Seven Trays in Labour Room: What You Need to Know: Fast-Track Guide to Setting Up Seven Trays in the Delivery Suite

I’ve set up, audited, and re-planned dozens of labor rooms alongside obstetric and midwifery teams. A well-organized seven-tray system keeps the room orderly, reduces time-to-instrument, and lowers cognitive load during critical moments. Spatial clarity has measurable impact: research from the Interaction Design Foundation notes that structured, low-friction environments reduce errors by cutting decision points; in healthcare, simplifying reach and visibility directly supports safer workflows. On the human side, color and lighting cues matter—Verywell Mind’s color psychology overview highlights blue-green tones as calming, which can help lower perceived stress for laboring parents and staff.

Lighting and ergonomics also play a quiet but decisive role. The International WELL Building Institute (WELL v2) recommends tunable lighting with maintained task illuminance (e.g., ~500 lux for procedures and ~150–300 lux for rest) to balance circadian comfort with clinical visibility. From an ergonomics standpoint, consistent tray height (around 34–36 inches / 86–91 cm for standing tasks) reduces reach and shoulder elevation. These aren’t just preferences; consistent light levels and intuitive reach zones correlate with fewer micro-delays and smoother handoffs during active labor.

Understanding the Seven-Tray System

The seven trays typically map to the key phases of labor and immediate postpartum care. Naming conventions vary by hospital, but the logic remains: one function per tray, clearly labeled, color-banded, and placed in predictable zones. Below is a widely adopted structure that aligns with obstetric workflow and sterile technique.

Tray 1: Triage & Admission

Purpose: First contact and baseline assessment when the birthing person arrives.

- Contents: Blood pressure cuff (manual backup), pulse oximeter, thermometry covers, urine dipsticks, specimen cups, IV start kits, tourniquets, alcohol swabs, label sheets, and consent forms.

- Placement: Non-sterile zone close to the door and nurse station line-of-sight.

- Design notes: Neutral color band (gray/white) to signify non-sterile status; high-contrast labels aid quick grab. Keep this tray out of the sterile field to prevent confusion.

Tray 2: Labor Support & Monitoring

Purpose: Ongoing maternal-fetal assessment and comfort during labor.

- Contents: Fetal monitoring belts/transducers, ultrasound gel, lubricant, sterile gloves (various sizes), perineal warm packs, repositioning wedges, telemetry patches (if used), and spare batteries or chargers.

- Placement: Near the patient’s bed on the non-sterile side, with cables neatly coiled in dedicated compartments.

- Design notes: Use a calm color band (soft blue/green) to reinforce stress reduction. Maintain a clear cord routing path and avoid cable crossover with the sterile field.

Tray 3: IV, Meds & Hemodynamics

Purpose: Rapid access to fluids and medications.

- Contents: IV fluids, administration sets, saline flushes, extension sets, securement devices, syringes, needles, alcohol and CHG swabs, medication labels, and standardized emergency meds per protocol (e.g., oxytocin, antiemetics; high-alert meds stored per pharmacy policy).

- Placement: Non-sterile, close to the anesthesia interface and wall gas/infusion pumps.

- Design notes: Red banding for high-alert segregation; double-check labels. Include a quick-reference med chart in a splash-proof sleeve to reduce search time.

Tray 4: Sterile Vaginal Exam & Amniotomy

Purpose: Sterile interventions during labor progression.

- Contents: Sterile gloves, drapes, amnihook or amnicot, lubricant in sterile packets, lighted speculum if indicated, sterile gauze, and specimen containers.

- Placement: On a dedicated sterile cart, above waist height, covered until use.

- Design notes: Strong visual distinction (solid green band) for sterile-only. Position within the primary reach zone for the provider’s dominant hand to minimize unnecessary motion.

Tray 5: Delivery (Vaginal Birth Set)

Purpose: Instruments and supplies for the moment of birth.

- Contents: Sterile instrument pack (forceps if indicated by protocol, scissors for episiotomy and cord, clamps, needle drivers), sterile drapes, bulb syringe, cord ties/clamps, sutures (various), local anesthetic with labeling, sterile saline, and sterile towels/receiving blankets.

- Placement: Sterile cart at the foot of bed, locked wheels, predictable orientation (instruments left-to-right by sequence).

- Design notes: Task lighting should deliver at least ~500 lux at the field while keeping ambient light softer for patient comfort. Ensure anti-glare positioning to reduce reflective hotspots on instrument surfaces.

Tray 6: Postpartum Repair & Uterotonic Support

Purpose: Immediate postpartum stabilization and repair.

- Contents: Perineal repair kits, additional sutures, local anesthetic, sterile syringes/needles, uterotonics per protocol, peri-bottles, cold packs, maternity pads, and mesh underwear.

- Placement: Adjacent to the delivery tray but visually differentiated to prevent premature opening.

- Design notes: Clear “Postpartum Only” label and color band (purple) to avoid mix-ups. Add a quick checklist on top for count reconciliation and documentation cues.

Tray 7: Newborn Immediate Care & Resuscitation

Purpose: Neonatal transition and emergency readiness.

- Contents: Warm blankets/hats, pre-warmed surface access, bulb syringe, suction catheter, neonatal bag-mask device with appropriate masks, pulse oximeter probe (neonate), umbilical clamps, vitamin K and erythromycin per policy, and if indicated, equipment consistent with NRP guidelines (e.g., T-piece resuscitator).

- Placement: At the radiant warmer, within a dedicated neonatal zone, with oxygen/air and suction verified.

- Design notes: Bright, high-visibility banding (yellow) communicates critical care. Keep the warmer’s light focused but avoid glare on the newborn’s field; maintain quiet acoustics to support neonatal stabilization.

Room Layout Strategy and Flow

The seven trays work best with a clean zoning plan: non-sterile entry/triage near the door; maternal support and monitoring flanking the bed; sterile field toward the foot of bed; neonatal zone at the warmer with clear circulation paths. Good spatial ratios—around 1.2–1.5 m clear on the instrument side and a minimum 1.8 m turning radius for emergency equipment—help avoid congestion. If you’re mapping a new unit or optimizing an existing room, a layout simulation tool such as a room layout tool can help the team test cart positions, lighting cones, and cable routes before committing on site.

Lighting, Acoustics, and Human Factors

- Lighting: Aim for layered control—ambient 150–300 lux; task lighting 500–1000 lux at the sterile field; amber night mode for low-stimulation periods. Follow glare control fundamentals: shielded sources, matte finishes on tray surfaces, and indirect uplight for general comfort.

- Acoustics: Soft-close drawers, rubber bumpers, and felt-lined instrument holders temper impulse noise. Minimizing sudden high dB peaks preserves focus during critical steps.

- Human factors: Color-banded trays, large-type labels, and consistent left-to-right instrument order reduce cognitive load. Behavioral patterns are predictable under stress; keep the most-used items in the primary reach zone (within 40–50 cm) and set identical tray logic across rooms so float staff don’t relearn layouts.

Sterility, Cleaning, and Restocking

Establish a closed-loop: count in/count out for instrument sets, peel-pack integrity checks, and point-of-use pre-cleaning before transport to sterile processing. Post-case restocking should follow a standard checklist taped under each tray lid. Use wipeable, chemical-resistant materials for tray liners; high-contrast indicator cards signal when an item is below par level.

Training, Drills, and Continuous Improvement

Run quarterly drills for shoulder dystocia, PPH, and neonatal resuscitation with the trays in their live positions to test true reach and sightlines. Track near-misses tied to search time or misplacement and adjust the tray contents or zoning accordingly. Small tweaks—like adding redundant cord clamps to the delivery tray—often pay back during real events.

FAQ

1) How do I customize the seven trays for different hospital protocols?

Start with core functions (admission, monitoring, IV/meds, sterile exam, delivery, postpartum, newborn). Crosswalk your formulary and instrument lists to each tray, then pilot with a small team. Lock the sequence and labels only after a live-scenario drill surfaces gaps.

2) What lighting levels work best during delivery without overwhelming the patient?

Keep ambient light soft (around 150–300 lux) and add focused task lighting to reach ~500 lux at the sterile field. Use dim-to-warm or tunable LEDs to reduce harshness and manage glare with shielded heads.

3) How do color cues improve performance in the labor room?

Consistent color-banding helps staff instantly distinguish sterile vs. non-sterile trays and critical zones. Calming hues near the bed support patient comfort, while high-visibility colors flag emergency items.

4) What are the most common contents that teams forget to stock?

Spare batteries/chargers for monitors, extra neonatal oximeter probes, lubricant in sterile packets, and additional cord clamps. A laminated restock checklist prevents drift over time.

5) How should trays be positioned for left- or right-handed providers?

Keep the tray face oriented consistently (e.g., suture on the provider’s dominant-hand side). If staffing varies, mirror the instrument order on two shallow levels or use pivoting trays that can be rotated without breaking sterility.

6) How do I prevent acoustic distractions during birth?

Specify soft-close hardware, felt-lined holders, and rubber feet on carts. Avoid metal-on-metal contact; use silicone mats on sterile trays to damp clatter and reduce stress.

7) What’s the best way to train new staff on the tray system?

Use a short, visual orientation card on each tray plus a 20-minute hands-on walkthrough. Sim drills under time pressure embed muscle memory faster than classroom explanations.

8) How often should the tray contents be audited?

Do light checks after every case and full audits weekly. Tie audits to incident reports—if a delay relates to a missing item, adjust par levels or tray layout.

9) How do I integrate postpartum and neonatal trays for rooming-in models?

Keep neonatal resuscitation capacity at the warmer, but add a small caddy of newborn routine items near the bedside for skin-to-skin workflows. Maintain a strict boundary for any equipment that must remain sterile or emergency-ready.

10) What ergonomics standards should guide tray height and reach?

A standing work height near 34–36 inches (86–91 cm) suits most providers; store frequently used items within a 40–50 cm reach envelope. Adjustable carts accommodate staff of different statures.

11) How can we reduce visual clutter without hiding critical tools?

Use compartmentalized inserts with clear lids and bold labels. Keep one layer visible at a time; stack only if trays open flat and reveal the entire set at a glance.

12) What data can we use to justify investment in a new tray system?

Reference human-factors research on error reduction through structured environments (Interaction Design Foundation) and patient-centered design benefits. Track your own metrics: time-to-instrument, staff steps saved, and restock accuracy pre/post implementation.