A Life-Saving Update to a Life Monitoring Device

WHY THIS PROJECT?

While my wife was pregnant with our first child, her water broke prematurely at 23 weeks. We hurried off to a hospital to see what was going on. Once we got to the hospital they told us that she would be on bed rest at the hospital until the baby came. While she was there she had to do many tests, one of the most common ones being a nonstress test.

During a nonstress test, two monitors are kept tight against the woman’s belly. They are either held down by straps or by a compression sock that goes around the woman’s torso. Once the two are strapped down, one of the monitors is used to track the woman’s contractions, and the other is used to track the baby’s heart rate. It must be placed over the baby’s heart and if the baby moves, the monitor must be moved as well. This requires a nurse to come back into the room to replace the monitor so that it is over the baby’s heart again. Sometimes this can take up to an hour while the nurse tries to find the right positioning to get a strong reading on the baby’s heartbeat. The other one that is used to monitor the woman’s contractions has fewer rules as to where it must be placed and usually does not require replacement. This monitor is usually placed in less than twenty seconds.

My wife ended up spending 66 days in the hospital before our baby boy was born. The first three days were spent on what is called “continuous monitoring” which means exactly what the name implies, that the monitors were on her 24/7. If she wanted to go to the bathroom, she had to call in a nurse to unplug the monitors from the nonstress test machine and then have the nurse reposition the monitors as necessary once she had come back to the bed. After those first few days, the monitoring requirements went down to an hour twice a day, once in the morning and once at night, with extra time added if our baby moved and “went off monitor” or if he had abnormal fluctuations in his heartbeat. However, even with those updated monitoring times, we still spent a lot of time asking nurses to come back to readjust the monitor, and the nurses spent a lot of time trying to find where our baby had moved to.

Because of all of this, I thought that the current process could use a new design.

HOW MIGHT WE STATEMENTS

With all this time that the nurses spent in our hospital room with us, I had a lot of time to talk with a few of them about what a good design would need to do and/or have to be considered a good design. It had to be something they would want to use even though there would be a bit of a learning curve for something new. Based on the things that they talked about, I came up with the following “How Might We” statements:

  • How might I design a monitor that doesn’t require the nurses to come in so often?
  • How might I design a monitor that is easier to attach and remove from the pregnant women it is used on?
  • How might I design a monitor that can be used on women no matter how far along they are or how large their belly is?

PREPARATION/PROCESS

I spent some time ideating things that could be designed to help out with this whole process. Below are just some drawings of the designs that I thought could work:

Figure 1: Drawings of ideas that I thought
might be able to satisfy the
“How Might We” statements.

Starting from top to bottom, here is an explanation of the ideas presented above. The top two drawings represent a semisphere of preformed plastic. It would have multipe sensors embedded within the plastic. This would be placed on the woman’s belly and would allow for different sensors to activate if the baby moved at all. An adjustable elastic band would attach to the left and right side of the plastic dome and keep it on the woman’s belly. The middle two drawings represent a larger sensor housing body. Once again this would have multiple sensors so that if the baby moved around at all there would still be a chance that the baby could remain on the sensor. This would be attached using the current method of either a large compression sleeve or elastic bands. The bottom row represents a blanket-like material that would have various sensors on it as well. It would be attached via a zipper on the back.

As I was coming up with this ideas, I would share them with the nurses that were helping my wife with her stay. I felt good about these ideas since they all had extra sensors which I felt would help out a lot with the first “How Might We” statement. In my mind, sensors would constantly be reading, and it would be an average of the sensors that were picking up on the baby’s heart rate that would be displayed on the sensor monitor. If the baby moved, the sensors that contributed to the average would also change thus adapting to the movements of the baby. This would make it so that the nurses wouldn’t have to come in often if the baby moved.

From there, I started to evaluate these ideas based on the second “How Might We” statement. The larger cylinder idea has merit as it would be familiar to the nurses. There wouldn’t need to be any new training or learning curve with using a new device. However, there would still be some time required to find where the baby is initially. So while there is some benefit of familiarity with placing this kind of sensor, it was excluded from the final design since it wasn’t as easy to use as the other two ideas. The adjustable strap of the plastic dome idea and the zipper of the blanket idea both were viewed as easy ways to attach the monitors to the patient.

Lastly I looked at the final “How Might We” statement. When thinking of the preformed plastic, if we were to make a preformed plastic dome for every size of woman’s belly that came in, therer would be a lot of storage space required. However, with the blanket, you would only need a small, medium and large size.

THE FINAL IDEA

After evaluating the ideas based on the “How Might We” statements and talking with the nurses, I decided that the blanket idea would be the best I went about designing what the idea might actually look like. The following drawings show the ideation and selection of what the final design would look like:

Figure 2: Ideation for monitor head design and how they would be placed along the blanket
Figure 3: Ideation for sizes of blankets that wuold be used.
Figure 4: Initial drawing of final design

With this final design, I believe that it would accomplish the “How Might We” statements the best. There are multiple monitors so even if the baby moves, the nurses don’t need to come in to replace the sensor. The blanket would be easy to wrap around the patient and the zipper allows for a easy attachment. Lastly the storage for the blanket would be minimal while maximizing the number of people that it could be used on.

The nurses did give some feedback once they saw the initial drawing up in Figure 4. They mentioned how they would prefer the zipper to be accessible from the side of the patient rather than the back. Due to that feedback, I got rid of half of the sensors so that the sensors on the patient’s back wouldn’t get readings that would interfere with the readings from the sensors on the patient’s belly. The darker blue lines indicate a stretch material that would be tight to ensure that the sensors would be tight to the woman’s body once the zipper has been done up. Below is the drawing of the design after I got the feedback from the nurses.

Figure 5: Drawing of the final design