KANGA: Keep All Neonates Growing Affectionately

by Vivian Nguyen

Coauthors: Coauthor: Jon Stingel, MS - Stanford University, Department of Mechanical Engineering Considerations: Thank you to the Hasso Plattner Institute of Design at Stanford for catalyzing the creation of this project, to our mentors Jules Sherman and Dr. Henry Lee, and to the patients and families that provided insight and feedback throughout our process thus far.

Medical Devices & Digital Health

Background
Kangaroo Care (KC) colloquially refers to a method of caring for a baby that emphasizes the importance of skin-to-skin contact. The neonatal period is one of the most vulnerable times for a child’s survival with nearly half of all under-five deaths occurring during the first 28-days. Research has demonstrated that KC offers a myriad of benefits for premature and low-birth weight infants such as physiologic stabilization, physical growth and development, and earlier hospital discharges as well as efficacy in reducing infant mortality and severe morbidities. Unfortunately, the simple concept of skin-to-skin contact is often complicated by the tangled environment of the neonatal intensive care unit (NICU). For nurses who are primarily concerned with the safety of the infant and avoiding displacement of lines, facilitating KC between a parent and their infant can be cumbersome, time-consuming, and stressful. The visual of tangled wires, the beeping of monitors, and the difficulty in transferring the child can evoke feelings of fear and inadequacy from parents simply seeking to hold their baby. These challenges to kangaroo care pose barriers to the implementation of a simple, low-cost intervention that has been shown to be beneficial in the care of infants in developed and developing countries alike.

Methods
We propose a device called KANGA. KANGA is a modular, ergonomic product designed for the ease of organization and transfer of babies in the NICU. Each modular component is no larger than 1 cubic inch and is designed to secure lines via an integrated medical-grade silicone slot. The mechanism accounts for typical line and tubing diameters while also providing nurses the flexibility to adjust for slack as needed. Each component can be attached to one another via interlocking connectors, creating a system that accommodates a varied number of lines specific to each patient’s needs and that can be easily maneuvered with one hand. When not being used for kangaroo care, the system can be secured to a docking station, and it can also be sterilized using traditional methods. Furthermore, the system is fabricated with non-metallic materials which allows it to travel with the infant for any imaging (e.g. MRIs) or procedures, offering safety and maintenance of organization during a variety of transfers throughout the hospital. KANGA offers a new solution to decluttering the NICU environment, streamlining the workflow of nurses, encouraging the implementation of skin-to-skin care for the benefit of neonates, and empowering parents to engage in the care of their child.

Conclusion
As an ongoing project, KANGA is a way to secure vital tubes and wires for NICU patients and their care team in order to (1) decrease the time preparing for kangaroo care, (2) decrease the risk of displaced lines, (3) increase time of skin-to-skin care, and (4) promote long-term health and feeding benefits for NICU patients and their families. As an acronym, KANGA intends to “Keep All Neonates Growing Affectionately,” and as an innovation, KANGA seeks to address the age-old problem of cord management in a new, scalable, and impactful way.