As a registered nurse, Jill Drew has watched the number of type 2 diabetes patients with chronic kidney failure grow. More than half of these patients have an arterioveinous fistula surgically created in the arm to create an easier, safer access point for dialysis, thanks to a CMS initiative called Fistula First. But Drew has seen firsthand that there’s a risk busy nurses overlook a wristband alerting them to avoid using the av fistula arm for an IV hookup, blood pressure cuff or blood tests. She decided that a bigger stop sign was needed.
That planted the seed for the NoNo Sleeve. Call it a textile equivalent of a big stop sign warning nurses and other healthcare professionals to use the other arm.
Drew started the company two and a half years ago near Baltimore, Maryland. Her co-founder Kelly Reif, another RN, joined more than one year ago.
Although AV fistulas are the most common reason for the sleeve, Reif and Drew say mastectomies where the lymph system is interrupted can also pose problems if the wrong arm is used. Lymph nodes help drain fluid and other cells out of the arm. When a patient has lymph nodes removed as part of a mastectomy reduces the drainage system to carry fluids away from the arm. Complications could result in secondary lymphedema. Using an arm with an av fistula for an IV or blood pressure cuff can lead to a litany of potential problems. It could mean an increased risk of a blood clot forming or additional surgery to fix the fistula and the unwelcome wrath of the surgeon who performed it.
Drew and Kelly see the device as a useful, simple way to prevent costly medical errors that can be accompanied by additional hospitalization. Hospitals are he main customers for the sleeve and a national map they keep in their office is peppered with pins charting its customer base. It frequently receives orders from patients or their families keen to protect loved ones in the hospital. It also helps reduce patient anxiety. That’s an exciting development, said Drew, because it can lead to hospitals adopting the sleeve.
Although the company’s is generating enough revenue to pay for its operating costs, Drew and Reif are convinced there is much more room for the company to grow. Neither has quit their day job, though they have each scaled back their hours. Reif has switched roles from nursing to the administrative side.
Still, Drew admits growing the business has been a grind at times. Numerous calls and emails will sometimes only yield a handful of responses. She continues to split her hours between the business and her work as a post anesthesia recovery nurse.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The way Drew and Reif set the scene of a typical hospital, nurses are constantly innovating and troubleshooting as they manage patient care. They both believe the NoNo sleeve is only the beginning. It’s also looking at ways to reduce bed sores, among other areas.
