biggest thanks to my mentors Sanjana and Kevin, my classmates Reid, Kristine, Heli, Haley, Andrew, my teammates Alex, Anu, Aliah, and anyone who was part of M-HEAL Project Guatemala/ Project Alivio.
Background
Michigan Health Engineered for All Lives (M-HEAL) is a student organization that fosters interdisciplinary global health education, design, and entrepreneurship. Students have opportunities to participate in needs assessment trips in communities around the world and start project teams focused on solving a specific health need. Project Alivio was formed after multiple needs assessment trips to Antigua, Guatemala where Michigan students were put in contact with the Universidad de San Carlos (USAC) medical students and International Relations faculty member. Through this collaboration, we defined our need statement and formed a co-design relationship with the Student Association of International Medical Research (SAIMER) to reduce a high incidence rate of pressure ulcer formation in the San Juan de Dios Hospital in Guatemala City.
Problem statement
Pressure ulcer, which is an injury to the skin and underlying tissues caused by unrelieved pressure, commonly occur in patients who are immobile due to surgery, trauma, or disease and thus cannot reposition themselves in bed. They are most commonly treated by turning patients onto their sides to alleviate pressure from high pressure areas (coccyx, sacrum, heels, other bony prominences). The incidence rate of pressure ulcers in San Juan de Dios hospital is accelerated due to multiple factors such as low nurse to patient ratios, humidity environment, and others. One average nurse is responsible for 10-16 patients; turning takes 2-5 minutes; 2-3 nurses are needed to turn a patient. Therefore, by developing a method to reduce the incidence of pressure ulcers, we could not only help relieve pressure ulcers in Guatemalan patients but also alleviate the burdens of understaffed nurses in overseas hospitals.
Need statement
Develop a method to reduce the incidence of pressure ulcers that form in the San Juan de Dios Hospital by lowering the physical demand of patient turning.
Personal timeline
September 2016 - December 2016
Familiarized myself with the team structure, creative design processes.
Collaborated with 4 team members to generate and refine +200 design concepts.
Explored novel mattress materials to be integrated with the concepts.
We went from here
to here
January 2017 - May 2017
Narrowed the scope of the design mechanisms to 5: alternating air, alternating water, repositioning, foam configurations, and moisture wicking.
Conducted research on existing pressure-ulcer devices for all 5 categories above.
Benchmarked between our concepts with available 47 market solutions in terms of advantages, limitations, stages of pressure-ulcers that the device tackles.
Chiefly wrote the team’s grant application and received $300 funding.
September 2017 - December 2017
Mentored new team members, introduced them to the team’s background, structure, and current development stage.
Generated 11 criteria to rank and down-select from 200 to 2 concepts - pressure mapping and alternating pressure.
January 2018 - May 2018
Led pressure-mapping sub-team to prototype a system that detects and ranks applied pressure to help nurses prioritize patient-turning.
Managed to build a system, in which the input is a voltage signal from the applied pressure, the output is a digital reading of whether the external force is large, medium, or small, and an alarming system that reads from the output.
Delivered this prototype to the M-HEAL Design Review and Guatemala for evaluations.
Summer 2018
During Summer 2018, our team travelled to Guatemala to redefine our needs statement and to have our 2 prototypes evaluated by the the doctors, nurses, and medical students there. Pressure mapping, unfortunately, did not make it to the final round because it could be difficult to be implemented. However, the idea of prioritizing patient-turning by looking at the patient’s pressure distribution is maintained.
As a lasting member of the team (many of the members in my sub-team have left), I faced a dilemma whether I continued working on the prioritization or I formed a new team. I chose the latter option because the graduated members who were comfortable with circuits/hardware have left and I also want to learn new mechanical skills. So from this time forward, I joined the turn-assist team.
September 2018 - May 2019
Founded the turn-assist sub-team.
Led efforts to prototype a bed frame-mounted lift assist mechanism so that nurses can use less force to lift the patients manually.
Successfully built a medium-fidelity, functioning prototype to be evaluated in Guatemala (Summer 2019).
