies in the cabinets if the patient was in isolation. That got shot down immediately by us. The content in those packages is sterile and they are in cabinets.

We no longer get rid of supplies. It was the biggest waste of money.

Now, if I could get them to see that tape is not an infection risk.

There's been debate about whether nurse servers can be used in MDRO isolation rooms since there's actually little evidence their contents end up any more contaminated with an MDRO than supplies kept anywhere else, but otherwise there's no reason they can't be kept in the rooms without tossing all the supplies between patients.

If you're being asked for evidence that it's safe to keep a supply cart in the rooms, the better question would be to ask for evidence that it's not, as there's not really any rationale to assume it isn't.

For any responding, I would like an opinion. I was looking for information regarding regulations for nurses who are doing a medication pass in a long-term care unit. I couldn't find anything on any website about medication cart etiquette . I have been practicing for two years as a long term/ acute care/dementia/ float nurse and never in my life have I questioned this very specific med cart etiquette until I started at a new facility and it’s driving me NUTS. In regards to my medication cart I need to be able to give out my medication and park my cart the proper way. I need to find out WHERE to park my cart when giving medication . I was taught to park it in front of my patient's room and lock it before giving medication, then come back and move to the next resident next door and so on and so forth, but recently this etiquette has been challenged by the people orienting next to this specific facility. Which way is the proper way: parking it in front of the doorway LOCKED and facing the resident's room or leaving it to be parked out by the hallway, LOCKED, and facing the hallway? I never put the cart inside the patient room but I had it outside the room so I have a good view of the cart if anyone had to grab something from the top of my cart.