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Using design to reduce cross infection

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A porter’s chair was redesigned to help reduce the risk of healthcare associated infections


Jane Kent, is new product development manager, Vernacare.


Kent, J. (2009) Using design to reduce cross-infection. Nursing Times; 105: 36, early online publication.
The Design Council and the Design Business Association held a Design Bugs Out challenge this year. The aim was to looks at how design led innovation can combat healthcare associated infection. This article describes how one of the winning designs was developed.

Keywords: Healthcare-associated infections, Porter’s chair, Design

The winners of the national Design Bugs Out challenge organised by the Design Council and the Design Business Association on behalf of the NHS Purchasing and Supply Agency were announced this year. The aim of the challenge was to identify and fast-track the implementation of new technologies and design led innovations to combat healthcare associated infections.

The project, funded by the Department of Health, challenged teams of designers and manufacturers to redesign furniture and equipment to make them easier to keep clean and help reduce HCAIs. The successful teams were awarded £25,000 each to develop their concepts, which included solutions for porter’s chairs, commodes, mattresses, patient furniture, patient chairs, cannulas, curtain clips and blood-pressure cuffs.

Designing a porter’s chair

A porter’s chair poses an infection risk because it transports patients inside and outside the hospital.

The design of the traditional porter’s chair has stood still for 30-40 years. As part of the Design Bugs Out challenge, Vernacare and its design consultancy Minima have redesigned the product.

The new chair was designed from scratch. The starting point was to research user touch points - examining precisely which parts of the chair are touched most frequently and assessing the potential for spreading infection. Coloured chalk was used on the hands of volunteer porters and patients to map these high contact areas and inform the redesign.
Experts, including infection control nurses, porters, lifting and handling experts and other healthcare staff were consulted to gain insights into what the design should include.

Different construction techniques, materials and production processes and the number of wheels were examined.
The development team looked at improving manoeuvrability and patient comfort, and improving the brakes and stability. Another important consideration was the patient’s sense of well-being. Therefore the chair had to feel safe to sit in, look clean and be easy to wheel around.

The new chair has very few dirt traps and is quick and easy to clean. It incorporates a footrest that rests on the floor but is raised as the patient’s weight is applied to the seat thereby eliminating the need to use hand contact in manoeuvring it.
The surfaces of the chair are smooth and easy to clean, and any joins are carefully located to reduce the risk of trapping harmful bacteria.

The chair’s metal frame is protected by a smooth plastic body, and is made up of three moulded plastic parts that come apart for deep cleaning. Single parts can be replaced in the event of damage.

The arms swing out of the way for lateral transfer of patients and the leg supports can come straight out or angle down at 20º to provide support without the need to elevate the whole leg to horizontal.

The new design also incorporates storage space for gas bottles and patient documents; a flat base under the seat provides a storage area for the patient’s belongings. There is a hook for carrying catheter bags. A holder for antibacterial wipes encourages frequent cleaning.

The chair’s braking system locks all four wheels at once, making it safer and easier to get in and out of. The new design uses light coloured materials which help to reassure patients that the chair is clean.

Manufacture of the chair is expected to begin later this year, with a view to having the product available by early 2010.

For further information on the challenge and award winning designs visit

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