Inserting an IV needle into a child's hand is a difficult task because children's veins are thin and flexible. Often, several attempts are needed before the needle is in place. This regularly causes stress and tears. What if a colourful and smart sleeve could reduce anxiety?
It sounds almost too good to be true – and yet that is exactly what the ACHILLES project aims to achieve. ‘We are investigating whether we can improve infusion therapy for children and make it more child-friendly,’ says Hellen van Rees, principal investigator at Saxion's Sustainable & Functional Textiles research group. With her background in design, she brings a fresh perspective to this medical problem. ‘I am the project leader and therefore closely involved in all aspects of the project. My design background helps me to collaborate with people from various disciplines,’ she says.
A question from practice
Nurses and doctors in the paediatric ward saw how often an IV line shifts after insertion, how checks take time and how stressful the process is for children and parents. ACHILLES is the answer to this: a soft sleeve in which technology supports care.
But before you can improve something, you need to know exactly where things go wrong. The research team therefore started with thorough observations at the Medisch Spectrum Twente and Deventer Hospital. They looked at current practices, noted times and held discussions with nurses, doctors, parents and children.
‘With children, things go wrong more often than with adults,’ explains Hellen. ‘The vein wall is more flexible, which makes it more difficult to insert the needle. Often, multiple attempts are required. Additionally, children move around a lot, making it difficult for them to understand what is happening. So, for them in particular, there is much to be gained from a system that is more stable, more comfortable and looks less intimidating than all that white bandage.’
Budding designers
A special part of the research was the co-design sessions with children. Children in the ward were asked to draw their ideas for the design of the sleeve. Hellen: ‘That was great fun to do. What struck us most was that the children used a lot of colour and made imaginative drawings. Nothing sleek or simple.’
The researchers took this input seriously. Colour helps to make it less clinical. ‘And we also added some playful elements to the design, with questions such as: how many coloured squares can you count? That distraction makes the tense moments less tense.’
ACHILLES offers a helping hand
All these insights led to ACHILLES, short for Advanced CHild-friendly IV Line Lock Early warning Sleeve: a child-friendly sleeve that secures the IV line and provides early warning.
The solution consists of three parts. A reusable textile sleeve with a built-in splint that can be quickly opened and closed with Velcro. The existing method of securing the needle (taping) remains, because that works best. Hellen: ‘The user test showed that this was the ideal combination: the current taping with the new sleeve around it.’ And then there is the innovation: flexible sensors that measure movement, moisture and temperature. These can provide early warning signs of leakage or the early stages of inflammation before they are visible to the naked eye. The sensor sends a warning to the nursing station, so that the child is not startled by beeps indicating that something is wrong.
How do the children feel about it?
An exciting moment: testing whether the sleeve is workable. Doctors and nurses practised with the children to see whether the sleeve was easy to put on and take off. Without a needle, of course, it was purely about the procedure and the fit. The verdict was clearly positive. ‘The sleeve was much easier to apply, felt more comfortable, and the children thought it was cool,’ says Hellen. ‘They were proud of it and showed it to others. It was really clear: compared to the current splint and bandage, the sleeve was very well received.’
The system is also reusable and washable, which is important for preventing infections. In addition, less disposable material is beneficial for the environment and costs. The hard data will only follow once the system is running in practical pilots.
Taking up the gauntlet together
The ACHILLES project demonstrates the value of broad collaboration. ‘This is truly a joint project,’ says Hellen. ‘Paediatricians, technical physicians, nurses, textile engineers and sensor specialists are all sitting around the table. That mix works perfectly and ensures faster and more targeted designs.’
The support of the Pioneers in Health Care Innovation Fund (PIHC) played an important role. The fund connects hospitals and knowledge institutions, organises matchmaking and ensures that good ideas are turned into testable prototypes.
The first steps have been taken
The PIHC project has been completed, but the work continues. A follow-up application is pending for clinical testing: on the one hand, to use sensors to gain a better understanding of current infusion behaviour, and on the other hand, to further develop the textile prototypes and test them in practical situations.
The biggest challenge? ‘Implementing it in the current healthcare system,’ says Hellen. People are used to doing things a certain way. By designing together with the clinical wards, you build support and help to gently change habits.’ Training, logistics around washing and stock, and a handy alarm system for the nursing station are points that still need to be carefully worked out.
But the first steps have been taken. Children proudly showing off their new sleeves, and nurses being enthusiastic about how easy they are to use. ‘It's very motivating for us to see what we're doing it for,’ says Hellen. ‘There are so many challenges in healthcare where you can make a meaningful contribution. The exchange with people in healthcare, designing together – that's what we do it for.’
About PIHC
The Pioneers in Health Care (PIHC) Innovation Fund is a collaboration between the University of Twente (TechMed Centre), Saxion University of Applied Sciences, and the hospitals MST, ZGT, and Deventer Hospital. Each year, the Fund provides €600,000 for 10 innovative projects that make smart use of technology for the healthcare of tomorrow. PIHC brings doctors and researchers together to develop new technology for better patient care or to use existing technology for new medical applications. Text: Susanne Bosscha.
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