NarKit
This project addressed the problem of public drug overdoses. Design Science requested assistance in designing products to support the public installation and use of Narcan (Naxolone).
Our purpose is to research, design, and develop a mechanism(s) to mitigate the growing number of deaths related to the national opioid epidemic.
Our team conducted extensive research and identified that public access to Narcan to be a key factor relating to opioid overdoses across the U.S. Narcan is an emergency medication known as an “opioid antagonist” because it immediately reverses the harmful effects of an opioid overdose. Narcan saves lives – so we aimed to design a public system, called NarKit, for bystanders and the public to use in case of an overdose. Seconds count during an opioid overdose, and NarKit can facilitate a quicker response by leveraging the ability and presence of bystanders and the public to administer Narcan.
Questionnaires
Our team conducted several interviews and questionnaires with subject matter experts such as police officers, substance abuse counselors, bystanders, and food and beverage workers who all provided valuable insight into opioid overdose cases. Our overall intent with this method was to develop an idea of who our true “customer” would be by learning about where overdoses occur, and how to design a system that would support them best in the event they respond to a public opioid overdose event. Here are some key excerpts:
“I’ve dealt with drug overdose cases for many years as a patrol officer. Public bathrooms are hot spots, like at Walmart, Dunkin Donuts, and the library.” – Captain James Donovan, Somerville Police Department
“Focus on MBTA stations and late night spots like laundromats and Dunkin Donuts. OD’s in publc are more common in bathrooms, so if you want to get the Narcan to the right spot then look there.” – Ms. Kay Walsh, Substance Abuse Counselor, South Boston Action Center
“We had a woman overdose in the bathroom of the Starbucks I worked at in Seattle. It was horrible. I’m assuming it was heroin that cause it. She did not survive.” – Amy Hansen, Starbucks Barista, Seattle Pioneer Square
Task Analysis
Using our knowledge of the customer and their needs and requirements, we generated a Behavioral and Cognitive Task Analysis for a situation where an overdose occurs and a Narcan kit is nearby. We identified four main stages integral to this event:
Stage 1: Identify – User identifies a medical emergency has occurred and is possibly an opioid overdose.
Stage 2: Locate – User locates Narcan kit nearby.
Stage 3: Access – User opens kit, retrieved Narcan, and puts on protective gloves.
Stage 4: Administer – User administers the Narcan nasal spray, second dose if required, and calls 911.
Risk Analysis
The following Use Failure Mode and Effects Analysis (uFMEA) was conducted to identify hazards and apply mitigation strategies to reduce risk (see Appendix X for complete Risk Analysis). We prioritized five primary Failure Modes when using a Narcan kit:
Failure Mode 1: User contracts illness or virus from victim’s bodily fluids.
Mitigation Strategy: include rubber gloves in kit to protect against blood borne infection. Risk Severity = Catastrophic RAC = Unacceptable, Mitigated RAC = AFAP1
Failure Mode 2: User cuts finger on kit’s edge or corner.
Mitigation Strategy: polish and smooth all edges and corners of kit or box.
Risk Severity = Minor RAC = AFAP1, Mitigated RAC = AFAP2
Failure Mode 3: Children access kit and choke on small parts.
Mitigation Strategy: ensure no parts less than 1.25 inches in kit to prevent choking. Risk Severity = Catastrophic RAC = Unacceptable, Mitigated RAC = AFAP2
Failure Mode 4: User utilized expired Narcan from kit.
Mitigation Strategy: include monthly inspection log on box to check expiration dates. Risk Severity = Critical RAC = Unacceptable, Mitigated RAC = AFAP1
Failure Mode 5: User sprays medication in victim’s eyes or nose in error.
Mitigation Strategy: include direction card with simple steps and pictures how to use. Risk Severity = Minor RAC = AFAP2, Mitigated RAC = AFAP2
Prototype Development
When starting prototype ideation, we combined all of our prior knowledge and began to brainstorm possible solutions. Our primary interest was in a kit or box which can store Narcan on a wall, much like a mounted AED kit.
We built two prototypes using a laser cutter (Universal, VLS 3.60) to manufacture the acrylic sides of the boxes, and a 3D printer (Prusa i3, MK3 kit) to manufacture the handles. The smaller box measured 4 in wide, 6 in high, and 4 in deep. The larger box measured 8 in wide, 11 in high, and 3 in deep. The intention for each box is to contain Narcan and other required materials.
We utilized a small focus group to help us design the labeling of the front of the box. Ultimately, we settled on one version and built the final prototype containing Narcan and rubber gloves. The front of the box leverages highly visible branding and information about the medication. Box contains two Narcan doses and gloves.
The video below demonstrates a virtual usability test for our prototype: