Effect of a powered drive on pushing and pulling forces when transporting bariatric hospital beds

Efficacy of lifting devices for wheelchair transfers: a systematic review and meta-analysis

A high prevalence of work-related musculoskeletal disorders (WMSDs) has been reported among nurses as a result of the injuries caused by patient transfer and handling. This review examines the impact of motorised and non-motorised lifting devices on reducing physical stress during wheelchair transfers among nurses. Systematic electronic database searches were performed, and the review was prepared according to the PRISMA guidelines. The results of 20 studies on biomechanical stresses related to WMSDs were synthesised qualitatively, and 13 were analysed quantitatively using meta-analysis. Motorised lifting devices significantly decreased biomechanical stress among nurses [SMD -0.68; 95% CI -1.02 to -0.34], whereas non-motorised counterparts showed no significant change [SMD - 0.23; 95% CI -0.59 to 0.13]. This study underscores the effectiveness of motorised lifting devices in mitigating WMSD risk during wheelchair transfers. The findings provide practical guidance for hospital administrators, policymakers, and experts seeking suitable devices to prevent WMSDs in nursing professionals.

Practitioner Summary: This study investigated the impact of motorised and non-motorised lifting devices on nurses during wheelchair transfers. Findings revealed that motorised devices significantly reduce biomechanical stress, while non-motorised devices showed limited effectiveness. The research emphasises the superior role of motorised devices in preventing WMSDs during wheelchair transfers among nurses.

Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population.

METHODS

Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results.

RESULTS

A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention.

CONCLUSION

The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.

Determining the Number of Bariatric Beds Needed in a U.S. Acute Care Hospital

Aim:

This project used historical hospital data to forecast demand for specialized bariatric beds. Models were evaluated that determined the relationship between the number of bariatric beds owned and service level for patients of size requiring these beds. A calculator was developed for minimizing the equipment costs of meeting demand.

Background:

Failing to provide enough bariatric beds may negatively affect outcomes for patients of size and healthcare workers, whereas owning more bariatric beds than required to meet demand means unnecessary cost. With rising rates of obesity increasing care costs, minimizing equipment costs is increasingly important.

Method:

One year of hospital admissions data were used to determine arrival rates and lengths of stay for patients of size. Two subsequent years verified the consistency of these rates. Simulations modeled the flow of patients of size through the hospital and the service level associated with the number of beds owned. A minimization function determined the optimal number of bariatric beds to be provided. A simplified, generalizable model was compared to the simulation.

Results:

The simplified model produced similar results to more complex simulation. The optimization was robust, or insensitive to small changes in inputs, and identified substantial opportunity for savings if demand for beds was substantially over- or underestimated.

Conclusions:

The simplified model and cost optimization could be used in many situations to prevent costly errors in equipment planning. However, hospitals should consider customized simulation to estimate demand for high-cost equipment or unique circumstances not fitting the assumptions of these models.

Characterization of hand forces exerted during non-powered hospital bed pushing and pulling tasks

Accurate assessment of biomechanical risk associated with pushing/pulling tasks represents a challenging issue, especially in the health system where personnel are often required to maneuver beds and carts. Most studies in this field have been carried out in the laboratory, while few data have been collected under actual working conditions. This study aims to characterize the forces exerted during non-powered hospital bed maneuvering. Twenty participants were required to move a bed (equipped with a customized handlebar to measure exerted forces) along an actual hospital path including straight, turn and maneuver phases. The results show that higher forces are associated with the initial phase (peak and mean values 222 and 68 N) while the straight, turn and maneuvering phases required similar (lower) efforts. The combined effect of left, right and transversal forces suggests that the trunk of the operator might experience axial rotation, thus calling for further investigations of this aspect.

The effects of hospital bed features on physical stresses on caregivers when repositioning patients in bed

Repositioning patients in bed is the most common patient handling activity and is associated with musculoskeletal disorders in caregivers. Hospital bed features may mitigate the risk of injury. The current study investigated the effect of bed features on the physical stress on caregivers. Ten nurses were recruited to perform three repositioning activities. Hand forces were recorded, and spine loading was estimated using a dynamic biomechanical model. Results demonstrated that except for the peak L5/S1 compressive load in the turning task, the use of assistive features significantly reduced the physical stresses for all repositioning activities. However, recommended thresholds for injury were still exceeded in many conditions. Compared with spinal load, hand force was much higher relative to the injury thresholds, suggesting a greater risk of shoulder and upper extremity injuries than low back injury. Mechanical lift equipment remains the safest and most robust way to reposition a patient.

Human-Centered Design Process for a Hospital Bed: Promoting Patient Safety and Ease of Use

The modern hospital bed is a sophisticated medical device, and its users represent a diversity of abilities and needs. To develop a new bed, Hill-Rom studied these users in nearly 500 hr of observation across 29 hospital units. Focus groups were used to evaluate early concepts, and formative usability testing included over 130 users to evaluate design prototypes. This research and testing resulted in the development of the Centrella bed, which includes new features to address patient satisfaction, patient safety, and caregiver efficiency. The resulting design is the winner of the 2017 Stanley Caplan User Centered Design Award.

Design and Evaluation of a Motorized Robotic Bed Mover With Omnidirectional Mobility for Patient Transportation

Patient transportation in hospitals faces many challenges, including the limited manpower, work-related injuries, and low efficiency of current bed pushing methods. This paper presents a new motorized robotic bed mover with omnidirectional mobility to address this problem. This device is composed of an omnidirectional mobility unit, a force sensing-based human-machine interface, and control hardware with batteries and electronics. The proposed bed mover can be attached to the bottom of a manual hospital stretcher, transforming it into a powered omnidirectional bed (OmniBed) that can be used only by one person. The function of the OmniBed is compared with that of a conventional powered bed, which only provides forward assistance with a fifth powered wheel. We perform a pilot study with 14 subjects to evaluate the performance of this OmniBed and benefits for hospital application. The experimental results show that the OmniBed can half the manpower while decreasing back muscle activities, revealing the potential health benefits for older staffs. The OmniBed also shows the promising signs of high precision and handling in small spaces with its one-step "parallel-parking" ability. This device is more ergonomic, more effective, and safer than the conventional powered bed.

Experimental evaluation of a novel robotic hospital bed mover with omni-directional mobility

Bed pushing during patient transfer is one of the most physically demanding and yet common tasks in the hospital setting. Powered bed movers have been increasingly introduced to hospitals to reduce physiological strains on the users. This study introduces and quantifies the manpower efficiency and health benefits of a novel robotic-assisted omni-directional hospital bed transporter (SESTO Bed Mover) in comparison with a conventional manual transport stretcher (Stryker Trauma Stretcher 1037) and a powered transport stretcher (HOSPIMEK HMPT 740), which has a fifth powered wheel providing power assistance only in the forward direction. A total of 14 subjects were recruited (7 porters and 7 students) and were tasked to complete a course within a controlled lab environment. It is concluded that the robotic bed mover is able to halve the required manpower to push hospital beds as compared to conventional bed pushing without any additional physiological strain, potentially improving efficiency by two-fold. Electromyography (EMG) patterns showed that users relied on the shoulder and back muscles in a fashion similar to conventional pushing, further confirming the intuitive drive of the robotic bed mover. Overall, the robotic bed mover shows reduced physical demands, less manpower required for patient transport and reduced back muscle activities, which strongly suggest health benefits for workers in the hospital.

Ergonomic evaluation of brake pedal and push handle locations on hospital beds

Transporting patients in hospital beds is a physically demanding activity performed by healthcare workers and bed design may moderate the risk of injury. Nine healthcare workers participated in a study to investigate how brake pedal location affected maximal voluntary exertion (MVE) force and the level of acceptable force for engagement. Preferred and acceptable push heights when maneuvering a bed were also evaluated. The method of limits was used to determine acceptable forces and push heights. Results demonstrated that pedal depth, clearance above, and clearance behind the pedal significantly affected MVE force and acceptable force. Preferred push height was approximately at elbow level and a single height would not accommodate the user population. These findings provide important considerations for hospital bed design. The method of limits was a valid and reliable approach for evaluating user acceptance of design inputs characterized by continuous variables and may be useful in other design evaluations.