title: Effects of two hospital bed design features on physical demands and usability during brake engagement and patient transportation: a repeated measures experimental study.
abstract: BACKGROUND
  Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare workers worldwide. While existing research has focused on patient-handling techniques during activities which require direct patient contact (e.g., patient transfer), nursing tasks also involve other patient-handling activities, such as engaging bed brakes and transporting patients in beds, which could render healthcare workers at risk of developing WMSDs.
  
  
  OBJECTIVE
  Effectiveness of hospital bed design features (brake pedal location and steering-assistance) was evaluated in terms of physical demands and usability during brake engagement and patient transportation tasks.
  
  
  METHODS
  Two laboratory-based studies were conducted. In simulated brake engagement tasks, three brake pedal locations (head-end vs. foot-end vs. side of a bed) and two hands conditions (hands-free vs. hands-occupied) were manipulated. Additionally, both in-room and corridor patient transportation tasks were simulated, in which activation of steering-assistance features (5th wheel and/or front wheel caster lock) and two patient masses were manipulated.
  
  
  METHODS
  Nine novice participants were recruited from the local student population and community for each study.
  
  
  METHODS
  During brake engagement, trunk flexion angle, task completion time, and questionnaires were used to quantify postural comfort and usability. For patient transportation, dependent measures were hand forces and questionnaire responses.
  
  
  RESULTS
  Brake pedal locations and steering-assistance features in hospital beds had significant effects on physical demands and usability during brake engagement and patient transportation tasks. Specifically, a brake pedal at the head-end of a bed increased trunk flexion by 74-224% and completion time by 53-74%, compared to other pedal locations. Participants reported greater overall perceived difficulty and less postural comfort with the brake pedal at the head-end. During in-room transportation, participants generally reported "Neither Low nor High" physical demands with the 5th wheel activated, compared to "Moderately High" physical demands when the 5th wheel was deactivated. Corridor transportation was similarly reported to be easier when a steering-assistance feature (the 5th wheel or front caster lock) was activated.
  
  
  CONCLUSIONS
  Braking and steering-assistance features of hospital beds can have important effects on task efficiency and physical demands placed on healthcare workers. Selection of specific designs may thus be able to improve productivity and contribute to a reduction in WMSDs risk among healthcare workers.
authors.affiliation: Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA.
authors.forename: Sunwook
authors.initials: S
authors.lastname: Kim
authors.forename: Linsey M
authors.initials: LM
authors.lastname: Barker
authors.forename: Bochen
authors.initials: B
authors.lastname: Jia
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Agnew
authors.forename: Maury A
authors.initials: MA
authors.lastname: Nussbaum
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001513:Beds / Q000592:standards*; D001696:Biomechanical Phenomena; D015400:Clinical Nursing Research; D004867:Equipment Design; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D055805:Moving and Lifting Patients / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D009140:Musculoskeletal Diseases / Q000209:etiology / Q000517:prevention & control; D015404:Nursing Methodology Research; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control; D011187:Posture; D018570:Risk Assessment; D013996:Time and Motion Studies; D014187:Transportation of Patients / Q000379:methods*