An evaluation of the biomechanical risks for a range of methods to raise a patient from supine lying to sitting in a hospital bed

2015-10-06T08:18:02Z (GMT) by Mike Fray Sue Hignett
Transferring patients has long been identified as a contributory cause of MSD in healthcare processes. One common action that is known to increase the musculoskeletal risk to healthcare workers is raising a person from supine lying to sitting on the side of the bed (Jordan et al., 2011). Best practice guidelines suggest that this activity should be replaced with mechanical devices e.g. profiling bed or hoist/lifter technology (e.g. Smith ed 2011). Practitioner evidence from many locations indicate that many people are being assisted from supine lying to sitting using manual techniques and healthcare workers are being placed at risk. This study reviewed several different methods using single and paired carers and different assistive devices to complete this transfer. A simulation task was designed as part of a user trial. Patient actors (n=4) were trained to respond as specific client groups who represented 2.5th, to 97.5th %-ile patients. Healthcare workers (n=9) completed 5 methods for raising a person from supine lying to sitting and 3 methods for lowering a person from sitting to lying with (1 and 2 carers). All conditions (n=11) were repeated to ensure a standard method and movements were recorded (n=5 minimum per participant). Data were collected for the biomechanical evaluation by motion capture (CODAmotion) technology, anthropometer data for body size and a Kistler force plate. Additional force measures for analysis of the loading calculations were recorded using a Mecmesin AFG2500N force gauge using staged re-enactments using repeated measures. All participants and patients completed subjective reviews of the transfers reporting effort, security and safety. The results were combined to calculate the musculoskeletal risks during the various transfers. Differences were identified between the movement, positions and the biomechanical loading characteristics of the fully manual methods, the profiling bed assisted methods and a novel assistive device. Practitioner Summary: The biomechanical risks of patient handling activities are well known. Many studies have quantified the risks for full weight lifting activities, which is widely accepted as hazardous and should be replaced by mechanical methods e.g. hoisting. The detailed biomechanical analysis of other patient handling tasks is not so well reported. This study explores the forces required to assist a range of patients from lying to sitting on the side of a bed and vice versa using a series of handling techniques. The results show that simple assistive devices that utilise the body weight of the patient can make a clear difference to the risks of these activities.