Radin Zaid Radin Umar

Hospital Patient Room Design The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms

Objective: The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. Background: In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. Method: One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Results: Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. Conclusions: There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress.

Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions

Abstract For more than two decades, surveys of imaging technologists, including cardiac sonographers, diagnostic medical sonographers and vascular technologists, have consistently reported high prevalence of work-related musculoskeletal discomfort (WRMSD). Yet, intervention research involving sonographers is limited. In this study, we used a participatory approach to identifying needs and opportunities for developing interventions to reduce sonographers’ exposures to WRMSD risk factors. In this paper, we present some of those needs. We include descriptions of two interventions, targeted for cardiac sonographers, that were developed, through an iterative process, into functional prototypes that were evaluated in pilot tests by practicing sonographers. One of these interventions is now in daily use. We would like other engineers and ergonomists to recognise this area of opportunity to apply their knowledge of biomechanics and design in order to begin to address the high prevalence of WRMSDs in sonographers, by working with sonographers to develop useful and usable interventions. Practitioner Summary: This paper discusses needs, opportunities and methods for working with sonographers in order to develop interventions to reduce their exposure to risk factors for work-related musculoskeletal discomfort. Results from field tests of two novel interventions targeting cardiac sonographers are also presented.

Association between spinal loads and the psychophysical determination of maximum acceptable force during pushing tasks

The objective of this study was to investigate potential associations between an individuals psychophysical maximum acceptable force (MAF) during pushing tasks and biomechanical tissue loads within the lumbar spine. Ten subjects (eight males, two females) pushed a cart with an unknown weight at one push every two minute for a distance of 3.9 m. Two independent variables were investigated, cart control and handle orientation while evaluating their association with the MAF. Dependent variables of hand force and tissue loads for each MAF determination and preceding push trial were assessed using a validated, electromyography-assisted biomechanical model that calculated spinal load distribution throughout the lumbar spine. Results showed no association between spinal loads and the MAF. Only hand forces were associated with the MAF. Therefore, MAFs may be dependent upon tactile sensations from the hands, not the loads on the spine and thus may be unrelated to risk of low back injury. Practitioner Summary: Pushing tasks have become common in manual materials handling (MMH) and these tasks impose different tissue loads compared to lifting tasks. Industry has commonly used the psychophysical tables for job assent and decision of MMH tasks. However, due to the biomechanical complexity of pushing tasks, psychophysics may be misinterpreting risk.

A biomechanical and subjective comparison of two powered ambulance cots

This study investigated biomechanical effects of different leg folding/unfolding mechanisms used for loading/unloading two powered cots (Cots A and B) into and from a simulated ambulance. Sixteen experienced emergency medical service (EMS) workers loaded and unloaded cots with weights of 45, 68 and 91 kg placed on the cots to simulate patients. Peak back and shoulder/arm muscle activity was reduced 52–87% when using Cot A in comparison to Cot B. Peak ground reaction force (PGRF) was reduced by 74% with Cot A. Adding weight resulted in increased muscle activity and PGRF when using Cot B, but had little effect when using Cot A. Task time was longer with Cot A, though was not perceived unfavourably by participants. This study confirmed that it is possible to substantially reduce physical stress imposed on EMS workers when loading and unloading a cot to and from an ambulance through improvements in cot design. Practitioner Summary: This study compared two powered ambulance cots, one that lifts/lowers the front and rear wheels independently and one that lifts/lowers the four wheels simultaneously during ambulance loading and unloading. Measured muscle activity, ground reaction forces and operator perceptions support using cot designs that lift/lower the front and rear wheels independently.

A biomechanical and subjective assessment and comparison of three ambulance cot design configurations

Effects of ambulance cot design features (handle design and leg folding mechanism) were evaluated. Experienced ambulance workers performed tasks simulating loading and unloading a cot to and from an ambulance, and a cot raising task. Muscle activity, ratings of perceived exertion, and performance style were significantly affected by cot condition (p < 0.05). Erector Spinae activity was significantly less when using Cot-2s stretcher-style handles. Shoulder muscle activity was significantly less when using Cot-2s loop handle. During loading and unloading, operators allowed the cot to support its own weight most often with Cot-2s stretcher-style handles. Preference for Cot-2 (either handles) over Cot-1 (with loop handle) was consistent across tasks. Handle effects were influenced by operator stature; taller participants received more benefit from Cot-2s stretcher-style handles; shoulder muscles’ demands were greater for shorter participants due to handle location. Providing handle options and automatic leg folding/unfolding operation can reduce cot operators effort and physical strain. Practitioner Summary: Paramedics frequently incur musculoskeletal injuries associated with patient-handling tasks. A controlled experiment was conducted to assess effects of ambulance cot design features on physical stress of operators, as seen through muscle activity and operators perceptions. Differences between cots were found, signalling that intentional design can reduce operators physical stress.

Participatory Ergonomics Applied to Sonographers’ Work

A participatory ergonomics process has been initiated, the aim of which is to work with cardiac, vascular, and diagnostic medical sonographers to develop interventions that will improve their work conditions and reduce their occupational exposure to risk factors for musculoskeletal discomfort. Numerous surveys have been conducted that have identified sonographers as experiencing high rates of work-related musculoskeletal disorders. However, intervention research involving them is limited. The presentation describes the research methodology and results from the first stages of the intervention process.

Barriers to Infection Control due to Hospital Patient Room Factors A Secondary Analysis of Focus Group and Interview Transcripts

Infection control is of central importance when designing hospital rooms, particularly to reduce hospital-acquired infections. Existing room design standards include private rooms, toilets, and showers, ample space between a patient’s bed and a family member’s bed, and separate spaces for clean and dirty nursing activities. We investigated various hospital room factors that make it challenging for staff to reduce hospital-acquired infections. Focus groups and interviews were conducted with multiple stakeholder groups as part of a larger research effort to generate guidelines for hospital room design. Transcripts were generated for eight of these stakeholder groups, including housekeeping staff, and qualitatively analyzed for emerging themes. The insights suggest additional areas for consideration during the design of hospital rooms, in particular the need for standardized, dedicated locations for supplies brought into the patient room and inclusion of the perspective of housekeeping staff in the design process.

Collaborating with mammographers to address their work-related musculoskeletal discomfort

Abstract Mammographers are an understudied group of health care workers, yet the prevalence of musculoskeletal (MSK) symptoms in mammographers appears to be elevated, similar to many occupations in health care. In this study, we used a participatory approach to identify needs and opportunities for developing interventions to reduce mammographers’ exposures to risk factors that lead to the development of MSK symptoms. In this paper, we present a number of those needs and several intervention concepts along with evaluations of those concepts from experienced mammographers. We include findings from a preliminary field test of a novel intervention concept to reduce the need to adopt awkward postures while positioning patients for a screening or diagnostic mammogram. Practitioner Summary: This paper discusses needs, opportunities and methods for working with mammographers in order to develop interventions to reduce their exposure to risk factors for work-related musculoskeletal discomfort. Results from a field test of a novel intervention to reduce mammographers’ awkward work postures while positioning patients are presented.

Powered Ambulance Cots: Effects of design differences on muscle activity and subjective perceptions of operators

An experiment was conducted in order to examine the effect of differences in the design of two powered ambulance cots on operators. Experienced EMS workers performed two common tasks, loading and unloading the cots from a simulated ambulance bed. Dependent measures included muscle activity (trunk, shoulder, and arm muscles) and subjective perceptions. Independent variables were cot (Cot R and Cot Y), and weight on the cot (100, 150, and 200 lbs., to simulate patients of different weights). Muscle activity was found to be significantly lower when using Cot R, for both tasks, in comparison to Cot Y. Subjective preferences were mixed, with many subjects preferring the handle design of Cot Y, while preferring Cot R overall. This study showed that it is possible to substantially reduce the physical stress imposed on operators when loading and unloading a cot to and from an ambulance through improvements in cot design.