DripAssist for Safer Labor and Delivery in Haiti

Clinical Highlight: Haitian Maternity Wards
Private and Non-Profit Obstetric Wards,| Port-AU-Prince, Haiti

“As a center where we do deliveries and don’t have a large staff, DripAssist ensures that the patients are getting the correct dose of solutions. The device acts as another staff that will never sleep and always be present.”
Community Clinic Medical Director, Haiti

Clinique Maternite de petion-Ville (CLIMAPEV) is a private clinic in the Haitian capital of Port -Au-Prince, Focusing solely on maternal health, the doctor and 18-nurse team at CLIMAPEV are dedicated to providing the best possible care to mothers and babies. That includes ensuring women are receiving accurate doses of the medications necessary for safe labor and delivery. Medications like magnesium sulfate and oxytocin are regularly given via IV, but this clinic, like many in low resource areas, lacks complex medication management technologies like infusion pumps. Staff are well aware of the difficulties associated with a gravity infusion, in particular the time it takes nurses to repeatedly check on patients to ensure infusion rates are safe and steady. Research clearly documents how hard it can be to sustain an accurate and constant gravity infusion rate. To combat medication error, they have a printed out drip chart at the nurses station that reminds them how many drops per minute to count for sample infusion rates. Unfortunately, drop counting alone can’t get them the accuracy they want for patient safety.

Introducing DripAssist

“I am really comfortable when using the device to give a drug to a patient” Nurse, Hospital St. Damien

In May 2016, Shift Labs began working with CLIMAPEV and four other Port-Au-Prince area hospitals to learn about their clinical settings and to see if the DripAssist Infusion Rate Monitor could help them provide effective maternal care. The study, funded in part by USAID, began with on-site training of 146 doctors and nurses by Shift Labs’ staff. The brief clinical training consisted of both a didactic presentation and hands on use of the portable, AA-batter operated DripAssist. The device is simple enough that nurses felt comfortable using DripAssist to provide constant infusion monitoring immediately after being trained. Following the initial training, two local research coordinators visited each hospital weekly to answer follow-up questions about the device and learn about ongoing patient care using DripAssist.

Though the study was initially introduces to understand how DripAssist could help nurses treat women in labor, within hours of training nurses saw a broader utility for DripAssist, using it for pediactric care and antibiotic and pain management treatments. Throughout the study and across facilities, nurses reported feeling much more confident when monitoring medication delivery with DripAssist. In the first two months, nurses used the 15 deployed DripAssist units to ensure safe medication administration for 79 patients.

During the study, nurses used DripAssist for:

  • Maternal Health– DripAssist was used to administer Magnesium sulfate to prevent preeclampsia and eclampsia as well as Oxytocin to treat post partum hemorrhage, the “leading cause of maternal death worldwide”.
  • Pediatric Care– The nurses used DripAssist to monitor Fercayl on iron deficient pediatric patients and when giving Lactated Ringer’s solution to rehydrate patients, which when unmonitored can cause over hydration and congestive heart failure.”
  • Pain Management– DripAssist was also used to accurately administer Nimesulide, Diclofenac, and Tramadol to treat pain.

Moving Forward
“With DripAssist, I am sure that the patient receives the correct dose the doctor wants to infuse” Nurse, clinique Maternite De Petion-Ville

All 5 hospitals continue to use DripAssist twenty-one months after it was originally introduced. The continued success of the device across different facilities is due in part to its versatility. Throughout the study, nurses reported ease when using DripAssist for infusions as short as 90 minutes to as long as 46 hours with varying infusion rates. The simple device also accommodated the supply chains and preferred tubing sets of each hospitals with no difference reported in user experience. DripAssist was seamlessly integrated into each of the different facilities because nurses could be trained in under 5 minutes. Perhaps most importantly, DripAssist supported the current standard of care rather than altering existing practices.

Like the nurses at Climapev, the clinicians at all five hospitals work hard to give the best possible care to their patients. DripAssist allows them to provide the highest standard of infusion care while reducing the burden on nurses and giving the clinical staff confidence and control.

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