NURSEWEEK: Kid-proof solution: Nurse adapts adult device to monitor children's heartbeats

Kid-proof solution
Nurse adapts adult device to monitor children's heartbeats

By Janet Kilgore
October 16, 2000
Photo: Texas Children's Hospital

Mary Beth Mauer, RN,of Texas Children's Hospital, enjoys the company of two pediatric patients. The children are wearing Mauer's invention, the TeddiTop, a vest that carries heart monitors.


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A resident of Houston since high school, Downers Grove, Ill., native Mary Beth Mauer lives with her husband, Ken, their two Labrador retrievers, Dave and Chula, and their two adopted daughters, Milagro, 9, and Lourdes, 10, who she met while working at Texas Children’s Hospital.

Six years ago, Mary Beth Mauer, RN, a clinical research nurse in the department of pediatric cardiology at Texas Children’s Hospital in Houston, had a problem. She was participating in a long-term study funded by the National Institutes of Health to track the natural history of AIDS in the pediatric population. This involved patients wearing a Holter monitor for up to 24 hours and going about their normal activities as the device registered data about their heartbeats.

The 2-pound monitor presented little problem for the older children in the study, but Mauer was working with some as young as 1 and 2.

"The monitors used with the children were the same ones used by adults. The shoulder straps made the monitors drag on the floor. And the kids had full access to it, too. They’d pull the tubes and wires out, which disrupted the data gathering," she said.

She put her problem-solving skills to work and invented a solution: the TeddiTop. Similar to the safety vests worn by highway workers, it slips over the child’s head, fastening on the side with ties. A pouch on the back holds the monitor safely out of reach.

"It took about three months to come up with the initial prototype," Mauer said, "and within six months, we had developed a final vest. We tried Velcro to close the sides, but it didn’t work. The children could pull it open. We tried bow ties, and still use them. There’s Velcro on the back pocket, to keep it closed," she said.

She uses the term "we" because the first TeddiTop was a group effort.

"When I was a teen-ager, a lady I baby-sat for taught me to sew. That lady, my sister-in-law and I got together and made the first one. After that, participation seemed to be contagious. Volunteers from Texas Children’s Hospital, the Gulf Coast Quilt Guild, the American Heart Association and Houston Alpha Phi Alumnae all eventually got into it, making vests and providing funding."

Funds have come from many sources, including the Alpha Phi annual lollipop sales, grants and the auxiliary to Texas Children’s Hospital.

"My mother happens to be the president of the auxiliary. She’s always been my biggest cheerleader, so she got them involved and was instrumental in getting the vests made."

Mauer’s invention met with mixed responses from her co-workers and others in the study. Telemetry at the hospital adopted the vests, but other departments turned them down. At a meeting of participants from other sites in the study, her idea was well-received. Back at the study centers, however, the concept fell apart in practice.

"I did it originally for my personal needs, to collect data, which wasn’t working with adult monitors. I was having success getting the data and other centers weren’t. Volunteers made my vests – other centers had trouble getting that kind of help. They didn’t want to use the idea, but eventually did. It was a matter of getting the data," she said.

To ensure the quality of the data, the children must be able to move about freely and play normally. The TeddiTop lets them do just that.

"It’s important to collect long-term data to accurately diagnose the children’s conditions. The vest is recommended for toddlers, basically from 1 to 3 years old. They’re not restrictive for the child. Also, the TeddiTop takes away some of the child’s fear of the monitor, and they get to choose which vest they’ll wear."

The children love getting to choose, and great pains are taken to make the vests attractive.

"Mostly we use denim prints. It’s sturdy and washes best. They use different designs, different patterns of denim, like with teddy bears and such, with different trim," Mauer said.

Last year, Texas Children’s Hospital asked the community to make donations to increase the number of Holter monitors and TeddiTops. For $2,000, the unit was inscribed with the donor’s name and a dedication. The TeddiTop captured the public’s imagination and made the drive a success.

"One vest was dedicated to Katy the Wonder Dog, and that unit is a great favorite with the children. We greatly increased our supply of monitors and TeddiTops, thanks to that drive."

Mauer’s advice for nurses who have a product idea to improve patient care? Get people around you involved.

"Community support and volunteers made the TeddiTop possible. The lady who came up with the name, the patch, the sewers, and my mother, who got donations and community support – they made it possible. We don’t make money on it – it’s just to help the kids.

"When I see the little kids in the vests, playing and laughing, the feeling is incredible. That’s what it’s all about."