Storage Units and Carts: Space-Saving Mobility

Storage units and carts may first appear to be ubiquitous, unimportant items when compared to the scopes and other medical instruments that make endoscopy possible, but they play an essential role in the ability of nurses and techs to do their jobs well. Carts can mobilize equipment that would otherwise have to be on-site, all the time, getting in the way when they’re not needed. But mobilizing this equipment means it can be stored out of the way, brought out only when necessary.

Recent innovations in ergonomics, weight and ease of use have made carts more crucial than ever before.

Omnicell Inc. offers a point-to-point system that integrates the cabinet tithe bedside medication administration system. “The job of administering medications to patients has gotten safer and more efficient for nurses at Jeff Anderson Regional Medical Center in Meridian, Miss. , with the installation of the new Point-to-Point Medication Safety Solution, ” says Bruce Lewis, Omnicell’s press relations representative. “The integration of Omnicell’s OmniRx™ medication dispensing cabinets and Safety Med™ RN bedside medication administration system adds six new safety checks, while eliminating the need for nurses to search for patient names in cabinets or document overrides and other decisions at both the cabinet and the patient bedside. ”

Previously, he adds, “A nurse would go to the cabinet and scroll through all the patients in the unit to locate his or her patient, then search through what can be a long list of patient medications to find due meds, ” explained Ken Nichols, PharmD, director of pharmacy at the hospital. “Add the need to compare the approved medications with the patient medication administration record and you have a process that is both time-consuming and fraught with potential errors. The possibility of two nurses, both caring for the same patient, giving medications to a patient, further complicated the process. Now nurses only see what medications are due. If they’ve been administered by another nurse, they don’t show up at the medication-use cabinet or in SafetyMed RN, the mobile bedside administration system. ”

Automation of the entire medication- use process has allowed Nichols to manage the facility’s pharmacy operation with a staff of 14, when previously it required a staff of 22.

The points of safety added by the Point-to-Point Medication Safety solutions include SafetyStock™ bar code confirmation at the medication dispensing cabinet, which uses bar codes to verify that the correct medication is stocked in the correct cabinet bin. SafetyStock verifies that the correct medication is obtained at the time of issue. For non-pharmacy-reviewed orders, allergy alerts are provided at both the point of use and the point of administration. OmniRx-SafetyMed RN integration identifies due meds, preventing errors of omission as well as errors of duplication. The medication override process is integrated and can be conducted either at the OmniRx cabinet or at the patient bedside with SafetyMed RN, improving nursing efficiency and data input accuracy. SafetyMed RN uses bar codes to verify the accuracy of patient medications, and OmniRx-SafetyMed RN integration generates a “Dispense Versus Administration” report, which tracks compliance and enhances billing accuracy.

Health Care Logistics Inc. (HCL) offers several products to assist the nurse. The HCL shelving and cabinet line offers convenience, versatility and affordability. Customers can choose from a single unit or outfit entire rooms by selecting from matching components. HCL offers a free three-dimensional design consultation service for customizing workstations to enhance existing spaces. The newest products are designed to be installed without utilizing hardware, with tool-less fasteners to enhance the assembly process — connecting and toggling the interlocking pieces.

The Isolation Door Caddie makes access to infection control items quick, convenient and reliable. The caddie, which hangs on a patient’s door, encourages improved isolation practices by keeping infection control supplies instantly accessible inside its three pockets. The caddie, which is made of vinyl encapsulated polyester mesh, provides space to store one box of gloves, masks, gowns, waste bags, and hand sanitizers.

It also allows important instructions and signage to be prominently displayed in the clear window, to draw attention to special conditions and requirements. The caddie, which hangs from two metal hangers, is designed to adequately hold the weight of the caddie contents and allow doors to close securely. It can help with the issue of hallways congested with equipment. The vinyl covering enables it to be cleaned with a surface disinfectant.

And the Color Crash Cart Boxes and accessories with built-in handles allow the nurse and tech to organize and secure crash cart contents. Color-coded boxes provide quick and easy access to the contents. They can be paired with slide-in lids and dividers, and built-in handles allow boxes to be easily carried to and from supply areas or alternate care sites without disrupting contents. The clear lids enable you to assess the inventory easily; but amber lids are also available for light-sensitive medication.

Will Parks, MBA, is the owner of Champion Cart. In the photo (above), he says, “The kids illustrate how you can take disorder, which five children are, and bring them into order, using the cart. The nurse can take all the many different supplies she needs to go mobile with, put them on a cart, and roll it easily.

“You can use that cart as an in-room cart, but it was designed for mobile use so it would be applicable in all situations. The cart includes an all-welded aluminum frame, which is unique to GI, with high-strength plastic covers for shelf lining, so it’s light. It has a six-inch medical grade caster, one with a directional lock, so you can actually steer the cart. If you grab the handle on the opposite side, it gives you a point to pivot from when you go around corners. We have a monitor stand as well that will roll up under the deluxe cart, and with the turn of one handle, it locks in, so the nurse can push it as one system. ”

Typically, Parks explains, the physician wants the procedure cart behind him and the monitor on the other side of the patient. “Obviously, one cart can't do that, so we have created this system so there is the ability to roll it as one and then separate them and stick that monitor on the other side of the bed. When the case is over, you lock them back together and one nurse can transport that system, vs. having two nurses or one nurse making two trips, ”he says.

“We also have monitors that mount anywhere along the back edge of the cart. Monitors, especially flat panels, are now becoming a pretty big deal, so people want to position them in different places; people might want multiples. The keyboard tray is side-mounted, so it’s out of the way of the front of the cart. It flips up and down, so if you’re going mobile, you flip it down to get it out of the way, then flip it back up when you get to where you’re going. ”

The carts are designed to hold much more weight than a nurse would ever put on them — thousands of pounds. However, they are also designed to be easily moveable. And if they are loaded with particularly heavy equipment, Champion Cart now offers a “tug. ” The motorized tugging device, the “EndoTug, ” is designed to be a solution for heavier, larger motorized carts. “There are other motorized carts out there, but the complaints we had from nurses in the field is that they’re difficult to maneuver; they’re too big, so when you get where you’re going, they often don’t fit in the room, and they're expensive, ” Parks explains.

“So we came up with a separate motor. It’s like a tugboat — it attaches to the side of the cart and pulls it to where you’re going. You stand with the handle at your side and the cart gets towed behind you with the EndoTug. Some big motorized carts won’t fit in [certain rooms], or you're maneuvering a motorized cart in this little tight space and it’s hard not to run into things. Now you tug it to the outside of the room, you detach the tug with the push of a button, and because our carts are light, you can easily push them ten feet into the room. When the case is over, you take it back to the hallway, hook the tug to the side of the cart, and tow it back to the GI lab. The other bonus is, now all the carts in your lab can be mobile. It's also safer; with those motorized carts, you’re driving them from behind and can't see where you’re going because you have all that stuff piled up in front of you. Now you’re walking out front, so you’re not going to run anybody over. It gives you the ability to go on and off elevators, with the whole system latched together; you can tug it with a monitor stand attached. ”

Ergonomics were also a consideration; the weight of the carts was an important factor, so that was reduced as much as possible while retaining strength and durability. “We put handles on both ends of the cart, so you can push and pull or have two people at one time, ” Parks adds. “We angled the handles so they’re more ergonomic. And the EndoTug uses the ergonomic thumb switch for power, because they say that turning the wrist is bad. ”

And the carts were also designed to be comfortable for employees of varying heights. “Our cover model is my wife, who is five feet tall, and she can push the cart. I’m 6’2” and it’s comfortable for me to push as well, ” he observes. “We have adjusted height as people have given us feedback, and that seemed to be the highest we could get while offering more room underneath it. ”

And finally, the monitor stand configuration also took ergonomics into account. The monitor cart is adjustable, so it can tilt and swivel to the appropriate height and angle. “We wanted to put it back on the other side of the room where the doctor likes it, ” explains Parks. “A lot of doctors had complained because there are carts out there with monitors mounted, so the doctor was holding a very awkward neck position, trying to see it as he or she is doing the GI case. ”

So don’t underestimate the importance of the cart, or other mobile instruments that simplify the tasks of the healthcare provider. They play a fundamental role in making it simpler to treat patients and reduce wear and tear on the nurse.

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