Ergonomics and Design: development of a “next generation” NICU portable ventilator.

Nowadays, research and innovation in the pediatric field represent both a challenge and a great development opportunity. The emergence of clinical problems and the convergence of scientific knowledge and multidisciplinary approaches allows us to offer innovative solutions to improve pediatric care. In particular, the new digital technologies represent an important factor of innovation in the field of health care and, above all, in delicate and complex contexts such as Neonatal Intensive Care Units (NICU), where due to the vulnerability of young patients it is necessary to use of ever more straightforward and more efficient care tools. However, in the pediatric field and, above all, in Neonatology, cases of errors in healthcare are increasingly frequent; it is estimated that a child is three times more exposed than an adult to potentially harmful situations of Medication Error because the level of assistance required is higher and the equipment required is more complex. In particular, one of the most common causes of access to the Neonatal Intensive Care Unit is the respiratory difficulty which requires specific mechanical ventilation treatment, which can involve human errors and risks related to its use with possible physiological complications. Sometimes, human error can be attributed to the excessive complexity of using the products/services or the need for more materials suitable for the personnel needs. In the neonatal field, there are frequent problems related to usability, ergonomic characteristics, software and hardware interfaces, the human factor, and the context and methods of use of medical devices that lead to errors. The general objective of this study, conducted at the Meyer Children's Hospital in Florence, was to improve not only the condition of the well-being of the young patient but also the working conditions of the medical and healthcare staff, promoting interaction, simplifying the actions and minimizing the possibility of error in use. This paper reports the main results of the research achieved thanks to the application of the evaluation methods of usability and safety of use typical of Human-Centered Design. These have made it possible to pay attention to the needs of users who interact with the medical system (patients, health professionals) and the different skills of the professionals involved in designing and providing services.Through field surveys and discussions with experts and healthcare professionals (user observation, semi-structured interviews, questionnaires, etc.) conducted at Meyer Children's Hospital in Florence, it was possible to collect data on current critical issues. In particular, the survey made it possible to understand how the user interacts with existing fans and how much these can lead to problems regarding the complexity of assembly, the difficulty of reading the physical and digital interface, the presence of numerous instruments during transport and the issues relating to the organization of the treatment phases. The analysis of the user and the evaluation of the criticality of the existing products/systems have therefore allowed the identification of possible scenarios and intervention solutions, defining the requirements of the new ventilation system. From the results obtained, it was possible to configure new solutions, which gave rise to the design of a new generation lung ventilator for NICU to improve ventilation assistance operations, reduce user errors and make the product versatile and easy to use both in the ward and during neonatal protected transport.