Hi all! I’ve decided to get a process thread going on my senior thesis project. I’ve seen classmates and alumni (Quinn Huffstetler and the Padilla brothers) generate a lot of great feedback through this and have been excited to finally get my work posted up.
We’re a couple weeks into the process, and are just about finished with the preliminary research phase. Thanks in advance for any feedback. Here’s where I’m at:
Problem Statement: To design a hospital bed table for children aged 4-6 that provides a level surface for meals and facilitates analog entertainment while bedridden.
USER CRITERIA +
The user is any child hospital patient (in either a general or children’s-only hospital), ages 4-6. Secondary users include the parent or primary caregiver and nurse. It is likely that the secondary user will be interacting with the device (adjusting, moving) while assisting the child.
PHYSICAL CRITERIA +
Dimensional criteria will depend on hospital bed dimensions and patient room regulation. Much of this is standardized by the federal government. Other physical considerations include, but are not limited to: child anthropometry, cords around the bed, and mobility of the product. The product should have a large enough level surface to accommodate a meal. It should be easily adjusted and moved by a nurse, parent or doctor.
Materials used in the product need in alignment with regulation. This includes materials that are flame retardant, non-toxic and easily sterilized.
AESTHETIC CRITERIA +
The aesthetic should be comforting and engaging to a child. Its presence should be elegant, yet subtle within the context of the patient’s room.
REGULATORY CRITERIA +
The U.S. Food and Drug Administration (FDA) regulates all medical products in the U.S. Although hospital beds and many other patient room items are listed as officially regulated devices, adjustable bedside tables do not fall under the umbrella of medical device and are therefore not federally regulated. However, regulation in hospital patient rooms is often in place to protect from entrapment - when a patient gets caught or entangled in the openings or gaps around the bed. The product must not increase the likelihood of this hazard. The AIA also provides widely accepted regulation for patient room design.
MANDATORY FUNCTIONAL CRITERIA +
The product will provide a stable surface suited to meal trays/dishes. It will employ analog means of entertainment and mental stimulation. A nurse, parent or caregiver will be able to adjust the position of the device over the child’s bed. It will be easily cleaned.
DESIRABLE FUNCTIONAL CRITERIA +
The product is easily disengaged and moved out of the way by a nurse or parent.
You need to focus on the patient care. The biggest physical obstacle is line management. IVs for fluids and drugs. Cardiac monitor lines. Suction lines. Wound care lines. DVT pump lines. Catheters. Oxygen. These, and many more critical functions, cannot get caught in a table.
Next, you need more information about infection prevention. These tables are used for everything. Food will go on them. Basins for bathing will go on them. Wipes from cleaning incontinence will go on them. Family, docs, nurses, techs, etc. will be touching them without washing their hands.
And finally, you need to get a sense of space in a hospital room. There is none. That is why all horizontal surfaces are filled with everything.
iab - Thanks for the tips. I’m definitely keeping those concerns in mind going forward. One of the ICU rooms I was able to check out had an absurd tangle of machinery and wires – and that was all without a patient.
The steadicam sketches I posted are early explorations of how the table could be moved around while maintaining a level surface. It would obviously be a pain to take everything off the table just to move it out of the way. I’ve seen how stuff will pile up on those tables.
It seems to me that a start to getting around this frustration would be taking wheels out of the picture. One of the biggest complaints from nurses I’ve talked with has been the wheels getting stopped up from wires on the floor.
And without getting too far ahead of myself… here’s an idea that went over surprisingly well in a critique the other day: The entire table/surface shifts upwards to become the roof for a ‘fort’. A blanket or sheet could be draped over, providing refuge from the scary place that a hospital often is for a child. I’ve got a brief sketch of the idea posted up (above the yellow box) There could even be a light underneath to illuminate the space…
I thought that was a pretty cool idea, too. And I’m sure some kids would love it. But, some are likely confined to their bed without the ability to move around much, so keep in mind how they could enjoy the fort, too.
Have you visited a Children’s Hospital? Or just a standard Adult Hospital?
I’ve only been into general hospitals so far (I’ve seen the children’s rooms/wings). It’s been a challenge getting into children’s hospitals, as I feared going into this project. Lots of red tape and restriction. Getting into one will be tough, getting pictures will be even tougher.
It’s interesting that the pediatric room/wing in the normal hospitals I’ve seen are hardly different from the normal adult patient rooms. They hang up disney pictures and might paint the walls. Maybe what I’m looking to design is actually for these rooms - a single product that begins to turn around the experience of the ‘children’s’ room in general hospitals…
Be careful, That’s going to kill your project if you don’t have real research. It was already the first thing I thought of when I saw your OP… where are the pics of kids using these things?
If you can’t get access, I’d suggest changing the scope to be a table for adults. Same thing I suggested for someone else here who was trying to do a project about crutches for kids, but had no kids to test with. Any project without real research and testing is not looking good in a portfolio.
Since this is the second med product school project that is having restrictions on accessibility, I’m noticing a trend on “I’m having a hard time getting passed…” If this is really the case, perhaps either the school should provide the necessary accessibility paperwork for the student, or the instructor/professor should communicate, “No med projects for thesis work.” This way, the student won’t devote weeks of project initiation research into a project that won’t provide the sustaining research for further concept development.
The second option for the student would perhaps be to partner with med product development company. This way, the student receives relevant feedback as well accessibility through the firms network of research contacts.
It’s too easy to say, “I’m not getting…” I don’t believe a senior student on the home stretch should be using this as an excuse at this point. It’s just going to get way harder after graduation.
R and Massod: Thanks for the comments - I agree that this project will lose a lot without more direct research. Getting clearance and access to children’s hospitals is starting to become a time issue at this point and I’ve been trying to think of an alternative method of extending my research to kids… Here’s what I’ve come up with:
I’ve set up a questionnaire that will be distributed to nurses and parents, who can turn around and have their child help answer. There’s a section for the participant to draw out their own idea of what the table should be (see below).
So far I’m seeing the nurse and parent as big time secondary users of this, and think it’s important that their needs are considered as much as the child’s in the end result. The table could be a ball of fun for the kid, but if it frustrates/hinders the nurse it’s as good as anything else out there. Hopefully this survey will be a good source straight from the kids.
Gaining access to patients is difficult. As I have written before, this is due to a law called HIPPA. Google it, and you will learn everything you need to know. Basically its purpose is to keep medical information between the patient and caregiver confidential. I’m sure no one in their right mind would want other people to know their healthcare information. If a hospital breaks this law, people get fired. It is just that simple.
To be in compliance with the law, you will need an informed consent form to be signed by either an adult patient or the legal guardian of a minor. All of which needs to be cleared with hospital administration. To make a long story short, it is never going to happen with a child or an adult.
Your best and only bet is to go to a teaching hospital. All patients there have signed a an informed consent form that it is a teaching hospital and there are students in that hospital who have permission to know parts of their medical condition. As a student, you would qualify. These teaching hospitals have rules on what you can and cannot do, but what you are asking falls within the realm of what is permissable.
A couple of notes:
You will get very few ( maybe 10) responses to your questionairre. If you are lucky, people will answer 2 open-ended questions. Keep it to 1 page and change the questions to a 1-7 rating system.
I would also beg to differ on calling the nurse a secondary user of the table. They are the primary user as it is needed for patient care. The patient would be the secondary user.
Also, I know you don’t like wheels (sounds like a bias), but look at the wall behind the bed. There are oxygen ports, air ports, suction ports, power, nurse call and dozens of other things attached to the wall. As there is no floor space, there is even less space on the back wall. The nice thing about wheels, it makes the position of the table to be very flexible. If hitting cords is a problem, why not have cord management built into the table?
Children’s Hospitals and Clinics of Minnesota’s Minneapolis location is a teaching hospital. And it’s fantastic. I’m sure there are some near you.
Why only ages 4-6? If a hospital is going to invest considerable money on a bedside table for children, why focus on such a small age range? Most Children’s hospitals treat kids ages 1 second to 14 years and older. Perhaps consideration for the wide variety of ages should be taken.
iab - Thanks for the thorough response. I’ve still been calling/emailing hospitals and have been in touch with a teaching hospital. It’s looking like I might be able to get into this one (VCU med center/children’s hospital of richmond). I knew sorting through all the restrictions for medical would be tough, but didn’t expect quite this much trouble…
I see what you’re saying about the questionnaire - It was something i hurriedly put together, It’ll get revised before being sent out for sure.
The picture you attached looks like an ICU room. I’m focusing on a normal room (maybe an earlier page I attached was misleading). I know there’s still some equipment on the headwalls of the general rooms too, but I’m not letting it shoot down any ideas just yet
NURB - again, hopefully I’ll be getting into a teaching hospital soon, thanks for the tip.
Regarding the age range - I originally proposed this as a table for all pediatrics, 0-18. The thought was that scope was way too wide to come up with a meaningful product after one semester. So many considerations quickly complicate with that wide of a range. I think I’m still standing by that fact (especially considering how fast this semester is going by…) but maybe my range could widen up a bit. I’m thinking younger - maybe something like 0-7…
Another thought on the age range was that I like that this group isn’t yet consumed by electronics when it comes to entertainment. I’ve been wanting to work on a project without digital elements for while, and I might as well take advantage of being a student and declare that, right?
Correct. Where I have been working lately we start in the ICU and then launch enterprise wide. I got caught up in my narrow focus. My apologies.
But I will warn you, hospitals loathe putting holes in walls. Proper procedure is to put a tent around the work area to contain dust and contamination. The bed can’t be filled at that time and the bean-counters really dislike an empty bed. Also, they run the risk of seeing mold in the walls if they drill a hole. That is a whole different nightmare.
3M makes a product called command strips. Its the adhesive that has a pull-tab so you can remove it from a wall without damaging a wall. I have had hospitals say no to putting that on their walls. Rules and regulations in the medical device industry can be quite nutty.