SE2: Hospital Bed Rail Device: Self and Design Evaluation

Friday, June 6, 2008

Self and Design Evaluation

Scope of Project
Background Information
The Hospital Bed Rail Device is a device that is designed to prevent entrapment in all 7 danger zones in hospital beds. Entrapment is any case where a patient gets trapped within the bed rails of the bed frame in a hospital bed. Entrapment can lead to serious injury or death. Between January 1, 1985 and January 1, 2006, the FDA received 691 incidents in which patients were caught, trapped, tangled, or strangled in hospital beds. Of those reported incidents, 413 were deaths, 120 nonfatal injuries, and 158 cases where staff needed to intervene to prevent patient injuries.
Although that may not seem like a high number of cases of entrapment, it still is an issue in the medical community. The FDA first alerted the hospital and nursing home community to this problem in 1995. Since then the Hospital Bed Safety Work Group comprised of representatives from the FDA, hospital bed manufacturers, healthcare organizations such as the American Nurses Association and the American Healthcare Association, consumer groups such as the AARP, and other government agencies have worked together to investigate the problem, identify its causes, and find solutions.
The 7 danger zones include: within the rail, under the rail, between the rail and the mattress, between rails, at the end of the rail, between split bed rails, between the end of the rail and the side edge of the head or foot board, between the head and footboard and the mattress.

Design Brief
To design and construct a device that would eliminate the risk of entrapment in all 7 zones in hospital beds.
Description of Solution
Two of the alternative solutions were adapted to become the final solution. The only change was the addition of a mesh material to the centers of 3 of the 4 sides so that patients can see out. The mesh sections were designed to be removable in case of an emergency. Another addition was a Velcro system to the sides of the device so that it can be attached to one another and stay together firmly on the bed.
Discrepancies Between Original and Final Solution
The first thing that had to change during the long construction process of this device was the mesh section at the head board. At first it was designed to have mesh sections in all 4 pieces. However, after the construction of the first model Ms. Green suggested that the headboard section shouldn’t have a mesh insert since patients wouldn’t be looking out of the headboard.
The next thing that needed to be changed was the shape of the bottom of the foam. When this device was first designed it had a 1” bottom. The shape wasn’t really working as planned and finally it was changed. The 1” bottom was too thick to fit between the frame of the bed and the mattress. So the shape was changed to be a triangle on the bottom, leaving the smallest amount of foam possible between the frame and the mattress.
Another thing that changed was the placement of the zippers for the mesh inserts. At first they were located in the middle of the side and footboard pieces as you can see in the model. However, once the zippers were attached to the foam pieces, it became clear that it was difficult to zip and unzip them. So the design was again changed to place the zippers on the outside. This made it easier to construct and easier to zip and unzip.
Another change was the inserts between the top pieces of the foam and the bottom. This gave the top more support so that it could stay up firmly. It also fixed the odd shape that resulted to that piece of foam during the sewing of the top.
The final change during the construction of this project was the addition of Velcro down the two side pieces to attach the mesh. The zippers were too long and weren’t working out the way they were designed to, so they were changed to Velcro.
Successes and Failures
Successes
Overall the device was a success. It fit on the bed properly and prevented entrapment in 6 of the 7 danger zones. The mentors felt that the device could be washed and sanitized and that it would be sterile enough to use in a hospital setting. They also felt that the device would be useful in many settings in the hospital.
During the construction of this device I had many successes with the parts that I built. Most of the parts came out to be exactly the way that they were designed to.
Failures
Although the device was a success overall, some aspects didn’t work as well as planned. The sides of the device ended up being shorter than they needed to be resulting in the failure of zone 6 as seen in Figure 2. The device also pinched when the bed was in the upright position as seen in Figure 3.
I also had some failures during the construction of this device. When I cut the foam I didn’t look at my 3D Isometric rendering and I ended up cutting the holes in the foam for the side pieces in the wrong places. I also did the same thing during the measuring and cutting of the vinyl for the side pieces as well.
The biggest failure during the whole construction process was the failure of our sewing machine here at MAST. After three weeks of attempting to sew the vinyl I had to take it to an industrial sewing machine in order to get the vinyl sewn. Finally it was finished and I could continue the construction process. The sewing machine problem was a major setback. It made me push the construction of my progress back three weeks.
What I have learned from my failures
The main lesson I learned from my failures is to measure twice and cut once. By not measuring twice and double checking my measurements I made more work for myself in the end. I had to fix the foam and the vinyl where I measured wrong.
I also learned time management from my failures. At first when one part of my project wasn’t going as planned I just stopped working until that problem was done. About halfway through my construction I realized that while someone else was working on one part of my project outside of school I could move on to another aspect of my project in school to save myself some time.
Additional Learning
Throughout the course of this project I have learned so many different things. I think the most valuable thing that I took out of this was learning how to do things on my own. I always rely on other people to help me when I have problems. Working alone on this project made it hard for me to rely on other people because most of the time they had no idea what I was talking about when I asked them to do something for me.
Another thing that I learned during this project was how to use a sewing machine. Although I never successfully used the machine at school on my project, I did learn how to thread the machine and run fabric through. Now if I ever need to sew something again I will know how.
One final important thing that I learned was how to manage my time. This project has tons of different things that need to get done in and out of school. It is vital to manage your time efficiently in order to complete this project on time. By learning how to decide what things are more important than others you learn how to prioritize your time so that you get the most out of it. In addition it is important to learn what things can be done at home and what things need to be done in school. This allows you to use your time in school to use the school’s resources and complete that part of the project. When I finally learned all of this I realized how much time I had wasted during the beginning of the year when I could have been doing some of my work at home and some of my work in school.
Design Flaws and Improvements
Design Flaws
After I tested the device at the hospital I evaluated it. I found that overall the device worked but there were about 5 flaws that needed to be improved or maybe even changed.
The first flaw was the length of all of the pieces. None of them reached all the way to the ends of the mattress as designed. They all needed another 6-10 inches in length. Once that addition length was added, the device would be able to successfully block entrapment in zone 6 and therefore would prevent entrapment in all 7 zones.
Another flaw that was discovered was the supports inside the holes in the side rail pieces. It was concluded that the supports were necessary on both of the side rail pieces. It was also concluded that the supports needed to be placed so that the device wouldn’t bend too much when the bed was in the upright position. However, the placement of these supports wasn’t clear to the evaluators at the time.
Improvements
One improvement that one of the mentors felt was necessary was the addition of some elastic straps to the bottom of the side devices. This would allow the devices to give each other support while holding them onto the bed in case the rails were put down during an emergency.
Another improvement deemed necessary was the addition of straps from the head and footboard pieces around the actual head and footboard. This would hold those two sections in place better and would prevent any movement the patient might be able to make on the device while in the bed.
Problem Solving Skills
This project helped me improve my problem solving skills a great deal. Not only did I solve the problem of preventing entrapment in all 7 zones in a hospital bed, but I solved mini problems throughout the whole project. When I measured and cut my foam and vinyl wrong I had to use problem solving skills in order to fix them. I also used problem solving skills during the developmental work of my project when I had to get the bottoms of the device to line up at the proper angle. This project improved my problem solving skills by teaching me to solve problems on my own. Nobody else knew all of the details of my project so it was hard for them to help me solve problems. This allowed me to learn how to solve problems on my own.
Communication Skills
This project helped improve my communication skills in a few ways. First it helped me learn how to communicate with teachers so that they could help me with my project. It also helped me improve my communication skills among my peers. When my peers would ask to help me I had to tell them exactly what to do in order for them to complete the task correctly. I think it helped me improve my communication skills with strangers the most. When I had to contact a company over the phone I had a hard time. By being forced to call companies and talk to mentors to help with this project I have learned how to communicate with people that I don’t really know in a polite fashion.
Organizational Skills
Like I stated earlier, this project definitely helps improving organizational skills. Not only do you have to make and organize a calendar at the beginning of every marking period, but you have to stick to that calendar as the marking period continues. Also, you learn how to organize your time to make the best use of the time that you have. This project definitely helped me learn time management. I learned how to multitask and make use of all of the time and resources available to me.
Conclusion
Overall I am really glad that I chose systems over oceanography. I think that by designing a project that is directly related to what I want to pursue in college, I got to learn a lot of things that will be useful to me in the future. I was also really proud of myself for designing a project on my own and finishing it. When I took the device to the hospital and put it on the bed my device actually fit. Seeing that gave me one of the best feelings. I finally felt satisfaction in the work that I had done since the beginning of the year. I am really happy that I actually put in the time and devoted myself to finishing my project. I think that all of the students in this class should do the same. Not only did I learn a ton of different skills that will help me in the future, but I also learned that if I set my mind on something I can do it.
I also think that this project may go somewhere one day. The hospital thinks that it should be patented because someone may want to buy it. When I think of it like that I am amazed. I would love to pass this project on to another student so that they could fix the flaws and together we could patent the device. I think it would be great to design something that will work and maybe one day even save lives.
I think that this year has been very successful. I feel like I completed a project that I am proud of. I also feel that I have learned many valuable lessons that I will be able to use in my immediate future at college and maybe even after that.

posted by ck @ 12:53 PM

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