Staff at Tallaght University Hospital have invented a new device that enables a kidney patient to access dialysis at home, which in turn has allowed them to return to work.

Rona from Dublin began kidney dialysis in September 2021. While the necessary life-preserving dialysis treatment was vital, it was also preventing her from continuing to work. Each of her three weekly dialysis sessions lasted between three and four hours at the hospital.

As Rona was keen to return to the workforce, she asked the Renal Home Therapy Team at Tallaght University Hospital (TUH) if she could join their home haemodialysis programme.

For people living with a chronic disease, home dialysis represents an enormous benefit. In general, patients no longer have to spend up to 16 hours away from home every week getting treatment. They can have their dialysis at home at a time that suits them and their schedule. Critically for Rona, it meant she could return to work.

The Renal Home Therapies Team at TUH was keen to support her in this goal. The hospital has special training rooms set aside in the Vartry Renal Unit where specialist nurses teach patients to operate the home haemodialysis machine for themselves.

Rona started her training in the Renal Unit but soon faced a challenge. She was finding it impossible to manage the different lines that carry the blood in and out of her body and into and out of the dialysis machine. As she tried to use the equipment, the lines kept spinning around and Rona could not keep them steady enough to plug in or out.

Normally, before dialysis can begin, surgeons create a fistula in the patient's arm (by joining a vein to an artery). The fistula is important as it enables the dialysis lines to be connected to the patient’s body. A needle is inserted first into the fistula, which is then connected to the dialysis line.

As Rona is left-handed, surgeons first tried to create the fistula in her right arm, but this didn’t work. So the surgeons had to create the fistula high up on her left dominant arm. The positioning of the fistula was making it very difficult for Rona to try and connect and disconnect the lines with her weaker right hand. She was finding it impossible to manage the process independently. Rona explains that “with my left (dominant) hand out of commission, it was much harder, the lines were twisting and turning, it was just too wobbly.”

However, the TUH Renal Home Therapies Team did not accept defeat. They engaged with Innovate Health, the hospital’s special innovation team to see if a solution could be developed. After meeting with Rona to hear and see first-hand what the challenge was and what Rona needed, product designer Alexander Fives developed a clever solution to solve the problem.

Alexander made a special plastic device which looks just like a flat board with a raised sloped edge on one side. This raised edge has special slots which can hold the various lines steady, which means that Rona can now manage her own treatment independently.

Alexander explains that he “started off with a prototype model which Rona road tested. Working together we were able to iron out any pieces of the process that did not work. When we were both happy that we had a design that could work, I set about making the device in a format that is longer lasting and also meets infection prevention control guidelines.”

Applauding the success, Rona explains that “the new holder is working great.”

The Head of Innovate Health at TUH, Natalie Cole, explains that “Rona’s story is a great example of the can-do attitude among our staff and their desire to help patients overcome hurdles.

“By engaging with our designer Alexander, the Renal Home Therapy Team helped to create a bespoke device which gives Rona much more autonomy and a better quality of life. It also demonstrates how important it is to have an onsite innovation team to work with frontline medics, to solve problems for patients.”

Rona is now at home managing her dialysis independently around her work schedule. A successful outcome for all and a testament to the hard work of Innovate Health’s designer Alexander as well as the Renal Home Therapy Team.