CryoCare: Reimagining Antimicrobial Delivery in the Community

As antimicrobial resistance intensifies, hospitals face increased pressure due to bed shortages and risks of hospital-acquired infections. Hospital-in-the-Home services address these challenges by allowing patients to receive essential intravenous antibiotic treatments at home. Freeing up hospital beds, reducing infection risks, and enhancing patient outcomes. However, certain unstable antimicrobials require chilled delivery, often necessitating hospital stays. Research – including a literature review, interviews with 25 patients, and autoethnographic study – revealed that current elastomeric infusers pose challenges in usability and comfort. This highlights the urgent need for a new device that maintains necessary cold temperatures while also improving comfort, usability, and patient dignity.

Developing a solution that could be managed within the single daily Hospital-in-the-Home nursing visit was crucial for patients with limited mobility and serious illnesses. Extensive bench testing optimised the phase change material, enabling the lightest possible design whilst ensuring the efficacy of temperature-sensitive antimicrobials. Autoethnographic research revealed that the flask’s size made changing clothes challenging, prompting the development of a two-part lid system that simplifies removing the infuser from the flask. A carrier bag suitable for various body types and supportive of the patients’ needs at home, was thoughtfully designed to enhance the portability, comfort, and appearance of the treatment.

Research and prototyping revealed several insights into the complex user experience created by introducing cooling elements around the infuser. These research insights established a spectrum between performance and comfort, guiding CryoCare towards specific size to weight ratios that were ergonomic to wear, while meeting clinical needs. Innovations included a new phase change material formulation, a streamlined workflow for daily cooling material replenishment, versatile wear options, and digital monitoring of cooling effectiveness. Additionally, the introduction of a removable core significantly simplified changing clothes, showering and cleaning for users. The product is currently being manufactured in small batches for hospital testing.

A literature review highlighted the need for designers to understand the complexities of treatment via elastomeric infusers, as current devices and treatment protocols presented significant design challenges. However, the infusers themselves could not be redesigned due to regulatory constraints. Consequently, the infuser design, PICC line, and treatment protocols remained unchanged. A critical decision in developing CryoCare was choosing between a hard or soft design. A vacuum flask ensures excellent thermal retention, essential for medication effectiveness. However, the metal body also increases bulk and rigidity, which may impact patient comfort. Conversely, a soft design, akin to an insulated cooler, could enhance patient satisfaction with greater ease of use, though it may struggle to consistently maintain the required temperatures. Ultimately, patient interviews highlighted clinical efficacy as the number one priority, leading to the selection of a vacuum flask. The vacuum provides consistent temperature control throughout a 24-hour infusion period, significantly reducing the need for frequent user intervention. Patients emphasised the reassurance felt by visually confirming successful medication delivery through the infuser’s transparent walls and elastomer. A small screen was included on the flask to easily display temperature data, enhancing the patient’s ability to make informed decisions during treatment.