A biomechanical assessment of floor and overhead lifts using one or two caregivers for patient transfers.

This study investigated the differences in peak external hand forces and external moments generated at the L5/S1 joint of the low back due to maneuvering loaded floor-based and overhead-mounted patient lifting devices using one and two caregivers. Hand forces and external moments at the L5/S1 joint were estimated from ground reaction forces and motion capture data. Caregivers gave ratings of perceived exertion as well as their opinions regarding overhead vs. floor lifts. Use of overhead lifts resulted in significantly lower back loads than floor lifts. Two caregivers working together with a floor lift did not reduce loads on the primary caregiver compared to the single-caregiver case. In contrast, two-caregiver operation of an overhead lift did result in reduced loads compared to the single-caregiver case. Therefore, overhead lifts should be used whenever possible to reduce the risk of back injury to caregivers. The use of two caregivers does not compensate for the poorer performance of floor lifts.

Design of built environments to accommodate mobility scooter users: part II.

PURPOSE.Accessibility standards for wheeled mobility devices currently use a 1.5 m turning circle, designed to accommodate manual wheelchairs. Scooters are less manoeuvrable than wheelchairs, so allowing a full turning circle would require too much space. Instead, we propose using a rectangle that provides space for a three-point turn. Here, we determine the area requirements of this approach. METHOD. For rectangular 'rooms' of varying aspect ratios, we measured the minimum dimensions in which two four-wheeled scooters (the Celebrity-X and Fortress-1700), which combine good outdoor performance with reasonable indoor manoeuvrability, could enter the space, perform a three-point turn and exit. Moveable Styrofoam walls defined each 'room', and a doorway was located either near the corner of the space or in the middle of one wall. 'Room' size was decreased until our expert driver could no longer perform the manoeuvre. RESULTS. Compared to the area required for a turning circle, 42-54% savings were achieved. Relative to existing requirements, 53-95% more space is required to accommodate the Celebrity-X; 173-223% increases are necessary for the Fortress-1700. CONCLUSIONS. When accommodating four-wheeled scooters, our proposed three-point turn definition would require more space than the current standards, but considerably less than if a full turning circle were used.

Design of built environments to accommodate mobility scooter users: part I.

PURPOSE: To determine the minimum dimensions needed to allow five models of powered mobility scooters to manoeuvre within five commonly encountered indoor spatial configurations. METHOD: We measured manoeuvrability of five scooters judged by their manufacturers to have a good combination of indoor mobility and outdoor performance (including in rural environments). We determined the minimum space needed to manoeuvre the scooters through the following five spatial configurations: turning 180° in a corridor, performing U-turns around 50 mm (2″) and 1200 mm (4') obstacles, turning 90° from a doorway and approaching a counter or work surface from the side. Free-standing styrofoam walls were used to define each configuration. An expert driver repeatedly manoeuvred the scooters through each configuration while we incrementally decreased the dimension of interest until it was no longer possible to complete the manoeuvre. Each scooter's turning diameter was also measured and compared to the manufacturer's specification. RESULTS: Minimum space requirements for each scooter for five spatial configurations are given and compared to existing standards. CONCLUSIONS: None of the scooters tested were capable of completing all manoeuvres within the space allowed by existing standards. These findings will contribute to recommendations for new standards for built environments that can accommodate scooter users.

Advanced technologies to curb healthcare-associated infections.

The commentary was prepared in response to the manuscript "Healthcare-Associated Infections as Patient Safety Indicators," by Gardam, Lemieux, Reason, van Dijk and Goel. Healthcare-associated infections are a severe patient safety hazard. Current patient safety initiatives targeting increased healthcare worker hand hygiene to prevent some of these infections have had limited effect. This commentary describes recent advances in electronic sensing and computational power that have provided new options to increase hand hygiene compliance as a step toward reducing healthcare-associated infections. Smart electronics can provide reasoning about a healthcare worker's circumstance and prompt the worker to perform hand hygiene when necessary. These novel approaches in technology development have tremendous potential to enhance the hand hygiene of healthcare workers and can support the prevention of this significant problem for patients in our hospitals.