Thinking about how fast these first few weeks have flown by, it’s really hard to accept that we are halfway through this internship. Recently, I have been taking more and more pictures of regular day-to-day tasks, not wanting to forget the small things: the sunrise, the walk from Queen Elizabeth to the Polytechnic, and our home-cooked family dinners at Kabula Lodge. The following blog will take you through one day of our lives here in Malawi. I’ll walk you through decisions my team makes while prototyping, things I notice on the streets of Blantyre, and my thoughts from when I untuck my mosquito net in the morning until I tuck it back in at night. Hopefully this blog gives you a sense of what it is like to be an intern in this amazing program. 

– July 5th, 2019 –

7:26 AM

It’s become kind of a tradition that every morning as we are eating breakfast, I will set down my tea and declare the time to be 7:26. The bus from Kabula leaves every morning at 7:30, and through trial and error, we’ve discovered that in order for every intern to take their seat on time, this is when we all must begin to scarf down our remaining tea and toast. 

This morning the normal bus was out of service. Instead, we rode to work in a smaller replacement bus with fewer seats and unfortunately, less leg room. Once at Queen’s we began our usual walk along the busy streets of Blantyre: through the small market outside of the hospital, under the bright blue walking bridge, and between two tall palm trees marking the side entrance to the gated Polytechnic campus. From there, we usually have around 30 minutes until work starts, so we spend our time either reading or journaling in the sunny seating of an outdoor amphitheater.

8:30 AM

Wongani, a technician at the design studio, waves to us from the covered red walkway on his way to unlock the doors to the studio. Inside, light pours in through the 360º windows onto the clean and shiny tables, signaling a fresh start to a new day. While we wait for the rest of our project teams to arrive, Shadé and I make progress on the Clean Machine prototype. 

9:00 AM 

My Ballard Score team sits down and begins a brainstorming session for one of the training model’s attachments. For 10 minute intervals, we sit in silence, each writing down whatever comes to mind in our journals. At the end of the time, we each have several pages filled with a mix of potential solutions and mechanical components. Each one of these ideas is then shared with the group, free of any immediate criticism. As someone reveals a drawing, others build off of it, presenting their own related thoughts and combining concepts. 

Betty and I spend the rest of the morning developing low-fidelity prototypes for two of the brainstormed ideas. While we bend pipe cleaners and straws to create proof-of-concept models, Rodrick and Racheal continue work on two other neuromuscular attachments: heel to ear and the popliteal angle. With a goal of finishing prototypes for both of these attachments by the end of the day, they make final adjustments to dimensions in various CAD files. 

12:07 PM

Not wanting to waste valuable time, my team hangs back a few minutes into lunch to get our 3D prints started. With stomachs growling, we all make our way across the street to Miko’s Dessert Shop. Rather than getting their extravagant ice cream waffle cones (like we do every Friday), we instead order freshly baked cinnamon rolls. Unable to resist the smell, I finish mine on the walk to get an actual lunch from LJ’s – a small red shack across from Queen’s.  

At LJ’s you get a choice of nsima or rice, a meat, and a variety of vegetables. I prefer to have nsima over rice, mainly because I think it is way more fun to eat. From what I have been taught, here’s how to best enjoy these bouncy scoops of corn flour: first roll a ball in the palm of your hand (quickly because it’s hot), use your thumb to press a hole in the center, then use the nsima as a spoon for the rest of your food. 

1:30 PM

The work ethic of the Polytechnic and MUST interns is incredible. In addition to the internship, they are still attending classes, completing homework, and working on their own side projects. I honestly have no idea how they manage to do it all. Today, Rodrick had to leave for a few hours to give a presentation. In his absence, Racheal, Betty, and I have found little ways to be productive. Racheal has begun working with the software we will be using next week to design our app. Betty continues to work on her low-fidelity prototype, and I start designing components of the training model’s arms in SolidWorks.

3:30 PM

Just as bright light pours in through the windows every morning, the warm beginnings of a sunset flood the design studio starting at around 3:30 p.m. Over the past few days, I’ve begun to notice the effect of this lighting on our productivity. This final hour truly becomes a test of our willpower to accomplish the goals we established in the morning. Today, we had hoped to finish prototypes for both of the neuromuscular attachments on the hip, but as the orange tint of the sun overtakes the fluorescent blue of the LEDs, we haven’t assembled either. 

When Rodrick returns from his presentation, I am staring with frustration at my computer screen, unable to get one dimension of an arm to change without having to start over again from scratch. Unlike the rest of us, he is somehow still full of energy. It spreads to the rest of us, and the next hour becomes a mad rush to finish at least one of the attachments.  

4:26 PM

With 4 minutes to go before the end of the day, we have completed the prototype for the heel to ear attachment. My fingertips are encrusted in a layer of solidified super glue and our table is a mess of PLA shavings, bits of elastic, and random hand tools. During the walk back to the bus, I reflect on what we were able to accomplish.

It’s difficult setting goals and then not being able to accomplishing them fully. Back at Rice, the OEDK is just a short walk away from my dorm room, allowing me to work on a project until I am satisfied, sometimes into the early hours of the morning. Here, a 15 minute bus ride separates me and the design studio. At the end of every day, we must set down our tools regardless of whether or not we have reached a natural stopping point. As frustrating as this is can sometimes be, I feel that it has helped me to become a better teammate. 

In the past, I have struggled to let others take the reins in group projects. If a calculation was being made, I wanted to double check it. If a prototyping method was modified, I wanted to be there to understand the decision. But for the first time in my life, the engineering design process has been shoved into the time constraints of a workday. With so much to do, there is no longer time for me to obsess over every detail. My group at the Polytechnic has learned to strike a balance of task-division and making sure the whole group remains on the same page.  

5:30 PM

Once back at Kabula, we all walk under the beautiful orange flowers that drape over the reception area. Having done laundry the night before, I take down my clothes from the line and begin to pack for our weekend hike of Mount Mulanje. Hannah, Liseth, and Cholo start preparing dinner in the kitchen. At the very beginning of the internship, we randomly selected four teams to trade off cooking duties. The system works well and has been a fun opportunity to learn how to make some new dishes from the Tanzania interns. For our last meal, Joel taught Kyla and I how to make nsima, or as it is called in Swahili: ugali. The process turned out to be more difficult than expected and requires a lot of arm strength (more than I have), especially when you’re cooking for 11 people.  

8:00 PM

Eggplant parmesan is ready. People slowly begin to crawl out of bed, up the stairs to the terrace, and take their seat around the dinner table. While eating, we joke about how we’ll probably die climbing the mountain this weekend. Liseth retells stories of Cholo’s misadventures in the kitchen. We laugh, talk, and eventually move into the lounge area. Some 0f us do research for our projects. Others snuggle up in a blanket to read a book. I begin writing.

10:00 PM

I finish this blog! 🙂

________________________________________________________________________________

 

 

After three weeks of needs finding, research, and brainstorming, we’ve finally begun to delve into the prototyping phase of the engineering design process. This week, we began to CAD parts, 3D print them, and prepare for the assembly of our prototype.

I should probably take some time to explain my team’s project, since I don’t think I’ve done that yet. We are Team Suction, and we’re working on a neonatal airway deep suctioning training model. I’ll explain what that means in a moment. My teammates are:

Napendael (Nanah) Msangi from Dar Es Salam Institute of Technology in Tanzania
Foster Sentala from Malawi University of Science and Technology (MUST)
Chisomo Mbale from Malawi Polytechnic (Poly) 

Different people with different levels of technical and medical backgrounds will read this blog, so I’ll take some time to explain neonatal airway deep suctioning and the approach we’re taking to developing a training model.
Sometimes, babies are born with their lungs and airways full of amniotic fluid, and this prevents them from taking their first breath. In order to remove the fluid, nurses must use a catheter and a suctioning machine. The catheter is a long, thin tube that must be inserted into the trachea of the newborn. One end of the catheter attaches to what they call a suctioning machine, which creates negative pressure in order to suck the amniotic fluid out of the airways of the newborn, enabling them to breathe. There are a few difficulties associated with this procedure. First, it is common for nurses to overestimate the amount of tubing appropriate to insert into the infant’s airways. If the tubing is not inserted far enough, not all the fluid will be suctioned out. If the tubing is inserted too far, past the trachea and into the lungs, the baby will go into respiratory arrest. The second issue is that it’s easy to traumatize the newborn’s airways with the catheter if one isn’t gentle enough. This is particularly difficult to avoid if the newborn is premature or is moving around a lot during the procedure. Trauma to the airways can cause a variety of issues, including scar tissue build-up within the airways, which could restrict breathing. For these reasons, it is critically important that nurses are empowered with the knowledge and confidence to complete this procedure carefully and effectively. My team and I have decided to develop a mannequin-style training model in order to give nurses the opportunity to get hands-on practice of this skill during their schooling years in order to gain confidence and experience before entering day one of their jobs in hospitals.

On Monday, we were able to visit the labor ward at QECH, where the deep suctioning occurs right after babies are born. We actually entered the ward right after a suctioning procedure had taken place – we just barely missed it! When we arrived, a nurse was wrapping a newly-suctioned newborn in chitenge and connecting them to oxygen.
The most valuable part of our visit was that the head nurse in the labor ward was able to show us an existing training mannequin. It’s used to teach manual airway ventilation, which is a totally different procedure from deep suctioning, but we were inspired by the model itself. It was a blow-up doll with a shell for the face and for the torso, underneath which the tubes reside. Similarly, we decided to use a baby doll. We made a plan to cut off the face and reattach it using hinges, making it able to open and close. The tubing will reside on top of the doll’s chest and underneath its clothing.
We have begun the process of creating CAD models of the tubing and airways. Foster pioneered the CADing process, since he had the most experience with Solidworks. So far, we have CAD models of the trachea, larynx, and airways to connect to the nose and mouth. We have also begun 3D printing these files. We finally managed to procure a baby doll that would work for us (shoutout to Sally for having an extra one from the Ballard Score project).

 

On Friday, we began to dissect our baby doll. We cut off the face of the doll, and spent far too long attempting to reattach it partially using tiny hinges. Who knew that pieces so tiny could prove infinitely more difficult to work with than their normal-sized counterparts?

Over the next two weeks, our biggest challenge will be figuring out how to mimic the trauma that can be caused by suctioning. We want nurses to practice on the model and know when they have not been gentle enough. Therefore, we want to include some sort of membrane which ruptures when too much force is used. The membrane would then be removed and observed in order to inform nurses whether they made a mistake. We are considering different approaches to manufacturing this rupturable membrane. Hillary recommended the use of a thin plastic such as tephlon, which could be cut into small strips and secured together at the ends to create a cylinder. I am also exploring the option of molding and casting using a delicate type of silicone. Unfortunately, we don’t have the ability to special order unique types of silicone molding and casting materials, so we’ll have to improvise if we go this direction.

Overall, I’m thrilled to have finally entered the prototyping stage. As critical as I believe the first steps in the design process are, they can feel arduous. There’s a certain exhilaration that comes during prototyping. It feels powerful to be able to turn the ideas we’ve been discussing for weeks into physical realities. This must be what it feels like to be an engineer.

 

BONUS CONTENT

Going into our 4^th week of work, all 4 teams have finally begun prototyping. After 3 weeks of extensive needs-finding and research at various hospitals, we are ready to get our hands dirty. And I mean that literally. I leave the studio every day with my hands covered in a layer of solidified hot glue.

Before I get into the details about my project and the progress we made this week, I want to formally introduce my three teammates:

Joel Ngushwai: Dar es Salaam Institute of Technology

Christina Kalulu: The Malawi University – Polytechnic

Boniface Kaseka: Malawi University of Science and Technology

As I mentioned briefly in previous blogs, my team was initially tasked with developing a low-cost continuous temperature monitor for mothers during labor. The project was actually started by a team at Rice University, and now we are taking over from where they left off. The current version of the device uses a thermistor to measure temperature from the axillary artery on the upper arm. It has 3 LED’s (blue for when temperature is too low, green for when the temperature is within a safe range, and red for when the temperature is too high) and a buzzer to alert a nurse when the mother’s temperature is unsafe.

Before I delve into the details of our prototype plan, I want to talk a little about the need for continuous monitoring devices in countries like Malawi. Over eight million neonates die due to complications during pregnancy and labor per year, and 95% of these deaths take place in low resource and developing areas. Many complications that contribute to these deaths are due to changes in maternal temperature and pulse rate during labor. Intrapartum fever (≥ 38°C) and high pulse rates (≥ 100 bpm) can lead to an increased risk of complications including infections and fetal distress.

After talking to many nurses at Zomba Central Hospital, Queen Elizabeth Central Hospital, and Mulanje District Hospital, my team learned that currently, most hospitals in Malawi use non-invasive thermometers which are often lost or easily broken, and many nurses end up relying on using their hand to check whether a mother has a fever. Additionally, many wards don’t have access to pulse rate monitors, and oftentimes, nurses have to manually count the patient’s pulse rate – which means it is too time consuming to be done regularly. As a result, nurses are typically too busy or overwhelmed and don’t always end up using a partograph to record maternal vitals. In fact, a 2017 study in Malawi found that on average, 65.3% of partographs lacked temperature recordings.

These findings confirmed the need for a continuous and accurate vital signs monitoring device that can assist nurses in monitoring and recording the incidence of maternal fever and high pulse rate during labor.

With guidance from Francis Masi (who mentored the team working on this project last summer), my team has decided to make the following changes to the existing prototype:

1. Include a circuit for pulse rate detection
2. Transition from 4-Digit 7-Segment display to an I2C LCD or TFT LCD display
3. Include a bluetooth or WiFi module to allow patient information to be stored on the device (so that nurses can access past data and view trends of temperature changes)
4. Transition from a cloth armband to one that is more easily cleaned, adjustable, and comfortable
5. Include battery life indicators

My team is slowly starting to formulate our project idea into a reality. This week we began recreating and troubleshooting the device’s temperature circuit using a thermistor, a basic I2C LCD Display, and 3 LEDs as a visual alert system. We also began designing the control unit (which will ultimately be 3-D printed) on SolidWorks.

It is absolutely crazy to think that we are over halfway done with our time in Malawi. In 4 and a half short weeks, I have grown to love this country and its people. I love waking up to the beautiful sunrise over the mountains that Kabula Lodge overlooks. I love cramming over 20 excited and passionate young engineering and medical students (onto a bus meant for 14 people) every morning to Queens. I love working with my team at the Poly Design Studio, eating lunch at LJ’s (a small red shack by Queens, which we have, rather appropriately, nicknamed “red shack”). I love family dinners back at Kabula with all the Rice and DIT interns. I love everything here and I’m determined to make the most of every day we have left.

***bonus content***

This weekend we finally attempted the long-overdue 3-day hike up Mount Mulanje! It was so hard that many of us found ourselves joking about how we might die before we make it to the top. Here are some pictures as proof that we made it out alive!!

— Nimisha 🙂

 

Hello everyone!

Presentations are never easy. My nerves get the best of me most times and I often stress over details, frantically writing down every sentence that I need to say. Even after doing countless presentations on our cervical cancer training model project in the Global Health 360 class, I still dread talking in front of groups. It takes a lot of concentration for me to not get flustered or stumble over my words. This past weekend, I saw presentations that inspired me to try to make presenting a more natural practice. We traveled to Lilongwe last Wednesday for the Malawi Innovation Pitch Night, an engineering design competition showcasing a variety of creative engineering ideas across Malawi. The event took place at mHub, a technology and innovation space dedicated to cultivating entrepreneurship. A total of ten inventive solutions to prominent problems in Malawi were presented to a panel of judges. Although I was just helping with the competition and not presenting, hearing the presentations was a great chance to appreciate the immense talent of young Malawian engineers. From a device that would purify water with UV light to a free educational tutoring hotline in order to improve testing scores, teams pitched a variety of impressive technologies. Not only were the technologies advanced, each presenter flowed through the information with grace and ease. They were engaging, educational, and effortless. For the future, I hope I can look at presentations not with a sense of dread, but see them as an opportunity to get more comfortable with public speaking. The entire event was a nice short break from the usual hustle and bustle of hospital wards.

Liseth and I are continuing to make our way all over Queen Elizabeth. Most recently, we had observational days within the Moyo House and labor ward of the hospital. Moyo House serves as an extension of the Nutritional Rehabilitation Centre and specifically focuses on providing nutritional support to babies and children in need. Through talking with nurses, we learned that Moyo experiences similar lack of resources issues as some of the other pediatric wards of the hospital. One new problem we encountered was that 90% of the heaters within Moyo are not functional. Patients who are undernourished or malnourished are more prone to hypothermic body temperatures, so they were bundled and wrapped in many blankets in order to keep warm without functioning heaters. In the labor ward, we learned about the heavy workload of the midwives and doctors. With up to 28 patients a day needing to be monitored every hour, it is a very strenuous work environment. The midwives showed us that they must often monitor things like blood pressure and heart rate manually by counting beats per minute. I really enjoyed discussing these issues with the midwives because they were so open and receptive to our questions. They were not afraid to say what needed improvement, which was extremely helpful in gathering ideas for future engineering projects. Some midwives had their own ideas for new engineering devices that could substantially help their day-to-day work. From my observations so far, I think I need to spend more time doing some background research into hospital resource allocation for district and central hospitals in Malawi. Scarcity of resources is a common trend across all of the wards we have observed so far, and I would like to investigate further to find out more about how funds are distributed and what economic, political, or sociological factors play a role in contributing to this problem. I believe it is important to examine this from all sides, as global health problems often do not exist in a vacuum.

In other news, the Incubaby prototypes have arrived in Blantyre! (However, we recently discovered that the team is working on changing the name, so name TBD). So Liseth and I will begin our second assignment of conducting usability interviews with the device within the week. We have a set of detailed questions to ask nurses about the prototypes. The responses from nurses should really catch any areas for improvement for the team of engineers. It is our hope that this usability interview can be used for all future devices in order to address any human factors issues early in the design process. This will help ensure that all new technologies are actually appropriate for their designated clinical setting and will be implemented regularly for their intended purpose.

On Sunday, our group took a trip to Zomba for a short (but rigorous) hike around the Chawe mountain. We ventured to Ku Chawe in the Zomba Plateau and took a guided walk with beautiful scenery and cold waterfalls. I thoroughly enjoyed being surrounded by nature (we even saw baboons and monkeys swinging in the treetops!) and I was very proud that I only tripped once during the steep and rocky descent down the mountain.

Thanks for reading and I’ll check in again soon! See you next week!

This week all 19 summer interns (16 from Poly Design Studio + 3 from Queens CPAP Office) piled onto a bus and travelled 5 hours to Lilongwe, the capital city of Malawi. The streets of Lilongwe, just like Blantyre, were lined with bustling markets selling everything from fresh fruits and vegetables to colorful chitenge cloths. As soon as we arrived, we checked in to the Bridgeview Hotel and rested in preparation for a busy day…

The main purpose of our visit was to attend the Malawi Technology Innovation Pitch Competition on June 27^th, but since the competition was in the evening we were able to squeeze in a visit to Physical Assets Management (PAM) at Kamuzu Central Hospital. We were greeted by Mr. Pius Chalamanda, an incredibly dedicated medical engineer at PAM, who was nice enough to answer all our questions for 2 whole hours AND give us a walking tour of PAM so we could learn about the challenges they face with maintaining and repairing broken medical equipment. I got to ask a lot of questions about patient monitors (which was useful for both the projects I am working on – a Maternal Monitoring Device here at the Polytechnic and a Neonatal Temperature Monitor for Kangaroo Mother Care back at Rice). One of the main issues with patient monitors, I learned, is the probes – SpO2 probes, temperature probes, ECG probes. They are super fragile and break easily even when handled carefully. Up until now, I was only aware of the infamous battery problems in almost all patient monitors. I’ve been so focused on ways to make our device rechargeable, that the probes never even crossed my mind. This new information about the fragility of probes definitely provides a new angle to pay attention to as I continue working on both of my projects.

Overall, I learned that the challenges faced in PAM can be summarized into 5 main categories:

1. Understaffing
2. Spare parts and consumables are difficult to procure
3. Lack of diagnostic tools (to test the functionality of medical equipment) and servicing tools (to fix broken medical equipment)
4. Language barrier (when trying to install / service donated equipment whose manuals are often in different languages)
5. DUST and MOISTURE significantly reduce the lifespan of nearly all medical equipment

The visit was enlightening and everyone we met at PAM was so dedicated and hardworking. Hearing them talk about all these challenges made me realize the importance of creating medical devices that are durable, sustainable, and easy to repair (paying special attention to ensure that spare parts/consumables are locally available). Although many of these challenges initially seemed difficult to tackle because of financial constraints, I left PAM with my mind full of ideas for new projects that Rice 360 could take on to help make the maintenance and repair of medical devices a much more efficient process.

Later that evening we dressed ourselves up in business casual and headed to the Pitch Competition hosted by mHub, an innovation space in Lilongwe. The competition consisted of 10 teams of student engineers in Malawi presenting exciting innovative technologies in a short 3-minute pitch. One team presented a voice-to-text application for sign language in order to bridge the communication gap between people who can and can’t hear. Another team presented a low-cost, solar-powered water filtration device that used UV light to eliminate bacteria. My personal favorite was a low-cost cold chain box to transport blood vaccines and diagnostic samples from rural areas in Malawi to central hospitals. The team that presented this device has already sent a prototype to FIND, a non-profit in Geneva specializing in diagnostic tools for low-resource settings. I’m so excited to see where they go from here!!

After the presentations, we got the chance to mingle with the student teams and it was so amazing and humbling to be among some of the most talented student engineers and in Malawi. I got to talk to donors from the Lemelson Foundation and partners of NEST 360 about both of my current projects and it was all so exciting. We also got to catch up with Dr. Richards-Kortum, Dr. Oden, Georgia, and Raj from Rice 360! 🙂

The whole night felt kind of magical. It reminded me how grateful I am to be a part of this global health community. I distinctly remember looking around the room and feeling inspired, realizing that each one of us comes from a totally unique background: there were people from the US, the UK, Tanzania, Malawi, India. We’ve all grown up with different experiences and have been exposed to different standards of health care, but one thing brought us all together: our passion for improving health outcomes across the globe, our passion for helping people across the globe. Now more than ever, I’m certain that this is what I want to do with my life.

As always, here are some bonus pictures! This weekend, we hiked Zomba Plateau (it was around 3 hours, so just a casual warm up for when we finally hike Mount Mulanje! 😉 )

— Nimisha 🙂

 

This week, my team had the chance to present at the first ever Malawi Innovation Pitch Night, and after the whole experience, I realized how little I have written about my main project in this blog. As a result, the following post is gonna be a little more technical so brace yourself for some facts and figures, but I promise every one of them is important. I’m super excited about the work we’ve been doing so far and its potential impact so please continue reading! 🙂 

Around the world, premature birth is estimated to be responsible for 35% of all neonatal deaths, mostly concentrated in developing countries. In many government hospitals in Malawi, nurses lack a systematic approach to identifying prematurity in newborn babies. Instead, birthweight, an inaccurate estimate of gestational age, is primarily used. In some cases, a reliable number can be calculated from the mother’s last menstrual period (LMP), but frequently no record is kept of this information. Rather than using birthweight, and in cases where the LMP is not known, a Ballard Score assessment should be performed. The Ballard Score is a set of 12 neuromuscular and physical signs that when combined, produce an accurate estimate of gestational age. However, even in hospitals where nurses have knowledge of this assessment, it is almost never performed. 

Wondering why this was, our team traveled to hospitals all over Malawi: Mulanje and Zomba District Hospitals, and this week, Kamuzu and Queen Elizabeth Central Hospitals. From talking with nurses, we identified two obstacles that make it difficult to complete the assessment for each and every newborn…

1. Many nurses lack the necessary knowledge to perform the assessment, especially in the case of the challenging neuromuscular procedures. Some nursing students told us the Ballard Score was only a single lesson during one day of their schooling, taught through pictures of the procedure rather than hands-on practice.
2. Nursing teams are often understaffed and short on time. As it stands, the Ballard Score assessment takes 15-20 minutes to both perform all 12 procedures and calculate a final score. This is too long for many hospitals where as many as 20 babies are born per day needing individual care and attention. 

Looking at the factors surrounding these two separate problems, my team has developed two separate solutions…

Our first design, a training model for neuromuscular Ballard signs, aims to tackle the knowledge gap between the classroom and the assessment room. The model consists of a main baby mannequin with two attachment points for interchangeable limbs: one at the shoulder and one at the hip. Each interchangeable limb corresponds to a different neuromuscular sign, and can be adjusted to replicate the muscle behavior of a baby at different degrees of prematurity. 

Once fully developed, we hope to implement our model as a teaching tool for nursing schools. Imagine a classroom filled with groups of students, each gaining hands-on experience through the use of our model with different attachments. A professor could walk around from station to station, providing advice and corrections for each of the different signs as they see the motions performed right in front of them. Ultimately, the model should provide nurses with the confidence to complete the assessment when working in a hospital setting.  

Our second second design aims to reduce the time required to perform a full Ballard Score. Having not conducted years of research like Dr. Ballard, there is no way we could remove any signs from the assessment while still maintaining an accurate estimate of gestational age. Instead, we decided to cut down the amount of time it takes to record and calculate a result from the assessment while also making it quicker and easier to match observations to the score’s criteria. 

In every hospital we visited, nearly every nurse carries a smartphone. After seeing this, we determined that one of the easiest ways to roll out our design to as many hospitals as possible would be through app development. Designing an app also allows for a user interface that cuts out a lot of the unnecessary information on the current assessment chart. Numbers are cut out entirely, as all calculations are performed in the background, simply producing an accurate estimate of age at the end of each assessment. Furthermore, the use of a sliding scale takes the diagrams of each sign in the current chart and consensus them into one changing image, letting nurses easily scroll until the image matches their observation of the real baby. 

So many aspects of care for premature babies revolve around knowing their specific age. In addition to helping nurses save these precious lives, we believe our project has the potential to contribute to an even greater picture. Organizations such as Nest360º rely on accurate data when measuring the impact of their technologies on neonatal outcomes. With the most common estimate of gestational age being birthweight, reliable data surrounding premature births is difficult to obtain in developing countries. Furthermore, the paper records of many hospitals are either non-existent for individual births or difficult to sort through. Together, our training model and assessment app for the Ballard Score can become the start of a solution. 

We fully realize that any prototypes we come up with in the next few weeks will no more than scratch the surface of this issue, but it is the potential for future work that excites me. What if the app could upload each assessment to a database? What if that database could be used to assess the impact of lifesaving technologies? What if that data revealed a need that had previously gone unidentified? By creating a solid foundation for others to build off of in the future, I feel that my team has an amazing opportunity to start something that truly matters. 

– Alex 

 

 

Bonus: Here’s some pictures from the rest of this week’s adventures…