Babies in neonatal intensive care units have fragile, underdeveloped skin. IV lines are used to provide life-saving fluids and medications, but they come with a downside - the adhesive tape used to attach the line often injures the baby's skin when it is removed.
This injury can lead to infection, scarring, and prolong the baby's stay in hospital. It's a common issue, with 70 to 90% of babies hospitalised in the NICU having skin injuries related to medical devices applied to their skin.
A particularly severe skin injury in a NICU patient inspired Dr Deborah Harris, a neonatal nurse practitioner and senior lecturer at Te Herenga Waka-Victoria University of Wellington, to find a solution.
Harris reached out to all the neonatal intensive care units across New Zealand and Australia, to find out how they were securing their drips. She told 1News she was surprised that no one had solved the problem.
"We got letters saying, 'This is an absolute nightmare. We need a better way to do this.'"
She approached industrial designer Mike Williams, Director of MWDesign Ltd, and together they came up with the Pēpi Splint.
Made of medical-grade silicone, with an internal aluminium mesh, the reusable device can be moulded to the shape of the baby's foot or arm. Tape goes directly onto the splint, without touching the skin.
Harris led a proof-of-concept study of the Pēpi Splint at the Wellington Regional NICU, with 38 babies of 30 weeks gestation and above taking part in the trial. Results recently published in BMC Pediatrics found that the device effectively kept the IV line secure, causing no skin injuries. Clinicians reported that it was easy to use.
Having a baby admitted to NICU is a stressful experience for whānau, and it was important to Harris to examine at how parents responded to the Pēpi Splint. Overall, their experience was positive.
"One of the parents really wanted to keep using the Pēpi Splint, because it was so much better than what was currently being used," Harris said.
Harris said that it is unusual for nurses to develop medical devices, but they are uniquely placed to do so.
"The nurse is the clinician who's with the patient for the longest period of time… they are the people who can develop new ideas, new questions, but they are not resourced or encouraged to do that.
I think it's an area where we really need to develop. Where tertiary institutions and hospitals… work with engineers to design products that will improve outcomes for families."
Williams, who holds the IP for the Pēpi Splint through MW Medical, is looking to find further investors and moving things forward to get the Pēpi Splint into production for a national and global market, something which might take place alongside further clinical trials.
He said the product has been getting a great response so far.
"Anybody who deals with NICU kids, they immediately get it, immediately understand how it's better."
Williams agrees that collaboration between nurses and designers can be fertile ground for innovation.
"[They're] wonderfully practical people… they know what works. You can come up with a solution that is great for the patient but just takes forever for a nurse to do, and it will never be picked it up… it's got to work for both patient and the practical application," Williams said.
Recent calls from schools of nursing seeking funding from Health NZ to double the numbers of nurse practitioners being trained, and help address the GP shortage, have been unsuccessful.
Harris, who became the first registered NZ nurse practitioner in 2001, sees the Pēpi Splint development and study as a great example of the innovation that nurse practitioners can bring to the healthcare sector.