Authors (including presenting author) :
HC Lin (1), HS Lee (1), Ngor Hui (1), KK Wong (1), CY Chow (2) CC Lee (2), KC Law (2), CK Kwan (2), CW Liu (2)
Affiliation :
(1) Occupational Therapy Department (2) Department of Oncology, United Christian Hospital
Introduction :
Antineoplastic drugs can be delivered in several different ways, depending on the type of medication. In order to reduce patients’ treatment time and improve patients’ quality of life, PHESGO® will be introduced by the Department of Oncology, UCH in the coming future. PHESGO® is an anti-cancer medicine for treating adults with ‘HER2-positive’ breast cancer. It is administered as a single injection just under the skin in the thigh (subcutaneous administration). It takes 5-8 minutes to administer PHESGO® compared to 1.5 hours with IV formulations for each round of treatment, thus reducing treatment time for patients by 90 per cent. However, increased syringe use in targeted drug delivery often associated with work-related musculoskeletal disorders in nurses. In addition, the medication administration process of PHESGO® required slow and continuous subcutaneous injection in the thigh area within 5-8 minutes, the prolonged syringe holding may induce the risk of strain injury in nurses. Therefore, an ergonomic-friendly 3D-printed syringe adaptor was invented to reduce the risk of occupational injuries in nurses.
Objectives :
To obtain the usability testing result of syringe adaptor prototype in preventing occupational injuries associated with targeted therapy subcutaneous injection procedure in Chemotherapy Day Center (CDC).
Methodology :
A working group including Occupational Therapists, Oncology nurses and technicians had been set up since August 2022 to discuss and formulate the adaptor design. To minimize the relative efforts required to use a syringe and minimize excessive muscle use, the design of the prototype syringe adaptor which printed by 3D printing technology adopted the power grip instead of thenar and two-handed pinch grips in syringe holding. It is made with minimal weight in the hand to reduce the load on the hand. The digital model of the adaptor was created with computer aided design (CAD) software and printed with thermoplastic polyester which is a strong and durable material. The first prototype was developed and for nursing application in September 2022. A review on the feedbacks from nurses was conducted to evaluate its effectiveness.
Result & Outcome :
From September to December 2022, 15 Oncology nurses in UCH CDC participated in the pilot trial of 3D-printed syringe adaptor application. In order to simulate the future application of PHESGO®, Trastuzumab (Herceptin) subcutaneous injection which is currently available in UCH was applied. The feedback was generally positive and they agreed that the prototype syringe adaptor was able to reduce the tension of muscle used that occurs so as to reduce the muscle fatigue and thus prevent the risks of developing musculoskeletal disorders. The satisfaction evaluation results also indicated that they were overall very satisfied (over 90%) with the adaptor, regarding both the application and the effectiveness.
Conclusion: With the availability of 3D-printed syringe adaptor for the targeted anti-cancer therapy, it allows nurses to develop better strategies for managing the cumulative loads during drug delivery. Further study on the effectiveness of the syringe adaptor is recommended.
