DOI: 10.1093/bjs/znad258.230 ISSN:

1016 A Quality Improvement Project Addressing the Healthcare Dimension of Effectiveness in a Large Cardiothoracic Surgery Department by Ensuring the Contents of the Current Emergency Surgical Chest Drain Boxes Are Correctly Stocked Through Additional

N Evans
  • Surgery



Emergency chest drain insertion on cardiothoracic wards is frequent occurrence due to complications such as pneumothorax. The emergency insertion requires the immediate availability of a significant amount of sterile equipment. A box containing all the equipment on the ward was checked and restocked by the ward nursing staff, however, data suggested missing equipment was prevalent. This has implications for clinical effectiveness, timely intervention, and ultimately patient safety.


This project establishes the frequency of missing items and aims to reduce this frequency through more rigorous checks of the emergency chest drain box contents.


Retrospective analysis of the box contents was performed over 3 months to establish baseline data. Thoracic surgery doctors completed a questionnaire, before and after the changes, about their experiences with the emergency chest drain boxes and missing items. A revised stock checklist was produced in collaboration with the project champion, the audit lead for thoracic surgery, and the procedural document team. The checklist introduction used transformational leadership. Subsequent completeness data was collected, in addition to a follow-up questionnaire.


There was an 81% reduction in the 3-month average number of reported missing items following implementation; and a 92% increase in perceived confidence that the box will be correctly stocked.


An 81% reduction using two Plan Do Study Act (PDSA) cycles represents an improvement in effectiveness. There are plans to implement a single-use, pre-packed emergency chest drains insertion pack. The ongoing third PDSA cycle introduces the single-use pack, ongoing improvement will be demonstrated with repeat audits.

More from our Archive