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Home Forums General Ergonomics Topics Ergonomics of pushing hospital beds on carpet vs smooth flooring

This topic contains 16 replies, has 13 voices, and was last updated by  pjacobs 10 years, 6 months ago.

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  • #36537

    FLOBRN
    Participant

    Greetings

    My first visit and posting to all, I hope someone can point me in the correct direction.

    I am a Labor and Delivery nurse in Florida. My "mission’ is to get the carpeting out of our perinatal unit. The labor and post partum beds are heavy. The average patient is now 250 lbs and up – HEAVY. We have to push these patients in the beds from the labor room to the OR. Then from the recovery room to their rooms on Mother Baby. Even with 2 people to push the bed and the IV pole it is difficult. Our backs hurt. Administration needs to be convinced to get the carpet out. We have not been able to accomplish this via the sanitation route but I think the ergonomics route may have a chance.

    Do any of you have resources I can use to show them how much more force carpet vs tile uses. Resources showing the incidence of back injury would be wonderful. My dream is a project titled "Improving Ergonomics in a Perinatal Setting". Leaning over Moms helping with breastfeeding is a whole other issue and is in fact, the reason I gave up that particular job.

    Hoping to hear from some of you.

    FLOBRN

    [email protected] 

    #39618

    [private user]
    Participant

    Cheryl,

    I agree, pushing a heavy cart on a carpeted floor requires considerably higher pushing forces than on a hard (tile) surface.  I would suggest that you hire the services of a certified ergonomist (CIE or CPE) to take readings of the actual forces required to push the cart (with passenger) on the various floor surfaces using a push/pull force gage.  This data can then be used to evaluate the task using the Liberty Mutual (Snook) tables, or possibly another method.  The Snook tables are a great source for determining the acceptable range for various pushing tasks, and would be appropriate to use in justifying changes to your floor covering material.

    There may be other alternatives to consider in controlling this risk, such as larger wheels or different tread surfaces (tires).  An ergonomist can help with this as well.

    Hope this helps…

    Joe Fox

    #41025

    [private user]
    Participant

     

    Hi Cheryl

     

    I’m surprised the sanitation factors weren’t convincing enough considering the environment in any hospital today.  

    In considering other changes – larger castors etc management might well find that removing carpeting would prove more economic than changing the beds.  .  

     

    As for push forces on different surfaces, one hospital-based study looked at hospital meal carts (Das, Wimpee, Das; Ergonomics evaluation and redesign of a hospital meal cart;Applied Ergonomics 33 (2002) 309–318; http://dx.doi.org/10.1016/S0003-6870(02)00018-2 )

     

    You might check out studies done on manual wheelchair propulsion forces over different surfaces – I’ve seen a fair amount of research put out on the subject. 

     

    Finally, there is a huge amount of information on nursing injuries (pushing a bed may be a musculoskeketal risk factor, but certainly one of many) There is a growing recognition of the fact that safe patient moving and handling saves nurses’ backs and makes economic sense.  Organizations such as the Patient Safety Center based at the Tampa VA Hospital (http://www.visn8.med.va.gov/patientsafetycenter) or WINGUSA (Work-injured nurses group) are excellent sources of information.  

    If you need more information or references regarding nursing injuries and hospital ergonomics programs you are welcome to get back to me.

     

    Good luck

     

    Joan Geiger

    ErgoCare

    Tel Aviv

     

     
    #41192

    pjacobs
    Participant

     Cheryl,

    This is a common issue, so you may be able to contact other hospitals to support your position.

    Working with nursing homes, we found that, when pushing med carts, the required pull forces on low nap carpet could be up to 3 times that required for pulling them on smooth, hard floor surfaces.

    This is an easy thing to measure, but requires a good quality ‘push-pull gauge’ or force gauge (typically $500 +).  However, you may find that a rehab or PT unit has one available for your use so that you can take some sample measurements and get people’s attention.

    There are many factors here: the weight/size of the beds; the size and type of the wheels on the beds and other equipment; the specific type, style, and pile of the carpet; etc.  There are many facility issues, such a noise, slip and fall, sanitation, etc., that also affect the issue of carpeting in health care facilities, so the decisions can be complex.

    Another avenue to explore would be the use of powered assists, or bed movers, to remove the manual component of the bed moves.  There are several vendors selling this type of equipment, and they likely can provide you with additional justification for the use of these types of products.

     

    Good luck

     

    Philip Jacobs

    Philip Jacobs, MS, CSP, CPE

    Jacobs Consulting, Ltd.

    #39620

    FLOBRN
    Participant

     THANKS!! to all who have responded so far. "keep those cards and lettters coming". I am hopeful we can get management to listen.

     

    Cheryll Howe

    #39621

    FLOBRN
    Participant

     Phillip

     

    Can you email me the names of the companies selling this equipment. We did a trial of one company that has a device like you see moving grocery carts in parking lots. It would only just barely move our beds while they were in the low position and would need extensive modification to be adaptable to labor and delivery beds.

    I "googled" the subject but was only able to find the company above.

     

    Best Regards

     

    Cheryll Howe

    #39622

    pjacobs
    Participant

     Cheryll,

    Many of the companies who make things like cart movers also make products like bed movers, so they are a good start.  Also, contacting hospital bed manufacturers or vendors is a good approach as they will be familiar with mover products that are compatible with their beds.

    I don’t sell or represent any of these products.  But if you Google ‘hospital bed movers’ you will find a bunch of hits, including both domestic and international vendors.  Some of these companies have familiar names from industrial products.  Some may specialize in health care applications.

    Some sample names, to get you started, include those listed below.  It is in no way an exhaustive list, nor am I recommending or endorsing any for your application, but it should give you an idea of what is available, what the cost range is, limitations, applications, etc.

    Good luck.

                http://www.daneindustries.com/

                http://www.nustarinsc.com/

                http://www.djproducts.com/

    PHS West            http://www.phswest.com/

    Lockwood            http://www.lockelec.com.au/evo-mover.html

    Electrodrive            http://www.electrodrive.co.nz/healthcare/healthcare-bedmover/

    Philip Jacobs, MS, CSP, CPE

    Jacobs Consulting, Ltd.

    #39604

    [private user]
    Participant

    Cheryl,

    In measurements we have taken of our own hospital beds, the push force on lineoleum is 23-30% lower than on carpet.  This would be a very inexpensive way for your administration to reduce risk of injury for all caregivers (and better for infection control!)  We removed our carpet about 10 years ago.

    We also found that pushing a 140 pound patient on a Total Care bed ranges between 20-40 pounds of push force on linoleum.  Depending on the distance travelled, this is likely already beyond the safe limits for pushing for most women according to the Snook tables.  Obviously with patients heavier than 140 pounds, the push forces will only be greater.

    Feel free to contact me if you need additional help or information.

    Tamara James, Duke University Ergonomics Director, 919-681-3140

    #40697

    [private user]
    Participant

    Visit http://www.djproducts.com and click on Ergo Calc.  the software package will allow you to enter known data for both hard floor and carpet conditions thereby providing you data regarding difference in push/pull forces for the different surfaces. 

    Hope this helps and best of luck to you in your efforts.

    Joe Selan

     

    #39627

    Johngh
    Participant

    Cheryl

    All of the advice you have received in this thread is good! However there are a number of variable factors which will affect the results of any measurements you make to determine the effort required to move a given patient on a given bed!

    Some of these factors are unique to your own facility, some are universal across all facilities.

    These variable factors, which are unique to your facility include:

    The type of carpet on the floor (ie wool, nylon or a mix), the length of the carpet pile, the thickness and type of underlay between the carpet and the hard floor surface beneath, the "nap" of the carpet relative to the direction of travel, any ramps, slopes or gradients which have to be negotiated, and the amount of space available in which to manuoevre the bed.

    The more universal factors include:

    The weight of the patient, the type of bed used, and, most importantly, the size and condition of the bed castors.

    Castor size and condition is usually the most overlooked factor. The larger the castor the less rolling resistance it produces. However, even a large castor which is in poor condition will increase rollng resistance by a significant amount, making the same weight much harder to move.

    Replacing the carpet with a hard surface vinyl product will certainly reduce the problem – but it will not elliminate it completely. The hard surface makes the initial inertia easier to overcome – but makes stopping and turning more difficult as you do not have the resistance of the carpet to assist you!

    The only way to totally elliminate the problem, and move beds and patients safely, is to use a mechanical device to do the work for you. It is also by far the most efficient solution, as it no longer matters what is on the floor or how heavy the bed and patient may be (within the specified limits of the device), a single operator can move any patient in complete safety.

    There are several companies which produce such devices, and I must declare an interest, as my own company Electrodrive NZ Ltd is one of them!

    We will be more than happy to provide any further information which may assist you, please do not hesitate to contact us or visit us at http://www.electrodrive.co.nz

    Best regards

    John Henderson, Director, Electrodrive NZ Ltd

    #39630

    GailNash
    Participant

    Cheryll,

    Read all the responses you have received to date and there is a lot of good information there.  Would like to key in on a few points; all carpets/soft surfaces are not the same and size does make a big difference. 

    Size refers to wheel diameter.  As mentioned in several of the responses; caster size can help.  HillRom and Stryker offer their beds with either a 5.25" and an 8" hard rubber caster.  Majority of the time hospitals order the 5.25" caster.  If they would use the 8" model it would significantly increase the mobility. 

    Measuring mobility with a wheel chair will not give you a true reading.  The diameter of the main wheel is very large.  We have done many studies comparing different surfaces using a "hospital bed" weighing 950 lbs.  On the different surfaces we compared the starting loads, continuing motion load and the pivot motion load.  There are big swings in load weights between hard surface and a "soft surface", but there are also substantial differences within the soft surface offerings.

    12′ wide broadloom is contructed on a backing that is designed to stretch (so they can match seams when installing).  That stretch, even when direct glued, allows the product to move over time, creating slight (or sometimes noticable) ridges, making it harder to push across.  The backing construction is key.  You want more of a hybrid flooring; a vinyl backing with a dense textile face. 

    The backing provides a stable base for the face fiber.  The face fiber should be at the very least  a 10th guage, preferably higher, of an all loop construction….low and dense.  As was pointed out in an earlier message, soft surfaces provides needed acoustic value, comfort under foot for extended standing/walking and a warmer visual with less glare (which is a key issue these days).

    The current carpet you are struggling with maybe the wrong product for the application. 

    Gail

    #40699

    mwh001
    Participant

    Hi Cheryl,

     

    I am an occupational therapist and ergonomist.  I used to work for a hospital corporation in Minnesota.  I echo Phil Jacobs’ comments, and I have data I can share, as well, since  I did a comparison study addressing this very issue for my previous employer.  Let me know if you’d like that by sending me a personal message.

    Best regards,

    Mark

     

     

    #40736

    [private user]
    Participant

    Hi Cheryl,

    I would certainly encourage you to take some measurements to build a case for changing out the carpets.  The Snook tables are great comparison tables.

    I have had very good luck with DJ Products as suggested by Philip Jacobs.  They were very accommodating in sending a trial puller to the site.

     

    Linda Miller, OT, CPE

    EWI Works International Inc.

    #41136

    glen_smith
    Participant

     

    The document below may be of benfit to you also as it has a simplified version of snook and cirello and variety of other guidance on various matters

    http://www.worksafe.vic.gov.au/wps/wcm/connect/wsinternet/worksafe/home/forms+and+publications/publications/import_designing+workplaces+for+safer+handling+of+patients+and+residents

    Designing workplaces for safer handling of people

    Designing workplaces for safer handling of people formerly known as Designing workplaces for safer handling of patients and residents is a publication for planners, facility managers and direct care staff. The publication is intended for those who have design and layout of a current workplace contributing to injuries, organisations designing new facilities or planning renovations, and for workers involved in the

    Cheers Glen

    #39661

    ClarenceFlagg
    Participant

    Hey Cheryll I hope they get rid of the carpets like you suggested. If anyone doesn’t realise that carpet causes more firction and is harder to work on than hard flooring then they’re pretty dumb. Also carpets harber more germs and are much harder to clean than hard flooring so it’s pretty stupid to have carpet in that condition anyway.

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