Overview
Background
Need to get an injection but worried it will hurt?
Want to donate blood but it seems scary?
Have a simple blood test to be done but feel slightly nervous?
We've all been there, even after having been poked and prodded by needles for years. It's not because the process itself is very painful. We let our past experiences and anticipation of pain hype up the experience of possible upcoming pain (which might actually be just like a pin-prick).
But for a moment, let's shift our lens to the people actually using these needles to draw blood or administer medication - the phlebotomists, medical school interns, nurses. They go through training, of varying lengths, to perfect the method to use these needles.
Let's take a closer look at the process of drawing blood
But wait, what are these different components that are required for handling a syringe?
Designing in healthcare is specific and precise. Each component that makes up the syringe is designed using the materials and processes best suited to them.
Problem Definition
After getting a rounded idea on hypodermic syringes and their working, it was time to speak to some of the people who actually use them. From a quick contextual inquiry, it was found that the most prominent issues faced were:
After shadowing, observing and conducting small contextual inquiries with a group of 5 medicine interns, 3 phlebotomists and 2 nurses, it was concluded that hands tend to slip while drawing blood, making it tougher to hold on to the syringe with constant grip and less strength. The slip happens along the length of the barrel making the hands move close to the lure lock, while making it difficult to keep pulling the plunger in the opposite direction.
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Hands slipping while pulling the plunger backwards
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Locating the most viable vein
To get a better understanding of these problems, it was time to go through any existing research. It was found that the inability to find a viable vein was a very common problem area, and it grew across patient groups that were either obese, had inelastic veins associated with ageing, were chemotherapy patients or patients in critical care. Since it is a popular issue, there are lots of solutions being developed in this space. The use of Infra-red to locate veins has proven to be one of the most viable solutions for the same and does provide a high level of accuracy and ease, without being very cost intensive.
This narrowed down the problem area to an ergonomic one:
Hands slipping while pulling the plunger backwards.
The next essential step was to understand how grip works on these hypodermic syringes.
After shadowing, observing and conducting further contextual inquiries with a group of 5 medicine interns, 3 phlebotomists and 2 nurses, it was concluded that hands tend to slip while drawing blood, making it tougher to hold on to the syringe with constant grip and less strength. The slip happens along the length of the barrel making the hands move close to the lure lock, while making it difficult to keep pulling the plunger in the opposite direction.
With a lens of anthropometrics and ergonomics, the action performed was recorded. A quick hand printing exercise revealed the slip area, the extent of slip and formed the basis of measuring success post a frugal innovation intervention
Bare palmed
With gloves
Solutioning
With a good idea on the areas of the syringe that were the centre of the slippage, a quick brainstorming session was conducted. It was a serendipitous co-incidence that the marker being used for this very brainstorming session became the centre of inspiration for the solution.
Most pens and markers come with added grip in the area where you hold them while writing.
This inspired adding a grip to the syringe barrel to help reduce the slippage.
The main idea here was to
Design a solution that adapts to suit the human body, rather than people having to adapt to the design
There were several things that had to kept in mind while creating the prototypes.
1. The material for prototyping had to be transparent to ensure the markings on the barrel were still visible.
2. The position of the material added had to be such that there was no issue of parallax while trying to read the
markings on the syringe barrel.
3. Ensure that varied sizes of hands could equally access the extra grip.
Ethylene-vinyl acetate (EVA) is an elastomeric (naturally stretchy) polymer that produces materials which are "rubber-like" in softness and flexibility. It is also already being used as a new drug carrier for 3D printed medical drug delivery devices. The material chosen was EVA, for its transparent nature and flexibility, and for matching all the criteria mentioned above.
Various sizes and number of rings for the barrel were made and tested.
Finally, a single ring, placed at an optimum position was chosen.
This ensures low costs and high effectiveness based on grip locations for different sized hands and the limiting placement options due to the angle of insertion of the needle.
With the new grips in place, the action was performed again and was recorded. The hand printing exercise was repeated and the images from the first hand printing session and the one after the intervention were superimposed to check for improvement in the problem area.
The red coloured print visible is the lower layer - the one without the intervention. As evidenced by the hand prints, the area of the fingers being used (marked in yellow) post the intervention are smaller. This indicates a smaller area of slippage. This was then taken forward and tested in a simulated environment for a better idea.
A take-away plastic container was used that contained red-coloured water.
A taut glove was fixed over it to act as the layer of skin. The reason to use this apparatus was primarily to attain the feeling of “travel” between the skin and the vein and to keep the layer on top feeling as close to skin as possible.
With a good amount of success with the simulation, the process was repeated in a real-world setting. The product was introduced to medical practitioners and tested. After testing the product through the same initial group of 5 medicine interns, 3 phlebotomists and 2 nurses, it was deemed a frugal innovation success.
Future Adjacent Innovation
The syringe that is available across the world today is an exemplary example of minimalistic and modular design.
The modularity provided allows the syringe to be disposed off appropriately after use. However, it requires extremely
steady hands for the syringe to not move while using the plunger to draw blood.
To counter this, the modularity of the plunger was also explored.
The idea mentioned in the sketches alongside show the use of a zip lock instead of a plunger. In this scenario, the plunger has been removed. To accomplish the task of drawing blood, a zip lock on the body of the barrel has been provided which utilises the concept of vacuum and longitudinal motion.
The doctor/clinician can now use the adjuster to pre-determine the amount of blood that needs to be drawn. This creates an area of vacuum that allows the blood to be drawn once the syringe is pricked.
The advantages of using this system is the reduction in material cost for the plunger, more steady collection because motion after pricking is completely negated and more ease, since the doctor does not have to specifically try to notice the level till which the blood is being drawn while in the process.
Finishing Notes
While these solutions were rapid tested, any product innovation would have to undergo detailed testing and analysis before launching.
It was extremely challenging narrow the focus on a small part of the object and find a way to to create a frugal innovation solution around a regular, mostly overlooked problem, that would actually create impact and work well.