Designing a Bubble CPAP training tool
A volunteer program for the Philips Foundation & the International Committee of the Red Cross | 2019
A volunteer effort between Philips employees, the Philips Foundation, and the International Committee of the Red Cross (ICRC) to design a solution to prevent childhood pneumonia.
Over 18 months I led a diverse international team of Philips employees to collaboratively design and deliver a training tool to guide clinical staff at the Mirwais Regional Hospital in Southern Afghanistan in the correct set-up and use of an improvised Bubble Continuous Positive Airway Pressure (CPAP) for newborn and children suffering from severe respiratory complications.
ABOUT THIS PROJECT
Photo credit: International Committee of the Red Cross
Prolonged conflicts continued to have severe consequences for people in Afghanistan. In the south. Children were put at further risk of contracting life-threatening diseases such as pneumonia, owing partly to the cold weather, chronic malnutrition, and lack of access to clean water, sanitation, and adequate living conditions.
Children suffering from pneumonia have difficulty breathing. They rely on airway support to keep their lungs open and to help them rest and recover from the illness. However, commonly available solutions to provide airway support are expensive and too complicated to implement at the Mirwais Hospital.
Source: ICRC, Activity Report, 2019
THE SITUATION
THE ASK
“The big challenge is lack of motivation and commitment of the staff to use the equipment properly, in addition to lack of knowledge of the importance and application of the devices we already have at the PICU.”
Gail, ICRC Health Delegate at the Mirwais
“In the context of the Mirwais Peadiatric wards the Trainers prefer educational resources focused on something simple and more improvised. If it were possible, an audio-visual learning material would be most preferred. Their main training need is on the general functionality of CPAP.”
Dr Fred, ICRC Physician at the Mirwais Hospital
CONTEXT
“At best, it’s the improvised bubble CPAP in use here. Correct CPAP setting would require the correct tubing, nasal cannula (well fitting), cap, airway pressure gauge, and the right bubbler. There is simply no proper CPAP equipment in this hospital.”
Dr Fred, ICRC Physician at the Mirwais Hospital
Source: World Health Organization Guidelines: Oxygen therapy for children
Video stills: Improvised bubble CPAP in use at the Mirwais Regional Hospital
IDEAS
With the advice of the clinical pediatric team at the hospital, we focused on developing a training tool to guide hospital staff on the proper setup and use of an Improvised Bubble Continuous Airway Pressure (CPAP) for newborn infants and children suffering from severe breathing complications.
THE FINAL DESIGN
To promote self-learning, the training tool in English and Pashto is printed and displayed in the pediatric ward. Clinical trainers will use it when instructing staff in setting up the Bubble CPAP.
The final design was printed and delivered in a lightweight, foldable, washable fabric format to facilitate low-cost shipping, durability, and cleaning. Additionally, a video version of the tool was created. The final design was sent to the ICRC, and delivered to the Mirwais Hospital for testing.
September 2020 Posters installed and used for training in the Mirwais Regional Hospital, Kandahar, Afghanistan
“From a pediatrician’s perspective, pediatric airway support in the Mirwais Hospital is far from optimal. With this very-good CPAP learning tool developed by the Philips Foundation Volunteers, newborns, and infants admitted to Mirwais Hospital with breathing complications stand to benefit so much from a properly set up CPAP, an essential component of their treatment.”
Source: an ICRC health delegate working in the Mirwais Hospital
Project team: Lloyd Spencer - Product Designer, Pittsburgh, Pascal de Graaf - Project Manager, Eindhoven, Amir Abdolahi - Research scientist, Andover, Aline Mittag - Healthcare Transformation Services, Hamburg
Special thanks to Fred Oola, Gail Corbett, and Rudina Turhani from ICRC, YuJin Lee, and Andy Ma for the artwork, Marjolijn Heslinga, Edouard Gebski, Alissa Millenson, Victor de Boer, Bart de Vries, Benjamin Loppnow, Helle Ullerup and the Pittsburgh Design Team for their support.