Biomechanical investigation of optimal bed height for egressing and ingressing hospital beds

• Published in: Human Factors in Healthcare (Online) Vol. 4; p. 100053
• Main Authors: Usmani, Ahmad Raza, Kotowski, Susan E., Kim, Jay, Huston, Thomas R., Davis, Kermit G.
• Format: Journal Article
• Language: English
• Published: Elsevier 01-12-2023
• Subjects: Biomechanics; Ergonomics; Fall injury; Ground reaction forces; Healthcare; Patient falls
• ISSN: 2772-5014; 2772-5014
• DOI: 10.1016/j.hfh.2023.100053

Aims and objectives: To determine what bed heights are optimal for egress and ingress to the bed, based on quantitative measures and subjective perception. Background: Many patient falls are related to the patient's interaction with the hospital bed. Beds with lower heights were introduced to reduce the impact of injury due to patient falls. However, low-height beds imposed different kinds of issues during ingress/egress without assistance, such as greater forces and increased inertia required to overcome the center of mass being below the knees. Design: A cross-sectional controlled laboratory study with 24 healthy adults was conducted to assess the biomechanical parameters at different bed heights. Methodology: The bed height ranged from 43 cm to 86 cm, in 2.54 cm increments (completed in random order). Two force plates measured ground reaction force and center of pressure. Perception of stability and difficulty were collected from the subject after each trial. Documentation of hand-support of subject was also recorded for each trial. A two-factor Analysis of Variance was conducted to determine the significance between ingress/egress and bed height with post hoc Tukey test to determine source for significance. Results: Bed Height emerged as a significant factor in determining the ability to ingress/egress from a hospital bed. The results indicated that for medium bed heights (51–66 cm), ingress/egress were less difficult (1–2, on a scale of 10), more stable (approximately 9/10), and had less vertical ground reaction forces (<1000 N). Conclusion: The ingress/egress was found to be best executed at medium heights (51–66 cm) as participants performed better biomechanically and were more stable than lower or higher heights. Relevance to clinical practice: The results conclude that hospitals should endorse policies to keep the bed heights between 51 and 66 cm for ingress and egress. Patient or public contribution: No Patient or Public Contribution.