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Medical Design project of Design & Engineering course. Autumn semester 2013/2014

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  1. 1. Abstract “Handtlers is a new approach to hand hygiene, which meant to be used in a hospital environment. Highly effective and at the same time, a natural way of cleaning hands... Fast, convenient and easily integrated into the daily routine”
  2. 2. Introduction Process and methods What was our task? Double Diamond design process model This semester we faced with project to work in cooperation with Regionaalhaigla. The North Estonia Medical Centre is Estonia’s foremost hospital. The mission is to provide top-level patientfriendly healthcare and to promote the development of medicine in Estonia. The hospital is a higher level medical institution. We were given a task to observe usual day in a hospital and discover areas which could be improved from a perspective of dignity or privacy. To explore clinical spaces that are integrated with their surroundings and are accessible and responsive to patients’ needs. The aim of the project is to give an experience of participating in a practical conceptual development process in a given topic. Design has become the theoretical concept for what are called healing environments. 1. Discover 2. Define 3. Develop 4. Deliver 1-5 weeks 6- 8 weeks 8-12 weeks 13-20 weeks Methods: Research for understanding the problem and identifying space of opportunity. Data collection, hospital visit, user scenarios. Methods: Defining goal and scope of the project, narrowing problem to solve Methods: mapping, brainstorming, design sketches, mock-ups, analyses of analogues, user and specialist feedback. Methods: Detailing design and sub-solutions, prototypes and tests.
  3. 3. Team and tutors Tutors: Martin Pärn Janno Nõu Henrik Herranen Estonian Academy of Arts Tallinn University of Technology Tallinn University of Technology Partners: The North Estonia Medical Centre Envirolyte Tallinn Students: Mohammad J. Almutawa Iuliia Vorobiova Dima Malezki I year D&E student Bachelor of Architecture II year D&E student BSC Computer Science I year D&E student MSC Rocket Science
  4. 4. Research Visiting hospital In a society where understandings of health have Forcing the inhabitants to adapt to a poorly During the visit to hospital we came to the expanded to encompass a holistic notion of designed set of tools means that the tasks of daily conclusion that hygiene is important part of a daily mental and physical well-being, rather than a living cannot be successfully completed’’ routine. straightforward idea of a disease-free body, it is not During our visit we tried to focus on items and Now in the hospitals, doctors and nurses use several surprising that hospitals are changing in form and activities in the immediate environment observing techniques to get their hands clean. function. social activities. The time required for nurses to leave a patient’s The environment as a collection of tools used to bedside, go to a sink, and wash and dry their hands support its inhabitants. before checking the next patient is a deterrent to . frequent handwashing. • More rapid access to hand hygiene materials could help improve adherence. • Alcohol-based hand rubs may be a better option than traditional handwashing with plain soap and water or antiseptic hand wash because they require less time, act faster, and irritate hands less often. Another issue is that the constant washing of hands makes skin dry. As well there are some cases when people have an allergy to chemicals which are present in current solutions.
  5. 5. Defining problem Where do hands go? An observation noted as an effective method at So Why All the Fuss About Hand Hygiene? Pamela 28 years old nurse has an experience working in Norwegian and Serbian hospitals. Hand hygiene is a general term that applies to either handwashing, antiseptic hand wash, alcohol-based hand rub, or surgical hand hygiene/antisepsis. Most common mode of transmission of pathogens is via hands! this stage of the project development. We decided to keep a track of a personnel in a hospital and think about possible scenarios and situations when they need clean hands . Healthcare workers should wash hands with soap and water when hands are visibly soiled, and use an alcohol-based hand rub when hands are not visibly dirty. “It’s not possible to forget about washing hands, the system has very strict rules, if you forget doing Negative factors: - that most likely you lose your job” Handwashing agents cause irritation and dryness “Of course there is problem that chemicals which - Sinks are inconveniently located/lack of sinks are present in washing soap which damaging - Lack of soap and paper towels skin, but there is other more major problem: some - Too busy/insufficient time people have an allergy and they just cannot use it.” More rapid access to hand - Understaffing/overcrowding - Patient needs take priority “You have to wash hands before you touch patient hygiene materials could and after, you cannot touch anything help improve adherence. around in not sterile space”
  6. 6. Research Inspiration from nature Thinking about designing new product would Equity. Is the trading equitable and what start with environmental aspects. During the last is the impact on the local and global community? century, environmental problems were often seen What about employee conditions of work? as local problems due to the impact from the certain Technology. Optimise the extraction of raw product. In the world with limited recourses we materials, production, lifetime and quality and obliged change our life style into more sustainable. functionality of the product. But now it’s just obvious that the problems much Ecology. more complex and occur all the phases in a product’s minimize the environmental impact. Eliminate emissions and waste and life cycle. Criteria for the future product: As a lot of factors are taken into account from the Material. begging its makes the rest of the work the most Minimise the material use and energy consumption and try to use renewable materials, sufficient. avoid toxic materials, etc. Economy. Product and service must be cost efficient and comparable with similar products. Consider the total cost during the life cycle including the cost for restoring environmental impacts. Design. Design for the environment and the product user as well as for recycling and transporting. Market. Develop products and design them according to the needs from the specific market and target group. Achieving excellence design evaluation toolkit
  7. 7. Market research Hand-in-Scan Hand Hygiene Control System Plasma Sanitizer Self-Sanitizing Doorknobs Wristband Hand-in-Scan’s utility is plentiful: integrated into Instead of scrubbing, the workers would put their This clever door handle idea uses UV light to An RFID-reading, motion-sensing wristband buzzes medical institutions, it can protect both the patients hands into a small box that bathes them with disinfect itself. It uses an interior UV lamp to to tell health-care workers if they are washing their and the medical staff by indirectly motivating plasma — the same sort of luminous gas found constantly disinfect its surface when the handle is hands properly. proper and frequent hand washing and compliance in neon signs, fluorescent tubes and TV displays. not in use. The lamp clicks off when someone grabs A startup called IntelligentM wants to make with the local regulations. It could be used in This plasma, though, is at room temperature and the handle, then clicks right back on once they’ve hospitals healthier by encouraging workers to clean training: helping medical students to learn effective pressure, and is engineered to zap germs, including passed through the portal. their hands properly. Its solution is a bracelet that hand disinfection. Beyond, the general public can the drug-resistant supergerm MRSA. This concept could greatly cut down on the vibrates when the wearer has scrubbed sufficiently, also be trained for proper hand hygiene with it. The devices can probably be built for $100 or less, suffering and health risks of colds, influenza and giving employees a way to check their habits and Digital image of the hand is automatically analysed as no expensive parts are used, he said. other illnesses with no additional effort from users letting employers know who is and isn’t doing after a general hand washing procedure had been things right. performed. Hand-in-Scan has the potential to It also collects data from the bracelets through a reliably compare and verify different hand washing microUSB connection at the end of each shift, which techniques, and through microbiological studies, gives hospital epidemiologists a chance to see how their correlation to cross-contamination can also each employee is doing. be proved, thus it can reduce HAI by 30%, saving patient lives and hospital treatment costs. In addition to hand sanitizer has developed a prototype for plasma jets that can be built into airconditioning systems. As air is transmitted through the system from one hospital room to another, for example, the jets inactivate microorganisms, fungi and viruses in the air.
  8. 8. Eco water Raw material These are metastable solutions containing wide Thinking which other substance could be used variety of very reactive ions and free radicals which instead of soap or alcohol we had in our mind led to the description of Electrochemical Activation activated water but had no idea what is the process of Water. of making it active and for how long it had its Anolyte – acidic in nature properties or how effective. - very strong oxidizing compounds Concept and Principle of Electrochemical Activation - pH 2 - 4 (ECA) - ORP - +900 to +1000mV EAC of Water – exposure of water and the natural Catholyte – basic salts therein to a substantial electrical potential - strong reducing agent difference in the environment of a special - pH 10 – 12 conductive metal. - ORP –800 to -900 Salt is added to water and passed through double- Neutral Anolyte – formed by mixture of Anolyte and chamber- membrane Catholyte or changes in inflow and outflow to and electrolytic cell from the reactor A high-strength active biocide - anolyte - is created - pH 6.5 – 7.5 in the form of HCLO - ORP +650 to +810 Anode (-) and Cathode (+) in pure water For the particular needs of this study, Neutral Direct current Anolyte meant to be produced with a pH of 5.5 and Electrolysis of water at the poles a redox of +800. (Breakdown of water into constituent elements The design was made to approximate the skin pH to producing gaseous O2 and H+ and migration of minimize skin reactions while maintaining enough electrolytes to anodic and cathodic poles). redox to achieve disinfection of the hands and arms. In terms of cost for raw materials, plain tap water will only be the significant cost plus the addition of a very small amount of electrolyte solution. The energy cost in electricity is close to a using a 50 watt electric bulb. How does this disinfection work? Active components kill pathogens such as bacteria and viruses by breaking the chemical bonds in their molecules. Disinfectants that are used for this Anolyte, as a proposed alternative to the traditional hand scrubbing agents, has fulfilled the criteria set by the FDA-TFM in obtaining >90% microbial reduction. It has been proven to be far more superior to povidone-iodine in terms of efficacy and safety. Anolyte was found to have less adverse effects on the skin. purpose consist of active compounds which can exchange atoms with other compounds, such as enzymes in bacteria and other cells. Summarizing a bit all written above activated water: Are non-toxic to both humans and animals; Do not require special handling; Are powerful biocides; Can be safely disposed of in sewage systems; Composition of Nutrient Broth Used in the Analysis Peptone……………………….. 5.0 g Yeast Extract…………………. 2.5 g Sodium Chloride……………... 5.0 g Beef Extract…………………... 2.5 g Distilled Water………….......... 1000 mL Final pH……………………….. 7.2 Incubation period – 48 hours at 35oC Are fast-acting; Can be generated on-site, thus eliminating handling and storage of chemicals; Can be produced on-site from any source tap water and salt in required quantities and concentrations of active ingredients and pH.
  9. 9. Concepts The Toaster Concept The Ball Concept For the first concept we decided to study the effects For this concept we aimed to look at natural hand of extending the arm to place the hands within a positions designing around them in a way that device to get them clean would be natural and easy. The idea would be to have a device with two The idea stemmed from the cupped resting position compartments where the hands are placed, a of the hand and worked on creating a system that reservoir of disinfecting solution, spray nozzles and would utilize this to clean the hands. We deduced tubing which make up the delivery system and a the system starts with the user and the hands placed sensor that detects the presence of the hands and at a comfortable cupped position, a spray nozzle triggers the process. placed within the hands and a mesh that places the hand at the correct spray distance and also acts The inception came from the idea of having a ‘black as an active component to pump the disinfecting box’ which you insert A in and B is outputted, we solution through the nozzles from a reservoir. applied this hands and generated the toaster concept where dirty hands are inputted into a device and clean hands are taken out.
  10. 10. Process Mock-up build We adapted an existing water sprayer to be our As for the mesh, we acquired prefabricated metal pump by removing the nozzle and attaching tubing mesh that we cut down to a to the pump to extend the reach of the solution. We manageable size using metal sheers. We then cut at inserted a splitter channel to the end of the tubing strategic points so we were able to hammer it into and attached two nozzles to either side. The system the desired spherical shape. The sharp edges of the needed to be pre-pumped to remove air from the metal mesh were grinded down to be smoother tubes and fill them with water so it would be able to and nicer to touch, as well as safer. work at full capacity.
  11. 11. Product solution Using the device is very easy, hands are placed on the mesh handles and are made to squeeze both sides together which in turn activates the pump which draws disinfecting solution from a reservoir and ejects it as a dense mist through spray nozzles placed strategically between the hands, coating the hands in a layer of the solution. The process is then completed when the user rubs their hand together to dry them, which as well gets the solution on to areas of the hands where the spray mist did not Handtlers: A New Approach to Hand Hygiene sufficiently reach, resulting in both dry and clean Utilizing people’s natural hand positions and hands. movements, the Handtlers device seeks to find a The device is eco-friendly and sustainable. It unique, easy and relaxed way to effectively disinfect uses zero-energy to operate, working on purely germ-ridden hands. mechanical principles. It consists of only 7 unique Based on the aforementioned ball concept, the components that are easily manufactured and device consists of 3 main parts; replaced which means the device is durable and Mesh handles where hands are placed and used long lasting. Also the device is built around the to trigger the disinfecting process, a pump that usage of eco-water as a disinfecting solution that is activated by the handle, and a reservoir of is produced using naturally abundant raw material disinfecting solution where the pump draws from. and minimal energy.
  12. 12. Product Solution and Testing Prototyping and Testing Determining the distance of hands from spray User testing Future Improvements had to be tested. First was the effectiveness of the that would release the right amount of solution The device was given to some users for testing to We’re seeking to find stronger and finer mesh spray in covering the hand through the mesh, if the to adequately cover hands. These were major provide some feedback and suggestions for further material as to cover more of the hands on the initial mesh holes were of appropriate size to effectively issues tackled in determining and maximizing the improvements. Some comments about the product spraying before rubbing hands together. Seeking spray hands. were that it looked peculiar and intriguing to to find spray nozzles that would spray at a wider approach, the method was different and strange but angle and not just concentrate the spray mist on also exciting. There were concerns about the spray a small area. Tweaking the pump as to release the coverage of the full hand due the mesh thickness right amount of water in one go rather than using but after usage it was clear that the solution it multiple times for adequate coverage. We’d like covered the hand properly after hands were rubbed to adapt the shame more as to be less ‘pointy’ as to together. The solution had a faint but distinct odor not to be a hazard to anyone. Better integrate the of chlorine despite it being just treated water, it device in the hospital so it could be used daily by gave the impression that it was taking action. The the nurses, and find other usages for the device in solution didn’t leave the hands feeling dry like other environments besides hospitals. During prototyping there were several issues that nozzle. Picking the right type of nozzles and pumps effectiveness of our final product. alcohol would of done and the device uses a small amount of water so a towel was not needed since rubbing hands was sufficient. There was concern with hospital wide integration as they couldn’t see the device being used daily by hospital staff but could easily see it being integrated at specific parts such as common rooms and waiting areas to be used by visitors and children.