Date of Doctor of Nursing Practice Project Completion

2026

Faculty Advisor

Debbie McCrea

Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement a needs-based supply retrieval system using mobile carts and evaluate its effectiveness in reducing supply costs and improving resource stewardship among nursing staff over an 8-week period.

Background

intensive care units are high-resource environments where medical supply overconsumption leads to significant financial strain and environmental impact. Preliminary audits in a high-acuity unit revealed a trend of excess waste driven by the automatic opening of standardized, pre-packaged admission kits regardless of individual patient needs.

Methodology

Guided by the Iowa Model of Evidence-Based Practice, a pre/post-intervention design evaluated 49 patient cases. Standard Heart Failure admission kits were replaced with mobile supply carts. Following early low compliance, a rapid-cycle Plan-Do-Study-Act (PDSA) pivot instituted daily shift huddles to reinforce the new workflow. Per-case supply cost from the carts was compared against $20.45, the sum of the institutional unit prices for the items in the standard prepackaged admission kit.

Results

Across 49 cases over 8 weeks, the cart system produced $21.69 in cumulative net savings. As case volume rose, bi-weekly savings rose from +$13.64 to +$16.65, indicating the workflow scaled with use. Mid-project losses in weeks 3–6 were corrected through PDSA refinements (daily huddle reinforcement, visual goal tracking, and a Cart Champion).

Implications

Needs-based mobile-cart retrieval is a cost-effective workflow that scales with case volume when supported by PDSA refinement. Sustainability is improved by daily huddle reinforcement, visual goal tracking, and a Cart Champion, which together embed resource stewardship into daily routines.

 

 

Keywords

ICU, supply waste, supply cost

Included in

Nursing Commons

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