69 research outputs found
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Evaluation of a Continued Safe Patient and Handling Program
Nursing staff have a high risk of on the job injury from patient handling and movement. Safe Patient Handling and Movement programs help reduce injury through education and training to employees. Programs need to be evaluated regularly to determine if the goals are being met. When a program is not meeting its projected goals, modifications are needed to improve the program and its outcomes. The purpose of this project was to evaluate a continued safe patient handling program. The goals were to provide best evidence from research. Use best evidence to enhance the program. Promote positive behaviors from employees. Reduce healthcare workers injuries related to patient handling and movement. The objectives were to determine if modifications would decrease safe patient injuries. To promote safe patient handling and movement behaviors that is positive from employees. Increase employees comfort, knowledge, and use of minimal lift equipment during patient handling and movement. The outcomes of the program are successful in meeting the goals and objectives. Modifications to the program were introduced and injuries from patient handling decreased by 50% during the implementation period when compared to the post implementation period. Positive behaviors were witnessed and expressed from employees. Employees also expressed they felt they had increased knowledge of the minimal lift equipment and increased comfort with use of the minimal lift equipment
Study and reformulation of the technical aid device HomeHoist
Dissertação de mestrado integrado em Engenharia BiomédicaCerebral palsy manifests itself in the first years of a child's life and may be caused by brain injuries, or abnormal brain development, reflecting in disorders in the child's motor capacity, each case varying in terms of severity and type of motor disorders. The average life expectancy of these children has been increasing, which means that it is relevant to find alternatives to improve the quality of life of those affected by this condition.
Thus, the HomeHoist project emerged, which aimed to function as a single device for transferring patients with cerebral palsy without burdening the caregiver. The HomeHoist device consisted of an electric wheelchair, with a built-in hoist, removable seat, and free interior space, which allowed the patient to be transferred between various surfaces, such as beds and toilets. Following an internship at the company Orthos XXI, the interest arose to revive this project, which had been concluded in 2014.
The aspects identified for improving the device were to incorporate verticalization; include leg raising, which despite being a goal in the original project, was not achieved; split the seat and backrest to customize the operation of the device; free up the lateral space on the seat to facilitate patient handling; and change the structure and components to meet the company's production, reducing production time and cost.
Using project methodologies such as the goal tree, analysis of functions, and the method of weighted goals, it was possible, among several solutions, to understand which ones best fit the intended goals, followed by the determination of dimensional constraints and the selection and placement of mechanical components, to obtain a 3D model of the final device. With the model it was possible to obtain 65º verticalization; 155º reclination; the dimensions of the device were as intended; and the foot elevation was incorporated, although it did not allow to completely stretch the legs. Then, a brief analysis of the electrical components to be incorporated was made, followed by the simulation of two components, and with the simulation of one of them, the arch, it was realised that it would have to be redesigned to withstand the load that was applied to it, by increasing the diameter of the tube and the positioning of the rings.
Finally, with the production of the prototype, it was possible to understand what should be improved to facilitate the production of the device, both in terms of production and assembly. The functioning of the device was also tested, to confirm the information obtained with the 3D model.A paralisia cerebral manifesta-se nos primeiros anos de vida de uma criança e pode ser provocada por lesões cerebrais, ou desenvolvimento cerebral anormal, refletindo-se em distúrbios na capacidade motora da mesma, cada caso variando em termos de severidade e de tipo de disfunções motoras. A esperança média de vida destas crianças tem vindo a aumentar, o que significa que é relevante encontrar alternativas para melhorar a qualidade de vida daqueles afetados por esta condição.
Assim, surgiu o projeto HomeHoist, que tinha como objetivo funcionar como dispositivo único para a transferência de pacientes com paralisia cerebral, sem sobrecarregar o prestador de cuidados. O dispositivo HomeHoist consistia numa cadeira de rodas elétrica, com uma grua incorporada, assento removível e o espaço interior livre, o que permitia transferir o paciente entre várias superfícies, como a cama e vasos sanitários. No seguimento de um estágio na empresa Orthos XXI, surgiu o interesse em reavivar este projeto, que tinha sido concluído em 2014.
Os aspetos identificados para a melhoria do dispositivo foram incorporar a função de verticalização; adicionar a elevação de pernas, que apesar de ser um objetivo no projeto original, não foi alcançado; dividir o assento e o encosto de costas, para personalizar o funcionamento do dispositivo; libertar o espaço lateral no assento, para facilitar o manuseamento do paciente; e alterar a estrutura e componentes para irem de encontro à produção da empresa, reduzindo o tempo e custo de produção.
Usando metodologias de projeto, como a árvore de objetivos, análise de funções e o método dos objetivos ponderados, foi possível de entre várias soluções, compreender quais as que melhor se enquadravam nos objetivos pretendidos, seguindo-se então a determinação das restrições dimensionais e de seleção e colocação de componentes mecânicos, para obter um modelo 3D do dispositivo final. Com o modelo foi possível obter verticalização de 65º; reclinação de 155º; as dimensões do dispositivo foram ao encontro do pretendido; e a elevação de pés foi incorporada, apesar de não permitir esticar completamente as pernas. De seguida, foi feita uma breve análise dos componentes elétricos a ser incorporados, seguida da simulação FEM de dois componentes, sendo que, com a simulação de um deles, o arco, percebeu-se que o mesmo teria de ser alterado de modo a aguentar a carga que lhe era aplicada, aumentando-se o diâmetro do tubo e o posicionamento das argolas.
Por fim, com a produção do protótipo foi possível perceber o que deveria ser melhorado para facilitar a produção do dispositivo, tanto em termos de produção como de montagem. Foi também testado o funcionamento do dispositivo, para confirmar a informação obtida com o modelo 3D
Musculoskeletal Models in a Clinical Perspective
This book includes a selection of papers showing the potential of the dynamic modelling approach to treat problems related to the musculoskeletal system. The state-of-the-art is presented in a review article and in a perspective paper, and several examples of application in different clinical problems are provided
Including plus size people in workplace design
Over 60% of the adult population in the United Kingdom is now overweight or obese or classed as plus size . This is higher than almost all other developed countries in the world. Even with numerous public health interventions, the incidence of being plus size continues to rise potentially changing the demographics of the working population. This presents a challenge to those involved in workplace design as the design process relies upon the utilization of appropriate anthropometric data to establish the percentage of the user population that will be accommodated by the design. The aim of this thesis is to identify issues affecting plus size people in the working environment, not previously explored within the literature. Furthermore, by understanding the size and shape of this population via the collection of key anthropometric data, this will help inform the design of safe, comfortable, inclusive and productive working environments for plus size people within the United Kingdom.
A first stage Scoping Study (n=135) found that fit (equipment, tools, furniture, uniforms and personal protective equipment) and space (circulation and shared spaces within the working environment) were issues of concern to plus size people. This suggests that aspects of the current design of the workplace are not suitable, and may even exclude plus size people. A better understanding of the anthropometric requirements of plus size workers is therefore required.
Self-reported anthropometric data is an acceptable way of studying large and geographically diverse populations and may assist in accessing the hard to reach plus size working population. A validation study (n=20) established that self measurement of 14 key anthropometric measurements, using a self measurement instruction guide, was a feasible and acceptable data collection method for a larger scale anthropometric study to further understand the body size and shape of plus size people at work. A unique measure of knee splay (for a non-pregnant population) was included. Defined as the distance between the outer borders of the knees whilst seated in the preferred sitting position it represents the observed sitting postures of plus size individuals not captured in existing anthropometric data sources.
The larger scale Plus Size Anthropometry Study (n=101) collected anthropometric data of plus size working age people via self measurement. The findings indicated that the study population was substantially larger in circumference, depth and breadth measurements than the population of existing anthropometric data sources. Knee splay was also identified as a key anthropometric variable for plus size people, however, it is not included in any datasets or literature relating to plus size people at work. These factors may contribute to high exclusion rates from current design practices that seek to accommodate the 5th to 95th or 99th percentile of users and may explain the high incidence of fit and space issues reported by participants with a BMI over 35kg/m2 .
Finally, semi structured interviews with stakeholders (n=10) explored how they would like the data from the plus size anthropometry study communicated and any additional requirements of a resource aimed at supporting stakeholders in meeting the needs of plus size people within the working environment. The primary concern from stakeholders was the lack of existing data on the size and shape of the plus size working population and the importance of access to such data in whatever format. A range of ideas were suggested including case studies, guidance and access to training which may assist them in understanding the needs of their end users ultimately supporting the inclusion of plus size people in workplace design
Musculoskeletal disorders in midwives: prevalence, impact and contributory factors
Musculoskeletal symptoms have been problematic for healthcare staff, resulting in sickness absenteeism, functional limitations, staff shortages and financial costs to organisations. Maternity professionals who care for women in labour, particularly midwives and obstetricians, are also at high risk of developing musculoskeletal disorders due to a range of associated risk factors including heavy working conditions and awkward caring positions. There has been, however, limited research into this condition in midwives. The aim of this thesis is to investigate musculoskeletal disorders with prevalence, distribution, severity and impact, and to explore contributing factors from a biopsychosocial perspective.A first stage survey study (n=635) explored the extent of musculoskeletal disorders and association with risk factors. The Nordic Musculoskeletal Questionnaire identified a very high prevalence of symptoms, mostly in the lower back (71%), neck (45%) and shoulders (45%) within a 12-month period. These symptoms resulted in activity limitation (50%), sickness absences (30%) and change of job/duties (45%). An investigation into the associations between potential contributing factors and musculoskeletal symptoms showed that younger age, less experience in the profession, a higher body mass index, longer working hours, lower job satisfaction and higher job stress can each play a role in developing such symptoms.In-depth interviews with 15 midwives and a further validation focus group (n=7) explored risk factors and prevention strategies in considerable detail. The majority of such symptoms were considered to be work related, including working tasks, equipment, environment, heavy workloads, staff and mother characteristics. The primary concern expressed by midwives was the lack of application of protective strategies in real practice due to the heavy workload and mother-centred practice approach. They also argued that they did not benefit from standardised manual handling training due to a lack of content dealing with midwifery caring activities.Finally, the risk of musculoskeletal symptoms associated with common working positions was evaluated by using the Rapid Entire Body Assessment postural analysis tool with a sample of midwives (n=22). This analysis suggested that working postures resulted in a significant increase in the risk of developing musculoskeletal disorders, with all postures having a very high to medium risk level, indicating that immediate action is required to address this issue. The trunk, neck and upper arm were found to be the most commonly affected body parts.The findings will inform the development of risk management strategies to reduce musculoskeletal symptoms in the absence of such data in the United Kingdom. Management of such symptoms may have a positive impact on staff shortages, early retirements, individuals’ life trajectories, mother and baby safety as well as staff wellbeing. Organisations and professional bodies play a key role in this regard.</div
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