1. Audit of Equipment Stocked on Resuscitaires in a Busy Maternity Unit in Wales
Dr Emmanuel Oluyomi (SHO) RGH Dr AnneMarie Proctor (ST5) RGH Dr Maria Tsakmakis (Cons Neonatologist) RGH

2. Introduction
Small percentage of babies require resuscitation at birth but can be difficult to predict which babies will require resuscitation prior to delivery
All resuscitaires in maternity units should be fully equipped and ready for use
In 2013 a standard checklist of equipment that should be available on all resuscitaires was agreed between the neonatal and maternity teams

3. Aim
Aim – to establish how well stocked and ready for use all resuscitaires are in the main delivery suite of a busy maternity unit in Wales
Objectives
To assess whether all resuscitaires are fully stocked
If not fully stocked to identify which items are missing
To make recommendations based on the findings

4. Gold standard Checklist
On Resuscitaire
I n Box
In Drawer
Light and clock working
Oxygen working with tubing and face mask
Suction working with blue and black suction catheters
Oxygen cylinder more than half full >500psi
Neonatal stethoscope
Ambubag micronate small mask hung on back
Ambubag neonate mask
One box Narcan 400mg
One box of Sodium Bicarbonate 4.2%
In date drug box
Laryngoscopic blades X2
Portex paediatrics tubes sizes 2.00mm, 2.5mm, 3.00mm, 3.5mm and 400mm
Intubation stylet
Yankauer sucker
Scissors x1
Neonatal airways sizes: 0x1(grey), 00x1(blue), and 000x1(grey)
Neonatal Circuit (Tom Thumb) x2
NeoPEEP x2
Oxygen tubing x3
Suction Catheters Black x3 and Blue x3
Baby hats
Plastic bag for delivery <29 weeks
Oxygen masks small, medium and large x1 of each size
Scissors x3
Cord clamps x3

5. Method of Data Collection
Standard checklist used as the gold standard
Performed over a 1 calendar month period, June 27 - July 25, 2014
Each resuscitaire on MDU checked 12 times on random unannounced occasions
At no time was any resuscitaire checked more than twice within 24hours.
Total of 108 checks recorded (9 resuscitaires x 12 occasions)
Items present but not in the required number as detailed on the checklist were marked ‘incorrect’.

6. Results
To help interpretation, data is reported within the 3 checklist subheadings:
Section 1 : Items on the resuscitaire criteria
Section 2: In the box criteria
Section 3: Items in the drawer criteria

10. Results Continued
In 108 episodes the full criteria (excluding NaHCO3) were only met 6.5% of the time. Including NaHCO3, ZERO %!
Most rooms always fully stocked with required ETTs. BUT Theatres (which are arguably the most likely rooms to require ETTs) were stocked <100% of the time
For multiple criteria eg. 3 x oxygen tubing – 3 sets rarely found in the drawer. However 100% of resuscitaires always had at least 1 x oxygen tubing

11. Recommendations Update criteria
- remove items not stocked deliberately e.g. NaHco3
- review need for multiple items e.g. 3x oxygen tubing
- Naloxone 400mg -> 400mcg
Identify who is responsible for re-stocking
Increase awareness of checklist & need to maintain it
Carry out small quality improvement checks monthly
Full re-audit in 6 months.

12. Any Questions?

13. Thank you