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Ergonomics for healthier staff by Aléxia Herms

By Wolfgang Dittmer- Healthcare Design Magazine

design

Why the ergonomic design of nurses’ stations has gained critical importance in healthcare facility design

In recent years, a growing number of designers for healthcare environments have started to look more closely at ergonomic design when choosing products that will best meet the needs of healthcare industry professionals and their patients. As many know, when designing for the healthcare setting, a laundry list of needs quickly arises: safety, functionality, performance, and durability are the obvious starting points, but covering these bases while still meeting the specific needs and requests of individuals in a variety of healthcare settings has become more and more of a challenge.

The design requirements for healthcare projects go well beyond those for office, commercial, retail, or hospitality environments. As we continue to see a growing shortfall in the number of healthcare workers in this country, designers who specialize in healthcare projects are faced with the challenge of creating spaces that promote health-preserving, long-term solutions to increasingly difficult working conditions.

Generally speaking, ergonomics applies science to workplace design to maximize worker productivity while reducing fatigue, discomfort, and the potential for injury. During the industrial revolution, ergonomics was often applied to manufacturing jobs to minimize the impact of the repetitive motions and static postures inherent to assembly and production line work. The rise of the computerized office in the 1980s created the need for ergonomic design to be considered for office workers, as those workers became tethered to their computers and their musculoskeletal injury rates began to skyrocket.

Rather ironic is the fact that, despite the tremendous physical demands placed on caregivers in healthcare environments, and despite the negative impact that fatigued and uncomfortable caregivers may have on their patients, ergonomics has yet to play a major role in the design of healthcare products and environments.

But that is beginning to change. As information technology becomes essential to all aspects of patient care, more and more designers and healthcare professionals are starting to look outside typical healthcare supply channels for the products that will make IT most accessible to caregivers. It turns out that many of the products that have been keeping office workers healthy and comfortable for years are perfectly suited to healthcare technology applications as well.

“Prior to starting our healthcare division, we found that some of the products we originally designed for traditional office settings were being used effectively in hospitals and clinics,” says Kevin France, national sales director of New York City-based Humanscale Healthcare. Through research, France’s company learned that a product they had originally designed for Wall Street traders was also being used for nursing stations, patient rooms, and medical imaging. As a result, the company created a division focused on design that supports healthcare-specific technology.

A prime example of how ergonomic products can make a difference in healthcare environments involves nursing stations. “Consider this dynamic work area where you often have six to eight nurses and technicians occupying the same space and performing a variety of tasks over an 8- to 10-hour shift,” says France. “Over the course of three shifts in a day, upwards of 20 to 30 different people of widely varying shapes and sizes may use the same computer and equipment.” Ergonomic work tools such as adjustable keyboard supports, adjustable monitor arms and task lights can help ensure that all of those individuals are able to perform their work in comfort, without putting added strain and stress on their bodies.

Other ergonomic work tools, including multimonitor displays and rails for mounting monitors, lights, and other accessories, have been useful in areas such as radiology rooms, where multiple users need to perform focused work in small spaces. Quite simply, products such as these can help healthcare workers do more with less.

While the above examples highlight some of the many ergonomic tools that can make healthcare work more comfortable and efficient, one product category in particular can have wide-ranging implications: seating. Today’s best-of-breed chairs, developed primarily for the office arena but now making their way to many healthcare environments, offer customized support and automatic adjustability without much, if any, manual intervention. Such automatic functionality is actually far more important in healthcare settings than in a typical office since, as we saw in the example above, a single chair in a healthcare environment may have a dozen or more users of all different shapes and sizes over the course of a day. Research has shown that the vast majority of workers rarely, if ever, adjust their chairs. So the more that a chair adjusts automatically to the user, the more likely everyone who sits in that chair will be comfortable from the start.

“In one hospital where I used to work, there was a desk we would use for preparing medications and for charting patient info,” says Amy Hacker, a Registered Nurse at Shands at the University of Florida in Gainesville, Florida. “The problem was that you had to bend over in order to reach the desk, which was really hard on the back. If you have six patients and they all have to be charted three to six times in a 12-hour shift, you can see how this could eventually cause back problems, especially for taller people.” Hacker goes on to explain that having ergonomic seating in her current hospital has gone a long way toward reducing the physical strain she used to feel at the end of a workday.

A variety of research studies support her sentiments. According to a survey of registered nurses conducted by Peter D. Hart Research Associates, the number one reason nurses leave healthcare—other than for retirement—is to take another job that is less stressful and less physically demanding.1 Another survey, conducted by the American Nurses Association, found that 76% of nurses believe that “unsafe working conditions” have a direct and negative impact on their ability to offer quality care.2

“When choosing products for a hospital, physician practice, or a long-term healthcare facility, special attention needs to be paid to ergonomics,” says France. “Ergonomic design is important in any work setting, but when you’re talking about people who work in environments that promote health, it takes on an additional layer of significance.”

“Things need to be where you think they should be … at your fingertips [and] within eyesight,” adds Bryon Graulich, ATC, PTA, CEES, the ergonomic coordinator at St. Joseph Health System in Orange, California. Graulich points out specific examples of how he has implemented ergonomic tools at St. Joseph’s. “Monitor arms and keyboard trays have helped us bring technology to the bedside. In traditional hospital settings, nurses are centralized in nursing stations, which are always away from the patient. Bringing technology into the hospital room, where nurses can look at the patient and have a conversation helps them to deliver better care because it improves communication,” he says. “At the same time, it’s important to remember that we have some nurses who are 4’10” and others who are 6’8″. Bringing in adjustable, ergonomic monitor arms makes the technology work for everyone.”

Graulich also points out the benefit of computer carts allowing registration to happen right at the bedside. These eliminate the need for intake notes to be taken manually and then entered into a computer. It also decreases the likelihood of error and increases the speed at which information is entered and processed.

Graulich’s points highlight another benefit to incorporating ergonomically sound products into the healthcare environment: proper placement of ergonomic components in a room will lead to users naturally assuming low-risk, healthy postures; the use of naturally adjustable, intuitive, and ergonomic products further ensures safety.

A November 2006 report published by Anjali Joseph, PhD and The Center for Health Design found that there was an “urgent need” to address many problems that are inherent to the healthcare workplace. The study found that improving the physical environment was a key step to reducing errors and increasing job satisfaction. The report went on to conclude that improving the environment alone would not help an organization achieve its goals without a “complementary shift in work culture and work practices.”3

What this means for healthcare designers is a vital need to find the products—such as seating, technology carts, and work tools—that will collectively create the healthiest, most functional environment possible. The more of these products available that allow easy, intuitive, and comfortable interaction with information technology in all settings, the better. By looking beyond traditional healthcare suppliers and implementing best-in-class ergonomic products, product designers are offering a world of good health to healthcare professionals.


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