Biomechanical Evaluation of a Bed Feature to Assist in Turning and Laterally Repositioning Patients

Abstract

Objective: This study investigated the effects of hospital bed features on the biomechanical stresses experienced by nurses when turning and laterally repositioning patients. Turn Assist, a common feature in ICU beds that helps to rotate patients, and side rail orientation were evaluated. Background: Manual patient handling is a risk factor for musculoskeletal injury, and turning patients is one of the most common patient handling activities. No known studies have evaluated bed attributes such as the Turn Assist feature and side rail orientation that may affect the stresses experienced by the nurse. Method: Nine female nurses laterally repositioned and turned a 63-kg and 123-kg subject on an ICU bed while motion capture, ground reaction forces, and hand force data were recorded. Loading of the spine and shoulder was modeled using 3D Static Strength Prediction Program (3DSSPP). Results: Spine compression and shear forces did not exceed recommended limits when turning or laterally repositioning. However, the mean pull forces required to manually laterally reposition even the 63-kg subject was 340 Newtons, more than 50% greater than limits established in psychophysical testing. Turn Assist considerably reduced spine loading and pull forces for both turning and laterally repositioning. Lowering side rails reduced spinal compression by 11% when turning patients. Conclusion: Laterally repositioning patients as part of turning may pose an injury risk to caregivers. Turn Assist reduces physical loading on nurses when turning and repositioning patients. Application: Caregivers should consider using Turn Assist and other aids such as mechanical lifts or sliding sheets especially when turning patients requires lateral repositioning.