Designing an IV Pole Detachable Step/Footstool; Equity and Access in Telemedicine: How Institutional and Government Decisions Shape Healthcare in Nepal 6 views

Access to healthcare is shaped by more than just medicine. It depends on how tools are designed, how systems are organized, and how decisions are made at institutional levels. My thesis explores this idea through two projects that approach healthcare accessibility from different perspectives. My technical project focuses on designing a detachable stepstool for IV poles to reduce injuries among nurses at UVA Hospital. My STS research examines how government and institutional decisions shape the development and accessibility of telemedicine in Nepal. In hospitals, poor ergonomic design can make routine tasks unsafe for healthcare workers. In Nepal, limited infrastructure, uneven resources, and policy decisions affect who can receive care. Together, these projects show that improving healthcare access requires both better design and stronger systems. My technical project addressed a common but overlooked issue in hospital settings. IV poles at UVA Hospital are set at a fixed height, which forces shorter nurses to reach above safe shoulder angles when hanging IV bags. This increases the risk of musculoskeletal injuries, which are already common among nurses. To address this, my team designed a 3D printed detachable stepstool that attaches directly to the base of the IV pole. The stepstool includes a folding platform and a locking hinge mechanism, allowing nurses to safely reach IV hooks without overextending. The design was developed through CAD modeling and evaluated using finite element analysis to ensure it could support at least 350 pounds. Physical testing showed that the prototype could withstand loads up to 500 pounds without failure. We also incorporated a foot-activated hinge mechanism so the stepstool could be deployed without using hands, reducing contamination risk and improving workflow. This design improves safety and accessibility in a hospital environment by addressing a clear ergonomic limitation. My STS research focused on telemedicine in Nepal and how it has developed under government and institutional decisions. Telemedicine has been promoted as a way to improve healthcare access, especially in rural areas and during the COVID-19 pandemic when usage increased significantly. However, my research shows that access to telemedicine remains uneven. While policies and guidelines present a strong vision of expanding healthcare services, implementation depends on factors such as reliable electricity, trained healthcare workers, and consistent funding. Using the sociotechnical imaginaries framework, I analyzed how government visions for telemedicine are translated into real systems. By comparing policy goals with challenges identified in academic literature, I found that telemedicine in Nepal has developed in a way that expands access in some areas while leaving others behind. These outcomes are shaped not just by the technology itself, but by decisions related to infrastructure, training, and regulation. The stepstool design shows how a small change in a medical device can directly improve safety for healthcare workers. The telemedicine research shows that even large scale technologies cannot improve access without strong institutional support. Both projects highlight that engineering solutions are not just technical. They exist within systems that shape how they are used and who benefits from them. Engineering solutions should not only function well, but also actually improve access and outcomes in real situations.

BS (Bachelor of Science)

Telemedicine; Nepal; IV pole; Stepstool

School of Engineering and Applied Science Bachelor of Science in Biomedical Engineering Technical Advisor: Timothy Allen, Leslie Wood STS Advisor: William Davis Technical Team Members: Allan Cheng, Venkat Tummalapally

English

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2026-05-08