The Effect of Working Position on Trunk Posture and Exertion for Routine Nursing Tasks: An Experimental Study

Abstract

Objectives:To examine the influence of the two following factors on the proportion of time that nurses spend in a forward-bending trunk posture: (i) the bed height during basic care activities at the bedside and (ii) the work method during basic care activities in the bathroom. A further aim was to examine the connection between the proportion of time spent in a forward-bending posture and the perceived exertion.Methods:Twelve nurses in a geriatric nursing home each performed a standardized care routine at the bedside and in the bathroom. The CUELA (German abbreviation for ‘computer-assisted recording and long-term analysis of musculoskeletal loads’) measuring system was used to record all trunk inclinations. Each participant conducted three tests with the bed at different heights (knee height, thigh height, and hip height) and in the bathroom, three tests were performed with different work methods (standing, kneeling, and sitting). After each test, participants rated their perceived exertion on the 15-point Borg scale (6 = no exertion at all and 20 = exhaustion).Results:If the bed was raised from knee to thigh level, the proportion of time spent in an upright position increased by 8.2% points. However, the effect was not significant (P = 0.193). Only when the bed was raised to hip height, there was a significant increase of 19.8% points (reference: thigh level; P = 0.003) and 28.0% points (reference: knee height; P < 0.001). Bathroom tests: compared with the standing work method, the kneeling and sitting work methods led to a significant increase in the proportion of time spent in an upright posture, by 19.4% points (P = 0.003) and 25.7% points (P < 0.001), respectively. The greater the proportion of time spent in an upright position, the lower the Borg rating (P < 0.001) awarded.Conclusions:The higher the proportion of time that nursing personnel work in an upright position, the less strenuous they perceive the work to be. Raising the bed to hip height and using a stool in the bathroom significantly increase the proportion of time that nursing personnel work in an upright position. Nursing staff can spend a considerably greater proportion of their time in an ergonomic posture if stools and height-adjustable beds are provided in healthcare institutions.

Medical work assessment in German hospitals: a study protocol of a movement sequence analysis (MAGRO-MSA)

“…The angular accuracy of the sensors is better than 1° in quasi-static conditions [ 20 , 22 , 23 , 32 , 33 ].…”

Evaluation of a Training Program to Reduce Stressful Trunk Postures in the Nursing Professions: A Pilot Study

“…This coincides with the video analyses, in which we found that in 55% of bedside care situations, nurses only partially raised the bed, if at all. Although proper adjustment of the resident’s bed resulted in better working postures and less strain on the body (Freitag et al , 2014), nurses argued that this procedure was time consuming (Petzäll et al , 2001). However, it takes an average of 53–59 s to raise a bed from knee to hip height (Freitag et al , 2014).…”

“…The corresponding work situations were then analysed interactively, and alternative ergonomic solutions were discussed. The aforementioned laboratory study not only showed that raising the bed height and using a stool in the bathroom led to a reduction in unfavourable body postures but also that when participants adhered to these ergonomic principles they felt that their work was less stressful (Freitag et al , 2014). These findings were taken into account in practical implementation of ergonomic ways of working at the residents’ bedsides and in the bathroom (Table 1).…”

“…The proportion of time spent in an upright position increased significantly, by almost 20%, when the bed was raised from thigh to hip height. Similarly, working in a sitting, rather than a standing, position in the bathroom resulted in a significant increase (26%) in the time spent in an upright position (Freitag et al , 2014).…”

What do healthcare workers in elderly care know about occupational health and safety? An explorative survey

“…In addition to pressure loads, awkward body postures are common in elderly care [ 12 ]. These can be reduced considerably by adopting ergonomic measures such as raising bed heights [ 13 ].…”