Nurse brings good news
Sunday, October 31, 2004 BY JIM LOCKWOOD
Just before one of Karla Coombs' patients headed home from Newton Memorial Hospital after surgery, Coombs showed her how to take her medicine through a feeding tube inserted into her abdomen.
The patient had to mix and pour medication into a big syringe, connect the syringe to the feeding tube, and then hold up the tube as the medicine dripped through.
It can be a difficult procedure. If the patient coughed or sneezed during the process, the medicine could spill or shoot back out of the syringe. Then, it would be impossible to know exactly how much of the dose got through.
"It's a nightmare for nurses," said Coombs, a registered nurse for 30 years who figured it would have to be even worse for patients or family members to do themselves.
Necessity became the mother of invention, and Coombs found a better way.
She took two pieces of equipment that were never intended to go together -- the large syringe and a drip chamber on the feeding-tube line, and fit them together. She put a cap on the open syringe end and a hook to hang it on an IV pole.
The 58-year-old nurse from Branchville called the adaptation a "dosage vessel," and had it patented in June. She said it could "revolutionize" the way medication is given in feeding tubes, and hopes it becomes widespread in hospitals, private homes, nursing homes, group homes and schools
Sharon Rainer, associate director of the New Jersey State Nurses Association, just might agree with her.
"It sounds like a great thing," said Rainer, a registered nurse and a leader in the 3,400-member advocacy group for the state's 110,000 registered nurses.
"You have to work with the products that are available and every nurse probably has some idea to make something better," she said. "But to actually carry it out ... (is rare)."
Rainer also agreed the device would benefit not only nurses, but also patients and their families.
"The traditional way (of dispensing drugs into a feeding tube) can be very messy. It would be nice to have it contained," Rainer said. "If you have this nice, intact system, it should be a little more palatable to patient. That's a big deal, not only for the psychological benefit of patients, but also for family members to do it. I've had families very stressed out about even watching them give the meds through the tube."
Patients typically have a feeding tube in their stomach or through their nose. The medication often is crushed pills that can cake up in the small tip of the syringe, or tiny time-release balls that can clog in the tip. Coombs snipped the small tip off the syringe to make a larger opening to help prevent clogging, and to make it fit snugly into the rubber drip chamber.
She's not surprised that no one fit these two pieces together before. "They weren't made to go together," Coombs said.
The drip chamber also can be gently squeezed to break up any clumping, and the device also has a vent to release air if needed and a roller clamp to control the flow of medication.
A cap to prevent spills and a hook to hang it up once the medication is poured in also would free up a nurse to do other tasks while medication drips by itself, Coombs said.
"Everybody I tell about it says, 'You gotta be kidding. Nobody thought of it before?' The patent attorney and (U.S.) patent office researched the world and there was no (such) device they could find," she said.
Coombs and her patent attorney submitted a patent application in February 2002. After various questions and clarifications, the patent was approved June 21. The concept still needs federal Food and Drug Administration approval, but Coombs is confident and hopes to find a manufacturer to make the dosage vessel and sell it worldwide.
Married for 40 years with eight children and 20 grandchildren, Coombs has invested $30,000 taking the idea from brainstorm to patent, and getting it protected in the United States, China, Canada, Japan and all of Europe.
"Nursing is a challenge," Coombs said. "My whole goal in doing this was just make it easy each time, rather than to just set yourself up for failure."