Modular Elastic Tubular Net Bandage Dispenser Design for Easy Access in the Context of Nursing Cart Chiao-Chun NI, Carlos Eduardo NUILA, Cheng-Kui FAN and Philip HWANG National Taipei University of Technology Dept. of Industrial Design 1, Sec. 3, ZhongXiao E. Rd., Taipei 10608 Taiwan, R.O.C. carlos.nuila@me.com
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Abstract— The emergency room treats many injuries daily, for which the last step is the application of an elastic tubular net bandage with the purpose of holding the remedy in place. The abundance of injuries and the diversity of wounds make it necessary to have various sizes of tubular net bandage readily available. Nonetheless, emergency room nurse carts are limited in space and the size of traditional bandage containers is substantial. As a result, often more critical supplies give way in order to have a full set of tubular net bandages on the cart at all times. Integrated Elastic Tubular Net Bandage Dispenser was designed to not only meet the space and quantity requirements of the emergency room, but also to provide a more usable product in terms of visibility and use ergonomics. Integrated Elastic Tubular Net Bandage Dispenser was subjected to various tests and validated for Usability, Bandage extraction and refilling; the results of which were satisfactory
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Keywords— Clinical Assistive Device; Usability; Human Centered Design.
I.
UNDERSTANDING THE CONTEXT OF USE. The last step in treating most injuries is the application of a Tubular Net Bandage (Hereinafter referred to as “Bandage”) with the purpose of holding the remedy in place; these bandages are most commonly packaged in thin and tall square boxes for use in regular clinics and hospitals. Normally the procedure for bandage application is not a particularly laborious process and imposes no noticeable impact on the efficiency of the treatment task. However, the requirements of the emergency room are quite different in some aspects; due to the volume and variety of injuries, there is an expectation for high skill and agility for the treatment. Currently, traditional Bandage packaging imposes a bottleneck on this process brought on by the design of its packaging. This situation is worsened in the context of a full and crowded nursing cart; in which there are higher order medicines and supplies that have to be reduced in quantity in order to accommodate a complete set of Bandages. Traditionally a nursing cart is comprised of three main sectors where supplies may be placed: A desktop working surface, a secondary surface and a set of drawers for further storage. In
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most situations Bandage containers are placed in the second level surface, where they take approximately 30% to 40% of the available area. This poses a problem for medical staff because they are forced to replenish higher order medicine more often than lower order supplies, which is far from ideal.
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II.
SHORTCOMINGS WITH THE ACTUAL MODEL. As a starting point, a diagnostic assessment was made to determine the problems associated with the actual configuration of Bandage containers in the context of a nursing cart. The most notable are listed below:
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1) The footprint of traditional bandage packaging is considerably large and takes up space that could be utilised for higher order supplies. 2) The carer treats the injury while standing upright until it is time to apply the Bandage, then they must bend down to obtain it. On the long run this may be detrimental [1]. 3) When the carer is standing next to the nursing cart the visibility of the number tag on the Bandage Box is greatly decreased and in some cases null. 4) After the desired length of bandage is cut, the remaining length is left hanging loose outside the container, this can lead to two situations: The Bandage becomes dirty or the Bandage drops inside the box and becomes hard to retrieve. After completing this usability assessment, the main areas for improvement were determined as follows: Placement, Upright use, Visibility, Usability and Bandage Hygiene.
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Fig. 1. Actual Model (a) Low Accessibility. (b) Low Visibility
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! ! Fig.2. Design Goal (a) High Accessibility. (b) High Visibility.
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III. RESEARCH METHODOLOGY The type of research used in this project was Quantitative and Qualitative. Quantitative to accurately translate tests and results into usable design outcomes, Qualitative to effectively gauge anecdotal results and opinions and adjust for further testing. Medical staff, professors and teammates all participated in varying degrees throughout the length of this research. The first assessment was performed at the Su’ao Veterans Hospital in Yilan County with the help of in-house medical staff and consisted of two parts:
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1) Questionnaire inquiring about Bandage usage and regular practice. 2) Observation of operation facilities, equipments and mockup injury treatment.
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Subsequent tests were carried out at the 507 Design Studio in Taipei Tech’s College of Design and reviewed by faculty professors and classmates on a weekly basis.
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Fig.3. Average Taiwanese nursing cart dimensions. (units: cm)
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IV. DESIGN PROCESS For the duration of this project several prototypes and variations were produced and evaluated with the purpose of refining, implementing or assessing new design features, sizes or materials that best translated the design requirements of the Medical staff within the constrains of small batch production.
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Table 1. Prototype production. Angle assessment: visibility and protrusion from edge
Paper Prototype 1: Full paper construction, form review.
Paper Prototype 2: Combination material for opening, volume variation.
Polypropylene Prototype 1: Form review, chamfered bottom
Polypropylene Prototype 2: Single PP sheet construction, latch design.
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Steel Prototype 1: Front and back stainless steel construction, Final form.
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Steel Prototype 2: Full stainless steel construction, pre production stage.
At the preliminary design phase, various ideas were sketched out and discussed. Some were taken to the Su’ao Veterans Hospital in Yilan County for critique and review.
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Fig.6. Corroboration with paper mock-up. (a) Placement. (b) Functionality
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2) Material Variation and Form Refinement:
Fig.4. Preliminary “Stackable plastic container� concept.
After this preliminary review, a formal usability assessment was executed; the results of which prompted us to reconsider the original design and iterate further. After discussion one of the most important and defining conclusions was reached: Place the device right below the desktop working surface; at a height of approximately 80cm for optimal access during upright operation.
For this phase, three materials and production techniques were considered and tested: Acrylic bending, PLA filament 3D printing and Polypropylene (PP) sheet folding. The latter best fulfilled the requirements for this stage; However, PP sheet is not easily bonded[2]. For this reason, other methods had to be devised to assemble a PP prototype. Due to the increased difficulty for cutting this new material and the precision required to make a successful model, a more sophisticated prototyping technique was in order. After researching various cutting methods, Laser cutting stood out as a low cost and high precision solution for the task[3]. (b)
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Successive prototyping was carried out in three main stages: 1) Initial Form Development, through the use of paper materials such as cardboard and cardstock. 2) Material Variation and Form Refinement, through the use of plastic materials such as Polypropylene sheet and PLA filament. 3) Final Form and Material definition, through the analysis of manufacturing processes such as Laser cutting and Metal bending.
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In the following paragraphs each stage will be described further: 1) Initial Form Developing: The goal of this phase was to provide a framework on which to build upon with subsequent revisions. It was clear that placement and visibility were key features for the end users. This condition called for a shape that allowed a more relaxed viewing angle from an upright position. A series of prototypes were built to asses the visibility and protrusion distance from the edge of the working surface at different angles; with the optimal balance being 45 degrees.
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Fig.5. Protrusion distance as a function of angle variation ((a) 30 degrees, (b) 40 degrees, (c) 45 degrees.)
Fig.7. (a) Polypropylene prototype 2 before assembly. (b) Joint detail.
At this phase, the form was adjusted to include one more chamfered angle in the front for easier bandage recovery. The volume of the container was slightly modified to allow for more mobility and lower cost production.
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3) Final Form and Material Definition: After refining the form through rigorous iteration the next step was to find a material that met the hygienic requirements for Hospital use, as well as the durability requirements for a long term life cycle. Costs for small batch production must also be considered, as this is not a mass consumer product. For all of the reasons listed above and for relatively easy manufacture at lower volumes, the logical choice was Bent Stainless Steel. It not only met all of the conditions for this specific project, but also provided flexibility for changes in design and aesthetic value[4].
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Fig.8. (a) Prototype assembly. (b) Full working prototype.
In the end, the form agreed upon consists of a Stainless Steel rectangular prism (Dimensions: 30x6x6 cm.) with three chamfered edges at 45 degrees from the bottom face, Front 45 degree angled face and cut out bandage opening with two different sizes for different numbered Bandages. (a)
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V.
SUMMARY
1) The new Bandage dispenser design provides an answer to the limited space on the nursing cart, in a way that is human centred and cost effective. 2) The placement of the dispenser plays a key role in the solution to the Visibility and Accessibility issues associated with traditional Bandage containers.
 3) Operation time and efficiency has been shown to improve with the use of the re-designed dispenser.
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Fig.9. (a) Dimensions. (b) Prototype.
The operation process was designed for simplicity and quickness. It consists of only three steps: 1) Bandage pull: The head of the Bandage is pulled to the desired length by the carer. 2) Fastening: When the desired length is reached the Bandage can be pulled upward and fastened in the diagonal crevice. 3) Cutting: With the bandage held in place the carer may get the scissors and cut, while the head of the bandage stays placed for the next use.
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Fig.10. Regular Operation Procedure.
1) Dispenser opening: The magnetically attached cap is easily detached with one finger, after this it will drop along a hinge on the bottom side. 2) Bandage replenishment: The Bandage is wound around a long board and then inserted into the container, after the board is pulled out the Bandage stays neatly placed. 3) Dispenser closing: After the Bandage is replenished, the user may push the cap back in place where it will snap in place.
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Authors
Chiao-Chun NI
Similarly, the replenishment consists of only three steps:
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2.
Lower Back Pain Symptoms and Causes. (n.d.). Retrieved March 12, 2014, from http://www.spine-health.com/conditions/lower-back-pain/ lower-back-pain-symptoms-and-causes Polypropylene(PP). (n.d.). Retrieved April 3, 2014, from http:// www.bpf.co.uk/plastipedia/polymers/pp.aspx Laser Cutting. (n.d.). Retrieved April 3, 2014, from http:// en.wikipedia.org/wiki/Laser_cutting Stainless Steel. (n.d.). Retrieved June 5, 2014, from http:// en.wikipedia.org/wiki/Stainless_steel
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Fig.11. Replenishment Operation Procedure.
Carlos 
 NUILA
Cheng-Kui FAN
Philip HWANG