Head Protection Device for Individuals at Risk for Head Injury due to Ground-Level Falls: Single Trauma Center User Experience Investigation

BACKGROUND

Falls represent a large percentage of hospitalized patients with trauma as they may result in head injuries. Brain injury from ground-level falls (GLFs) in patients is common and has substantial mortality. As fall prevention initiatives have been inconclusive, we changed our strategy to injury prevention. We identified a head protection device (HPD) with impact-resistant technology, which meets head impact criteria sustained in a GLF. HPDs such as helmets are ubiquitous in preventing head injuries in sports and industrial activities; yet, they have not been studied for daily activities.

OBJECTIVE

We investigated the usability of a novel HPD on patients with head injury in acute care and home contexts to predict future compliance.

METHODS

A total of 26 individuals who sustained head injuries, wore an HPD in the hospital, while ambulatory and were evaluated at baseline and 2 months post discharge. Clinical and demographic data were collected; a usability survey captured HPD domains. This user experience design revealed patient perceptions, satisfaction, and compliance. Nonparametric tests were used for intragroup comparisons (Wilcoxon signed rank test). Differences between categorical variables including sex, race, and age (age group 1: 55-77 years; age group 2: 78+ years) and compliance were tested using the chi-square test.

RESULTS

Of the 26 patients enrolled, 12 (46%) were female, 18 (69%) were on anticoagulants, and 25 (96%) were admitted with a head injury due to a GLF. The median age was 77 (IQR 55-92) years. After 2 months, 22 (85%) wore the device with 0 falls and no GLF hospital readmissions. Usability assessment with 26 patients revealed positive scores for the HPD post discharge regarding satisfaction (mean 4.8, SD 0.89), usability (mean 4.23, SD 0.86), effectiveness (mean 4.69, SD 0.54), and relevance (mean 4.12, SD 1.10). Nonparametric tests showed positive results with no significant differences between 2 observations. One issue emerged in the domain of aesthetics; post discharge, 8 (30%) patients had a concern about device weight. Analysis showed differences in patient compliance regarding age (χ12=4.27; P=.04) but not sex (χ12=1.58; P=.23) or race (χ12=0.75; P=.60). Age group 1 was more likely to wear the device for normal daily activities. Patients most often wore the device ambulating, and protection was identified as the primary benefit.

CONCLUSIONS

The HPD intervention is likely to have reasonably high compliance in a population at risk for GLFs as it was considered usable, protective, and relevant. The feasibility and wearability of the device in patients who are at risk for GLFs will inform future directions, which includes a multicenter study to evaluate device compliance and effectiveness. Our work will guide other institutions in pursuing technologies and interventions that are effective in mitigating injury in the event of a fall in this high-risk population.

Lessons learned from a non-traditional application process: Integrating user experiences to inform admission application design

PURPOSE

The research aim was to gather applicant expectations and perspectives with a user-centered approach during a pilot application process for a new dental school. The goal was to inform future admissions practices at our institution and for programs broadly.

METHODS

The High Point University admission team developed an electronic application external to current centralized services that was launched from May to August 2022. Participants who completed the application were requested to complete an electronic survey of closed- and open-ended questions about the factors influencing their application decisions, feedback about how to optimize the experience, and their overall satisfaction using a Net Promoter Score.

RESULTS

A total of 303 applicants (79% response rate) completed the survey about their application experience. The most influential reason for applying to the program was the optional Dental Admissions Test requirement (43%). Participants frequently referenced a need for a more human-centered process focused on the candidate rather than their numerical values and that the process should be smooth, straight-forward, short, easy, and simple. Participants requested that experiences should be weighed the most in the application process followed by letters of recommendation. Most applicants were "promoters" (68%) for the program with a Net Promoter Score of 62. Moreover, 32% and 45% rated the application process as the best or better application experience compared to other programs.

CONCLUSION

Programs can benefit from collecting applicant's (i.e., users) opinions and feedback about their expectations and experiences to inform more user-centered application processes.

Insulin Pumps and Remote Software Updates: A New Way Forward

This article discusses the future direction of insulin pump technology and its relationship to the software update process. A user needs analysis revealed that respondents wanted an insulin pump software update process to function much in the same way as smartphone updates. Users of insulin pumps have the same expectations as with other ubiquitous technology such as smartphones, tablets, and laptops. The development of a software update system within a regulated environment that meets the needs of insulin pump users by allowing optional software updates that provide access to pump improvements, feature additions, or access to algorithms that provide therapy-changing technologies is a new way forward for the management of a complicated disease that affects more than 450,000 people using insulin pumps in the United States.

Usability and training differences between two personal insulin pumps

The purpose of this study was to determine if there were usability and training differences between the Medtronic MiniMed Paradigm Revel Insulin Pump and the Tandem Diabetes Care t:slim Insulin Pump during use by representative users, performing representative tasks, in a simulated use environment. This study utilized a between-subjects experimental design with a total of 72 participants from 5 sites across the United States. Study participants were randomized to either the Revel pump group or the t:slim Pump group. Participants were 18 years of age or older and managed their diabetes using multiple daily insulin injections. Dependent variables included training time, training satisfaction, time on task, task failures, System Usability Scale (SUS) ratings, perceived task difficulty, and a pump survey that measured different aspects of the pumps and training sessions. There was a statistically significant difference in training times and error rates between the t:slim and Revel groups. The training time difference represented a 27% reduction in time to train on the t:slim versus the Revel pump. There was a 65% reduction in participants' use error rates between the t:slim and the Revel group. The t:slim Pump had statistically significant training and usability advantages over the Revel pump. The reduction in training time may have been a result of an optimized information architecture, an intuitive navigational layout, and an easy-to-read screen. The reduction in use errors with the t:slim may have been a result of dynamic error handling and active confirmation screens, which may have prevented programming errors.