Self-reported checklist logs overestimate compliance with defibrillator inspections

Improperly maintained cardiac defibrillators are an important cause of equipment failure during in-hospital cardiac arrest. The American Heart Association and the European Resuscitation Council recommend that defibrillators be inspected each clinical shift to identify potential equipment failures. Most commonly, the results of this operator level inspection are logged manually onto a crash cart inspection checklist log. Unfortunately, this pen and paper log system relies on self-reported data, the shortcomings of which have been widely reported. We sought to investigate how accurately self-reported checklist logs reflect the true incidence of compliance with regularly required defibrillator inspections. The Lifepak® 12 defibrillator features a helpful option that can be utilized to verify whether the machine was turned on for the required operator function test. Using this feature, we objectively determined the true frequency of defibrillator inspections. We compared the frequency of missed inspections from the checklist log to that of the computerized archives feature for all hospital defibrillators. There was an overall inspection error rate of 3.7%. Of all missed inspections, 45.8% would not have been captured without this archives feature. This archives feature should prove useful for quality assurance efforts focused on cardiopulmonary resuscitation.