For hospital patients on ventilators who do not have the ability to expectorate orbrush their own teeth, pneumonia is a significant concern. Ventilator Associated Pneumonia (VAP) affects 10% of ventilated patients and is caused by bacteria that grows in the mouth and infects the lungs. VAP leads to extended hospital stays, increased ventilator time, hospital expenses, and higher mortality rates. Studies have shown that proper oral care can reduce the risk of VAP by almost one-third. Yet, according to surveys of hospital nurses, current oral care products for the dependent patient market have long been too wasteful and failed to meet adequate treatment protocols.

The OralKleen Oral Care Convenience (OCC) Kit was envisioned as a next-generation product that advances hospital protocols, gives nurses the tools they need to prevent the bacterial infection that causes VAP in dependent patients, and meets regulatory standards while reducing waste. The OCC Kit is a sustainable, recyclable system that meets all regulatory standards and provides a comprehensive, six-point solution for fighting oral bacteria. With inspiration and guidance from hospital nurses, this product was taken from concept to development all the way through production.

THE PROBLEM

Even world-class nurses are only as good as the tools they're given.

- Surveys show that nurses consider current oral care products for dependent patients inadequate, failing to meet protocols and generating excessive waste.

- A patient's inability to expectorate, swallow, or maintain proper oral care promotes the growth of bacteria that can lead to up to a 10% greater risk of VAP.

- The mortality rate for VAP patients is 10%

-Costs associated with unreimbursed insurance claims cost hospitals up to $40,000 per patient.

A successful solution must sustainably and effectively address the challenge of providing proper oral care to dependent patients, which will significantly reduce VAP, the time patients spend on ventilators, the duration of hospital stays, hospitals' cost per patient, and mortality rates.

THE PROCESS

The OCC Kit project began with inspiration and input from those most familiar with the challenges of caring for dependent patients: the nurses. Their feedback and guidance continued throughout the project, from the initial concept to development, to production.

After initial interviews establishing clear project parameters and objectives, the design team began an iterative process, rigorously employing 3D fabrication to test prototypes for functionality. Materials were selected for their durability and sustainability in a hospital setting.

THE DESIGN

Central to the Convenience Kit is a first-of-its-kind oscillating toothbrush with suction and lighting. Based on an off-the-shelf electric model, the OCC Kit design integrates suction and lighting into a single device that simplifies and improves cleaning. Fluid, air, and waste travel through a channel within the brush to an exit port that clips securely to a standard hospital hose. The suction provided by the hose is available continually during operation and controlled easily by covering a port ergonomically designed for the user's thumb or forefinger. The design prevents patient injury or discomfort by constructing the suction nozzle of soft silicon instead of hard plastic, and its position just below and behind the bristles is angled for optimal suction. The twin LEDs built into the toothbrush housing are configured to deliver maximum illumination in the mouth without casting shadows from the toothbrush itself.

While combining the cleaning, suction, and lighting features, the design adds negligibly to the overall cross-section of the toothbrush. This allows it to deliver convenient, one-handed operation in tight spaces further obstructed by intubation.

Adding to the enhanced performance of the brush is a smooth, textured silicon skin that provides aesthetic appeal while providing a secure grip, even when wet.

The design thinking behind the Oral Care Convenience Kit extends to the container to address concerns about time and material waste. This new design replaces conventional "open-and-discard" packaging to be repurposed as a storage container at the patient's bedside. The kit is constructed to be space-saving, efficient, reusable, and biodegradable. All contents are organized according to priority for greater efficiency, with the toothbrush and replaceable oscillating heads arranged on top for direct access. Additional items, including the disposable swab sticks, low-profile tongue scraper, toothpaste, moisturizer, and lip balm, are located underneath.

Constructed of bagasse, a sustainable material derived from sugarcane. The water-resistant by-product is optimal for durability in the hospital environment and functions as a toolbox for the duration of a patient's hospital stay. Additional design features include ventilation holes to help keep contents dry and prevent the growth of bacteria and a built-in hook that allows the kit to be hung at a patient's bedside for ready access.

COMMERCIALIZATION

To ensure the OCC Kit's fitness for use in hospitals, sub-acute care facilities, and assisted living communities, the design process was closely monitored for compliance with all regulatory standards.

The design team was involved from concept through the design for manufacture stages and production runs to ensure the highest quality standards for the product and its production.

IMPACT

- Research shows 95% of caregivers prefer the OralKleen OCC Kit

- The OCC Kit saves minutes per treatment

- Up to 80% reduction in packaging volume vs. competitors

- Up to 90% reduction in space required for inventory storage vs. competitors

- Up to 97% reduction in total waste per patient vs. competitors

- Greater prevention of bacteria that leads to VAP and higher mortality rates

- Significant reduction in per-patient costs.