Infusion Evolution: Exploring and Refining a Novel Solution to Provide Rate-Controlled Medication Infusion in Ghana
Intravenous (IV) administration is crucial in modern medical practice for delivering medications, fluids, and nutrients with precision, particularly in life-threatening emergencies. The gold standard for safe IV delivery is rate-controlled infusion devices, which prevent over- and under-dosing that can lead to medication toxicity, subtherapeutic concentrations, and potentially fatal adverse reactions, including heart rate abnormalities, unstable blood pressure, and respiratory distress. While these devices are readily available in high-income countries, low- and middle-income countries (LMICs) face critical access gaps. At Korle Bu Teaching Hospital (KBTH)—Ghana's largest tertiary care facility—only one infusion device is available for a 275-bed maternity ward, while Komfo Anokye Teaching Hospital (KATH) has just one device per 15 beds in its Accident and Emergency unit. Commercially available infusion devices cost between $700-$2,500 and require electricity, making them unsuitable for resource-constrained settings. Alternative methods like gravity drip IV or manual bolus injections require increased nursing attention, suffer from poor accuracy and reliability, and lead to inconsistent dosing that risks patient lives, yet nursing availability is already severely limited in LMICs.
This project aims to evaluate and refine a novel, fully mechanical, low-cost ($150, 79% less costly than current market options) rate-controlled infusion device specifically designed for LMIC contexts through a collaborative partnership with colleagues in Ghana. The device operates without electricity, using a user-wound power spring, adjustable pendulum, and variable gear system to control infusion rate and duration for approximately two hours per windup. Through a mixed-methods study with healthcare professionals in the OBGYN unit at KBTH, the project will evaluate the device's usability, feasibility, and acceptability among physicians, midwives, and nurses; assess its adaptability within clinical workflows; and iteratively refine the prototype based on user feedback. Using validated usability scales, timed simulated trials, semi-structured interviews grounded in acceptability frameworks, structured observations, and focus group discussions, the study will engage approximately 80 healthcare professionals to understand device strengths, limitations, and integration opportunities.
Expected outcomes include a holistic understanding of how OBGYN healthcare professionals perceive the device's usability, feasibility, and acceptability; a comprehensive assessment of workflow integration possibilities; identification of key design refinement opportunities informed by frontline user experiences; and a redesigned prototype with enhanced implementation potential validated for usefulness in the OBGYN unit at KBTH. The project seeks to contribute to health equity by developing a sustainable, contextually-appropriate medical device that breaks the cycle of donation dependence and inadequate fit, empowers nurses and midwives—often women—to deliver accurate medication infusion, improves access to life-saving treatment for conditions like preeclampsia (a top cause of maternal mortality globally), and provides strong evidence to proceed through clinical testing, local manufacturing in Ghana, and pilot implementation that could transform IV medication delivery across resource-constrained healthcare settings.