External Hand Forces Exerted by Long-Term Care Staff to Push Floor-Based Lifts

Abstract

Results may help to address risk of work-related musculoskeletal injury, especially in locations with novel compliant flooring.

Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety

“…Focus group findings (sample size not reported) revealed that compliant flooring (Kradal, 1.20 cm) increased subjective ratings of leg fatigue for LTC nurses and difficulty when maneuvering equipment when compared to standard flooring (vinyl, linoleum, tile) [ 89 ]. In addition, six other records noted increased subjective ratings of perceived fatigue when maneuvering equipment, including beds [ 51 , 61 , 87 , 89 , 92 , 93 ], wheelchairs [ 51 , 89 , 93 ], stretchers [ 92 , 93 ], and floor-based lifts [ 51 , 61 , 87 , 89 , 94 ] over both carpet (n = 3 records) and NCF (n = 4 records) in acute and LTC settings.…”

“…Eight records revealed that carpet and NCFs increase the forces required to maneuver (push, pull, and/or turn) carts [ 84 – 86 ], beds/patient trolleys [ 90 ], wheelchairs [ 28 , 65 ], and floor-based lifts [ 90 , 91 , 94 ]. When considering recommended limits to safely maneuver equipment, 3 (of 6) records that examined carpet [ 86 , 91 , 94 ] and 2 (of 3) records that examined NCF [ 90 , 94 ] recorded values that were over the recommended limits, suggesting an increased risk for injury. Keeping the forces required to move equipment within recommended limits is essential to prevent injury, as indicated by one record which documented 5 adverse events from staff working on a NCF in a 16 month period, including 1 lower back muscle strain while moving a patient on a trolley (Tarkett Omnisport Excel, 0.83 cm) [ 73 ].…”

“…Third, the number of records representing the workplace theme is relatively small and, in general, conclusions were derived from small sample sizes. Despite several records acknowledging that compliant flooring increases the effort or forces required for participants to use medical equipment, only a few records tested a proposed solution (i.e., modifications to wheel characteristics, using motorized floor-based and ceiling-mounted patient lift systems instead of traditional floor-based lifts [ 85 , 89 , 91 , 94 ]). Future workplace safety studies should work to identify and examine additional potential solutions to the previously identified concerns of maneuvering equipment over compliant flooring.…”

“…Future workplace safety studies should work to identify and examine additional potential solutions to the previously identified concerns of maneuvering equipment over compliant flooring. Future study protocols should also reflect tasks and situations that are common in the workplace, such as measuring the force requirements to move equipment in confined spaces [ 91 , 94 ], testing a variety of healthcare worker populations, including novice and aging populations [ 84 , 87 , 89 , 92 ], randomizing the conditions being compared, and blinding the flooring systems that are being evaluated (when possible) [ 51 ].…”

A comparison of floor surfaces for injury prevention in care settings: impact forces and horizontal pulling force required to move wheeled equipment

“…Whilst the proposed testing method is written in the context of hip protector assessment, here we have used it as a novel basis for comparing flooring products, with a view to extending further standardization to this field. A hospital-based pilot study of shock-absorbing flooring for fall-related injury prevention indicated that the intervention has promising features with regards to potential for injury prevention (yet to be verified by a definitive trial) [32]; however, adverse effects may be present for staff having to wheel heavy objects across the floor, with risk particularly increased in instances where staff are handling equipment in isolation [33][34] [35]. There is an important assessment to be made therefore, when selecting a shock-absorbing flooring product, to understand the potential trade-off between impact force reduction and horizontal pulling force required to move wheeled objects.…”