Presentation is loading. Please wait.

Presentation is loading. Please wait.

Nebulizer Project Matthew Lawrence Brockman Daniel Puthenpurayil George Nathan Joseph Hankins Marissa Kathleen McHugh 1.

Similar presentations


Presentation on theme: "Nebulizer Project Matthew Lawrence Brockman Daniel Puthenpurayil George Nathan Joseph Hankins Marissa Kathleen McHugh 1."— Presentation transcript:

1 Nebulizer Project Matthew Lawrence Brockman Daniel Puthenpurayil George Nathan Joseph Hankins Marissa Kathleen McHugh 1

2 Outline I. What’s a Nebulizer, Needs Assessment & Scope of Work - Matthew II. Our Design – Matthew III. In-Country Implementation – Nathan IV. In-Country Training – Marissa V. Issues Encountered – Daniel VI. Evaluation/Feedback – Nathan VII. Cost Analysis – Daniel VIII. Testing and Results – Matthew IX. Sustainability and Ownership – Matthew X. Entrepreneurial – Nathan 2

3 What’s a Nebulizer Compressor, filter, tubing, cup, mask Compressor not a medical device, simply supplies air Cup aerosolizes water with medication 3

4 Needs Assessment: Respiratory Problem Causes Environmental effects Desert climate Dryness Wind Dusty air/Dust storms Allergenic trees Garbage and vegetation burned near homes Indoor cooking fires Cockroach infestations Factors contributing to high prevalence of respiratory problems: 4

5 Needs Assessment: Nebulizer Availability Problems receiving nebulizer treatment: Limited availability at local clinics o Only 1-2 nebulizers o Walking distance o Closed on weekends o Open 7AM to Noon o Frequent power outages o Days designated for non-respiratory problems High cost (about $100) compared to salary 5

6 Scope of Work and Needs Assessment Problem Statement: Deliver a simple, home-made nebulizer and an instruction manual Costumer: o Resistants of Choluteca, Honduras who suffer from respiratory problems o Larry and Angie Overholt Needs Assessment: o Large portion of the population suffers from asthma o Environmental causes o Low availability of nebulizers 6

7 Our Design Filter filters to about 10 micrometers, car or motorcycle fuel filters will work similarly Bike pump acts as compressor This project uses actual nebulizer cup, mask, and tubing Soccer ball filters out the duty cycle of the pump as a capacitive element 7

8 In-Country Implementation The team’s main goals were as follows: Source local parts Treat and take data in health departments and villages Train people in health departments and villages on how to build and use Distribute manuals on operation and creation of device Donate a nebulizer to each village Gain local feedback 8

9 In-Country Implementation: Week 1 DayDateTasks Completed Monday 5/5/ Sourced Parts Locally - Tested/Troubleshot Local Parts - Worked on Manual Tuesday5/6/ Worked on Manual - Reassessed Schedule and Desired Statistical Method to be Used - Tested/Troubleshot Local Parts 9

10 In-Country Implementation: Week 1 DayDate Wednesday5/7/2014 Tasks Completed - Finalized Manual/Made Copies -Introduced Both Methods, Treated, and Trained Local Woman, Erma (donated nebulizer) -Introduced Both Methods and Trained Nurses/Doctor at Choluteca Health Department 10

11 In-Country Implementation: Week 1 DayDateTasks Completed Thursday5/8/2014 -Introduced Both Methods, Treated Patient, and Trained Nurses/Nursing Students/Doctor at Namasigue Health Department (donated nebulizer, health department had no electricity) -Purchased Additional Parts -Introduced Both Methods, Treated Children, and Trained Women’s Guild of Siete de Mayo (donated nebulizer) 11

12 In-Country Implementation: Week 1 DayDateTasks Completed Friday5/9/2014 -Introduced Method and Trained Nurses/Patients at Choluteca Health Department (donated nebulizer) -Lined up Visits to Private Clinic, Hospital, and Pharmacy -Prepared for Pharmacy Advertising 12

13 In-Country Implementation: Week 1 DayDateTasks Completed Saturday5/10/2014 -Provided free treatments, demonstrated the method, and handed out manuals outside pharmacy (met teacher) -Worked on Poster design for Public Health Departments 13

14 In-Country Implementation: Week 2 DayDateTasks Completed Monday5/12/2014 -Introduced Method, Treated Patients, and Trained Nurses/Doctor/Patients at Dr. Gir ó n’s Private Clinic (donated nebulizer, committed to getting more data) -Printed and Laminated More Manuals -Updated Treatment Forms 14

15 In-Country Implementation: Week 2 DayDateTasks Completed Tuesday5/13/2014 -Introduced Method and Trained Nurses/Doctor in Namasigue Health Department (presented poster) -Treated Infant Successfully with Only Saline -Discussed Entrepreneurship Opportunities -Introduced Method and Trained Women in Siete de Mayo 15

16 In-Country Implementation: Week 2 DayDateTasks Completed Wednesday5/14/2014 -Visited Choluteca Health Department (presented poster) -Interviewed by Local News TV Station, TeleVida63 -Searched and Found Teacher of Cambridge Bilingual School we Met on the Street Saturday and Presented for His Class (donated nebulizer) 16

17 In-Country Implementation: Week 2 17

18 In-Country Implementation: Week 2 DayDateTasks Completed Thursday5/15/2014 -Introduced Method and Trained Nurses/Patients/Doctors at the Choluteca Hospital’s Nebulization Clinic, Emergency Room, and Pediatric Ward (donated laminated manual) -Introduced Method and Trained Entire Waiting Area of Hospital (ran out of manuals) -Returned to Dr. Girón’s office and were able to record results of 2 patients using an electrical nebulizer -Introduced Method, Treated, and Trained 2 Women of La Bonanza (donated one nebulizer) 18

19 The training process involved: Demonstration of assembly and operation Explanation of evaluation forms Review and distribution of manual Distribution of posters In-Country Training 19

20 Constructed a user manual 1. Instructions for assembly 2. List of materials including pictures, prices, and store names 3. Directions for usage and sanitation 4. Reservoir recommendations 5. Troubleshooting In-Country Training 20

21 Distributed laminated, color copies to public health departments and Dr. Giron’s clinic, the women’s group in Siete de Mayo, and Mr. Carlos from Cambridge. Distributed black/white copies to woman in Choluteca, woman in La Bonanza, public health departments, Dr. Giron’s clinic, and at Farma City. In-Country Training 21

22 All places visited followed the same basic pattern Trained doctor(s) and nurses Trained asthma and non-asthma patients and parents In-Country Training 22

23 Taught nurses how to use peak flow meters Taught nurses how to complete the pre/post evaluation forms In-Country Training 23

24 Issues Encountered Transportation dependability Quality of Honduran materials and healthcare Given “North American Prices” – Prices also varied Quantity and age of patients Language Barrier – Quality of our instruction may have varied Creation of the manuals – Far walk to print 24

25 Evaluation/Feedback Cheap; most who need cannot afford electric nebulizer (L1,800), ours cost L343 Generally preferred reservoir design General public eager to learn (passed out over 100 manuals) “Our country needs this” A few people were hesitant at first – required additional explanation 25

26 Evaluation/Feedback People were often excited by the design and would tell others - Cambridge teacher had told students and staff members including the security guard Doctor at Namasigue said it was a useful design because often patients are without electricity 26

27 R&D Cost Pre-Trip 27

28 R&D Cost During Trip 28

29 Total R&D Cost Mostly from purchasing balls and prototyping materials Large purchase of the filters to donate 29

30 Per Nebulizer Cost – United States Using a size 5 soccer ball and the cheapest of the other materials, one nebulizer cost the team approximately $30.57 Without a reservoir, the nebulizer cost approximately $

31 Per Nebulizer Cost – Honduras Cost with reservoir: $16.73 Cost without reservoir: $9.17 Hondurans can likely get these items for a lower price – One person commented they could get a soccer ball for L

32 In-Country Testing Regimen Assess situation Pre-treatment baseline measurements Qualitative testing Quantitative testing Post-treatment evaluation Qualitative analysis Quantitative analysis 32

33 Pre and Post-Treatment Qualitative Testing List observations related to breathing (Is patient coughing, wheezing, gasping for air, etc.) Doctor/Nurse observations or comments 33

34 Pre and Post-Treatment Quantitative Testing Have patient blow into peak flow meter three times, take maximum Ask patient to rate difficulty of breathing from uno to diez, uno being perfect lung function 34

35 Post-Treatment Quantitative Analysis Have patient blow into peak flow meter three times, take maximum Apply Equation 1 to find percent increase Ask patient to rate difficulty of breathing from uno to diez, uno being perfect lung function Report difference Equation 1 35

36 Testing: Results Treated 14 patients while in country: yielded 8 numerical data points Honduran Nurse at the private clinic collected 2 control data points and 4 more data points using our nebulizer The power of the test will be low, will hopefully increase as our contacts continue to take data Alpha level of 0.05 (medically standard) Null Hypothesis: The average percent increase in peak flow for the medical nebulizer is the same as the average increase in peak flow for the home made nebulizer. Alternative Hypothesis: The average percent increase in peak flow for the medical nebulizer is greater than the average increase in peak flow for the home made nebulizer. 36

37 Testing and Results 37 p-value was We therefore fail to reject the null hypothesis that the two means are the same Little data so far

38 Observational Results Treatment had qualitative success Stopped bronchospasms in one patient Patients reported less or no difficulty breathing post- treatment Some children fell asleep while using the nebulizer 38

39 Sustainability and Ownership Made from locally available parts for low cost: sustainable supply of nebulizer Ownership: instructions for constructing Trained variety of individuals Targeted individuals/groups who are most likely to continue using the device and teach others – parents 39

40 Sustainability and Ownership Cambridge teacher will continue to spread the idea Posters and manuals at health departments Dr. Giron will make and distribute nebulizers 40

41 Entrepreneurial Opportunities Demand exists Product: Nebulizer kit and manual End user: Asthma patients Costumer: Philanthropic or Social Enterprise Non-profits such as NGOs Social entrepreneur Dr. Girón Roger Henriquez Carlos Ferrera 41

42 Conclusions This was a reasonably successful pilot study There is a need for this project in the developing world Well-perceived and culturally acceptable device Future studies should collect more data Failed to reject the null hypothesis that this method is as effective as the medical nebulizer. 42

43 Acknowledgements Roger Dzwonczyk Mariantonieta Gutierrez Angie Overholt and the entire WGM team Anna K Young Kathy Stone Duane Hart Nationwide Children’s Hospital 43

44 Questions? 44


Download ppt "Nebulizer Project Matthew Lawrence Brockman Daniel Puthenpurayil George Nathan Joseph Hankins Marissa Kathleen McHugh 1."

Similar presentations


Ads by Google