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Use of Bedside Supply Carts

Nurses   (347 Views | 12 Replies)

NCline9 has 2 years experience as a BSN, RN and specializes in Critical Care.

31 Profile Views; 3 Posts

Hello,

I'm not sure if I'm posting this topic in the right place, but I wanted to get other nurses' opinions on this endeavor I'm undertaking.

I work in SICU at a VA Hospital, where we have one supply room and one limited supply cart located at the nurses' station. I'm wanting to request bedside supply carts to stock basic nursing supplies: IVs, gauze, tape, lab tubes, needles, syringes, etc. so that we don't have to run out of the room excessively to obtain needed supplies. In my experience in other hospitals, along with my colleagues' experiences, it appears as if this is already a standard practice in most ICUs. However, in order to request this type of change, I must submit a formal request to our EBP council, using evidence-based literature supporting my request. Unfortunately this specific topic has not really been researched and therefore my lit review turned up dry. 

So my questions for you is:

In your experience, are bedside supply carts common in the ICU?

How would you approach this EBP request, given that there are almost no articles specifically addressing this topic?

Thank you for your time and input.

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Okami_CCRN has 4 years experience as a ADN, RN and specializes in Critical Care.

792 Posts; 14,337 Profile Views

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. 

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NCline9 has 2 years experience as a BSN, RN and specializes in Critical Care.

3 Posts; 31 Profile Views

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!

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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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

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Okami_CCRN has 4 years experience as a ADN, RN and specializes in Critical Care.

792 Posts; 14,337 Profile Views

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. 

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420 Posts; 2,013 Profile Views

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.

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NCline9 has 2 years experience as a BSN, RN and specializes in Critical Care.

3 Posts; 31 Profile Views

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!

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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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

Edited by Hoosier_RN

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1,192 Posts; 8,017 Profile Views

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

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1,192 Posts; 8,017 Profile Views

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.

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

3 Followers; 6,592 Posts; 68,131 Profile Views

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.

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10 Followers; 3,547 Posts; 25,747 Profile Views

TJC has required us to have our carts locked at all times if the contents could be accessed by patients and could cause them harm. Which for us means they have to be locked at all times. We, of course, abide by that rule religiously.😇

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