医护人员在徒手将病人从床上转移到椅子上时所承受的生物力学压力

IF 2.5 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL International Journal of Industrial Ergonomics Pub Date : 2024-03-23 DOI:10.1016/j.ergon.2024.103584
Jacob J. Banks , Jie Zhou , Chelsea O. Riehle , Neal E. Wiggermann
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引用次数: 0

摘要

医护人员极易受到肌肉骨骼损伤,尤其是腰部和肩部。手动转运病人是常见现象,可能会产生导致这些损伤的物理应力。很少有研究使用体内肌肉骨骼模型来估计滑板和患者合作的影响,也没有研究使用测量的手部力量作为模型的输入。这项实验室研究使用测量手部力量的仪器步态带,对一名体重 64 公斤的模拟病人从床上到轮椅的手动转移进行了评估。13 名医护人员在有滑板和无滑板的情况下进行了转移,并使用了三种水平的垂直辅助(患者体重的 0%、18% 和 36%)。利用直接测量的手部力量和全身运动捕捉,通过胸腰部肌肉骨骼模型估算了体内下背部力量和由此产生的肩部力矩。结果表明,滑板和垂直辅助可减少身体压力。然而,所有转运条件下的试验都超过了人体工程学指导标准。为了给何时可以安全地进行人工转移提供一些指导,我们进行了一项事后分析,以估算在理想情况下仅使用步态带就可以安全地进行人工转移的病人质量。这些研究结果有可能为医护人员提供指导和可信的教育,让他们了解何时适合手动转移,何时需要移位机。无论如何,在大多数情况下,我们仍然建议使用机械移位机,以保护护理人员免受伤害,并防止病人跌倒。
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Biomechanical stresses on healthcare workers during manual patient bed-to-chair transfers

Healthcare workers are highly susceptible to musculoskeletal injury, particularly in their lower back and shoulders. Manual patient transfers are common and can generate physical stresses that contribute to these injuries. Few studies have used in vivo musculoskeletal modeling to estimate the effect of slide boards and patient cooperation, and none have used measured hand forces as an input to the models. This laboratory study evaluated manual, one-person bed to wheelchair transfers of a 64 kg simulated patient using an instrumented gait belt that measured hand forces. Thirteen healthcare workers performed transfers with and without a slide board and with up to three levels of vertical assistance (0, 18, and 36% of patient body weight). In vivo lower back forces and resultant shoulder moments were estimated with a thoracolumbar musculoskeletal model using directly measured hand forces and full-body motion capture. Results indicated that slide boards and vertical assistance reduce physical stresses. However, all transfer conditions had trials that exceeded an ergonomic guideline. To provide some guidance on when a transfer can safely be performed manually, a post hoc analysis was performed to estimate the patient mass that can be safely transferred manually under ideal circumstances with only a gait belt. These findings have the potential to guide and credibly educate healthcare workers on when manual transfers are appropriate and when lifts are required. Regardless, mechanical lifts are still recommended in most circumstances to protect caregivers from injury and the patient from falling.

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来源期刊
International Journal of Industrial Ergonomics
International Journal of Industrial Ergonomics 工程技术-工程:工业
CiteScore
6.40
自引率
12.90%
发文量
110
审稿时长
56 days
期刊介绍: The journal publishes original contributions that add to our understanding of the role of humans in today systems and the interactions thereof with various system components. The journal typically covers the following areas: industrial and occupational ergonomics, design of systems, tools and equipment, human performance measurement and modeling, human productivity, humans in technologically complex systems, and safety. The focus of the articles includes basic theoretical advances, applications, case studies, new methodologies and procedures; and empirical studies.
期刊最新文献
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