Joint Commission Crash Cart Requirements
Joint commission crash cart requirements are based on years of experience surveying hospitals and other medical facilities. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is a national organization that accredits hospitals and other medical facilities across the country. They survey hospitals on a regular basis (approximately every three years) to insure good medical standards are being met in a facility. Their goal is to improve patient care by encouraging hospitals (and other medical facilities) to improve healthcare practices and patient care initiatives.
The Joint Commission on Accreditation of Healthcare Organizations helps hospitals and other medical facilities identify and improve issues with their code blue response. The crash cart is a primary focal point during their assessment and they work with each facility to help them identify opportunities for improvement in their code response.
Having all the right supplies and equipment on your code cart is vital. But even with the right equipment and supplies there are situations that can lead to less than desirable patient outcomes. Missing equipment such as defibrillators, suction pumps, laryngoscopes, etc, can delay time to treatment in a code. If staff is forced to locate missing equipment prior to administering patient care the time lost can dramatically inhibit the level of care to the patient.
Additionally outdated medications are an area of concern that JCAHO helps hospitals identify. The top drawer of a code cart is traditionally inventoried and stocked by the pharmacy. It houses all the drugs/medications needed in a code blue situation. These drugs and medications expire at different life cycles. As a result, it is important that an accurate log is maintained that identifies when drugs are close to out-dating so that they can be replaced prior to their expiration. Failure to do so can have negative results in terms of patient outcomes. Typically pharmacy maintains a record of the “Next to expire” medication in a drug tray. As this date approaches, a member of the pharmacy team will visit each code cart and replace the expiring medication. Alternatively a facility may choose to exchange the entire drug tray when one of the medications expires. This eliminates the need to inventory every other item in the code cart medication drawer and helps reduce errors.
All equipment should be checked on a routine basis to insure that they are fully operational. Any electrical equipment should be tested to insure batteries are fully charged and ready for use. Equipment with power cords should be tested as well at this time. Most common electrical equipment includes defibrillators, suction pumps, laryngoscope handles, flashlights, etc.
The balance of the code cart equipment contained in the drawers below the medication drawer is typically inventoried and stocked by central supply. This includes, IV tubing, cannula, gloves syringes, extension tubing, tape, swabs, etc. Staff from Central supply should regularly check for any supplies in these drawers that have expiration codes on them. Additionally they should be sure that the correct number of each item is present prior to the tamper evident seal being secured to the cart. Waterloo Healthcare offers independent breakaway gatelocks for each drawer that can minimize the need to inventory all drawers when you are replacing one expiring item out of one of the drawers. This can dramatically reduce the time needed to restock code carts.
Other concerns that inspectors look for include damaged carts that may not reliably function in a code situation (Broken casters, drawers, etc). Carts in poor condition can not only inhibit patient care but could put staff at risk during code response.
Additionally, it is important that code carts are easily identifiable by hospital staff members. They must be easy to spot amongst all the other procedure carts found throughout the facility (This is why they are typically all red or all blue).
An emergency cart’s sole purpose is to facilitate a rapid response to a cardiac or respiratory emergency. It houses all the necessary life-saving equipment and supplies so that members of the code team can treat patients in respiratory or cardiac distress. The effectiveness of a code cart is directly related to the care that is taken to properly accessorize, stock, inventory and routinely check the code cart and it’s contents. By following the JCAHO recommendations for code cart contents and maintenance, code blue events will run more smoothly and with better patient outcomes!