Consumer's Digest: Using Human-Interface Design … · Using Human-Interface Design to Select...

© 2006 Applied Ergo Conference 10 - Dallas

Consumer's Digest: Using Human-Interface Design to Select Human-Moving Equipment

Miriam Joffe, PT, CPESenior Consulting Ergonomist

[email protected]

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Objectives

ð Understand principles of human-interface priorities when selecting people-handling equipment. Benefits are for both the provider and receiver.

ð Review selection criteria.

ð Review the need for a paradigm shift when choosing between manual handling devices and man-handling people/using body mechanics alone.


It is well established that…

• people are not necessarily reliable to identify their own safe load weight limits. (Jorgensen, et. al., 1999)

• over time, most manual assistance activities put the caregiver at risk for injury.

• pain can begin before structural damage is evident (Marras, 2006) but we often ignore pain when our patients need us.

• spinal loading and spinal tolerance limits change with time/continued exposure (Marras, 2006).


Apply ergo concepts from industry to patient handling because…

• How many private homes are equipped with “transfer teams”?

• Even with “transfer teams” excessive and repeated reaching, pulling and lifting may occur that exceed our capacity over time.

• How many private homes have “handicap” bathrooms?

• How many ceilings (both home and institutional) are rated for ceiling lifts?

Photos deleted due to file size limitation.


Learn from MMH guidelines in industry

https://www.ohiobwc.com/downloads/blankpdf/LiftGuideBackStudy.pdf

70 lb. in the primary

reach zone

35 lb. in the secondary reach zone

How many patients weigh only 70 lbs?

How many patient handling tasks are performed with the caregiver upright and patient in the primary reach zone?


Learn from MMH Tasks

If we put limits on lifting loads for boxes to protect our backs, why do we “handle” people differently?

And if muscle strength is a limiting factor, why

not rely on mechanical equipment to help us?

http://www.jhu.edu/news_info/news/home02/m

ay02/grasp.html

Voice-activated gripping device

Photograph Courtesy of Lynda Enos, 2006


So…we turn to assistive devices

Ah, the “Good Ole Days”

Photos deleted due to file size limitation. Gait belt, old wheelchair with no adjustable parts, old style bed and sliding board.


But today we have many choices…

…so how do we know which ones to choose?

Photos deleted due to file size limitation. Various transfer and assistive devices shown in presentation.


Making Good Choices

1. Determine level of patient’s needs/dependency

(physical and cognitive abilities)

2. Determine the activity needed

(bed mobility or positioning, transfer, gait, etc.)

3. Determine who will be around to help

(trained medical staff, family member, friend)

4. Determine environment in which device will be used

(hospital, independent living center, home)


Level of Need/Dependency(or “Who’s Steering This Ship?”)

Dependent and/or combative

Independent and/or

cooperative

Other photos deleted due to file size limitation.


Level of Need/Dependency

Dependent and/or not

cognitively intact

Independent and/or

cooperative

Other photos of tub transfer devices deleted due to file size limitation.


Level of Need/Dependency

Dependent and/or not

cognitively intact

Independent and/or

cooperative Photos of sling transfer from bed and gait belt transfer from chair deleted due to file size limitation.


Making Good Choices










Identify the Activity

Some devices are multi-functional• But may not work as well as uni-functional devices

– 3 in 1 commode (raised toilet, bedside commode and safety frame)

Some devices are applicable to many situations• Sling lifts may be used for bed to chair, commode or tub

depending on sling choice

- Solid sling for bed to chair transfer

- Slotted sling for chair to commode

- Webbed sling for chair to tub

Photo of 3 in 1 commode deleted due to file size limitation.


Making Good Choices










Who’s Minding the Store?• Spouse with (un)licensed care giver?

• Registered nurse / hospice

• Certified nurse’s assistant (CNA)

• Unlicensed sitter/caregiver

• Friends and family

• Facility with variety of licenses professionals• Experienced teams

• Supplement by OJT aides



Making Good Choices










Where ‘Yat?

§Home setting

§ Often in the living room

§ Cramped quarters / bathroom access problems

§ Limited funding

§ Institution

§ Floor plan generally better suited for equipment and storage

§ Shared resources and better funding§ Independent living center

§ Skilled nursing facility

§ Acute care or rehab facility


Fear Factor

Using equipment may be scary the caregiver and the

patient.



Principles for Choosing Controls

• Understand system operation easily• Group similar controls together

• Operate with simple or no direction

• Control adjacent to label and/or display

Bad Good Good


Principles for Chosing Controls• Use population stereotypes

• Left to right increases

• Counter-clockwise to open

• Red = danger or stop

• Green = safety, OK, go

• Up = on, higher, increase, raise

• Down = off, lower, decrease

On Off

Up / down Left to right


Principles for Chosing Controls

• Should not require awkward movements

• Force requirements should match user abilities

• Resistance provided – eliminates unnecessary force and repeated action

• Device should fit hand size

• One-hand operation preferred

• Redundant/consistent coding– Color, shape and sizing

– May have auditory, tactile and/or visual alerts

• Appropriate feedback provided – did you get the response expected?

– green light on with correct action vs. alarm for incorrect action


Principles for Chosing Displays• Labels

- adequate lighting and no glare

- legible

- consistent

- size appropriate for viewing distance

- black on white best

- locate next to control Low Light Adequate

Levels Light Levels

0.25 inches 0.15 inches

0.10 inches 0.10 inches

Critical Labels (Information, data, emergency labels)

Noncritical labels (Non-emergency labels, instructions, identification labels)


Principles for Chosing Displays

BIGGER

BOLDER

The appropriate size and type of the

characters can affect eye fatigue and DATA

ENTRY ERRORS

Character spacing and dimensions are important

BRIGHTERBRIGHTER


Principles for Chosing Displays

• Use icons or pictograms that are easy to understand

?What does that mean? Easily understood


Principles for Choosing DisplaysColor• Black on white for lighted conditions

• White on black for non-lighted conditions

Dear Mr. Bloggs:

Thank you for meeting with me yesterday.

I hope that we will be able to work together in the future.

Dear Mr. Bloggs:

Thank you for meeting with me yesterday. I hope that we will be able to work together in the future.


Human Interface/Design Features

• Build in adjustability where possible- Height (e.g. bed, lift, chair/toilet seat, handle length)

- Fit 90% of caregiver and patient population (reach for smallest person and clearance for largest person)

• Weight limit/capacity

• Neutral posture- Find equipment that promotes neutral posture for both

the caregiver and patient (e.g., using for controls)

- Fit hand size and finger length for hand controls

• Ease of use- Speed of response to controls

- Maneuverablity and handle design

- Number of parts to be manipulated



• Minimize force

- Minimize requirement to engage and grip equipment

- Consider limitations of user (e.g., finger, hand or foot weakness due to age or disability)

- Consider force to move equipment and/or parts (e.g., bed, rails, lift device)

- Steering and braking mechanism (via hand or foot)

- Push/pull force over flooring (e.g., carpet vs. smooth flooring, ramps/slopes, thresholds)

- Manual vs. powered



• Architectural limitations

- Structural integrity of floor, walls and ceiling

- Doorway clearance and room size

- Flooring and threshold

- Turning radius (e.g., room for equipment and people

• Maintenance and storage

- Easy to clean

- Easy to store

• Training

- Easy for caregiver to learn

- Easy for patient to learn



Paradigm Shift

If we use assistive devices to handle “product” in industry to protect our workers for cumulative injury, then we should also use assistive devices to handle people in (home) healthcare settings to protect our caregivers.

These devices are not barriers to kindness, empathy or therapy goals. Rather, they can be integrated into how we handle people so that we can be around to do the same tomorrow.


Paradigm Shift

Photos deleted due to file size limitation. They show modern equipment used for MMH in factories compared with those used for patient handling.


Summary

Chose devices that

ü fit the needs, size and complexity of both caregiver and patient

ü are easy to use and maintain

ü require minimal training

ü require minimal maintenance

Consider

§ Environmental issues

§ Architectural limitations (space, flooring, etc.)

§ Person who uses the control (caregiver vs. patient)

§ Impact on safety


Questions?Questions?Miriam Joffe, PT, CPESenior Consulting Ergonomist

[email protected]


Resources and References

Ergonomics Design Guidelines, Auburn Engineers (1997)

Ergonomics Guidelines for the Prevention of Musculoskeletal Disorders in Nursing Homes (2003). OSHA

Ergonomic Design for People at Work, Van Nostrand Reinhold Company, NY (1986)

L. Enos. “The Ergonomics of Patient Handling Equipment Design: Enchancing Caregiver and Patient Safety” presentation (2006)

Grandjean, E., Fitting the Task to the Man, 4th ed., Taylor and Francis

W.S. Marras. Safe Patient Handling Conference in Buena Vista, Florida (2006)

Ohio Bureau of Worker’s Compensation

www.baddesigns.com - examples of poor control designs


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