I wanted to present a study this week to show an example of objective assessment of equipment solutions for manual handling.
Weiner et al. (2017). Repositioning a passive patient in bed: Choosing an ergonomically advantageous assistive device. Applied Ergonomics, 60 (2017), 22-29.
I love looking at studies like this as although they are for research and research is not what we are trying to do in practice, they give us a really great template for making clinical reasoning decisions.
The study aims to evaluate how the use of three devices for repositioning a person (of 75kg) in bed impacts the loading on the back of the care worker.
The three conditions were:
- Cotton sheets
- Regular slide sheet
- Molift Multitrans with lifting handles on the side
They measured the risk of loading on the lower back using
- Electro-gomiometer – this measures the physical deviation from neutral body and is an observation tool
- Borg Scale of Perceived Exertion – this measure the care workers experience of the task
We all know what neutral body looks like. Breaking the task down into pieces you could easily do a checklist for how many times a person deviated from this neutral state when using device 1. You could compare it with the second device you are looking at.
Secondly, you don’t need to use a borg scale, you can just get a care worker to rate their experience – 1 being really easy and 10 being really hard – what was the task like with device one versus device two?
What’s more, there is a table on page 28 of the study that gives a really nice argument of the products from that softer qualitative side that is also very important. The data is clean as it is based on findings from the people who use it as opposed to the author’s opinion. You can therefore use it to justify clinical reasoning too.
The conclusion of the study was that slide sheets are better than traditional cotton sheets and carrier for moving someone up the bed. The carrier had the disadvantage of being hard to fit and remove while the slide sheet could be left under the person. I don’t even think they were talking about in situ slide sheets designed to be left under the person here. This study provides a great justification for these.
