Determination of Ability to Egress and Ingress Based on Hospital Bed Height

• Main Author: Usmani, Ahmad Raza
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2022
• Subjects: Biomechanics; Epidemiology; Public health
• ISBN: 9798381166989

Many patient falls are related to the patient’s interaction with the hospital bed. Beds with lower bed heights (as low as 13 cm from the ground) were introduced to reduce the impact of injury due to patient falls, with the thinking the lower the bed, less of a fall for the patient. However, the hospital beds with lower heights imposed different kind of issues during ingress and egress, such as lower heights force the knees to be in a biomechanically poorer posture, requiring an individual to generate large motion of the upper body and requiring more strength to stand. The influence of hospital bed height on biomechanics during ingress and egress has been largely unexplored. The objective of this study was to determine the impact of bed height on the ability to ingress and egress, based on quantitative measures. It was hypothesized that medium bed heights will be optimal, as there would be less forces generated and thus decreased risk of a fall.A laboratory study with 24 healthy adults (12 males, 12 females) was conducted to assess the biomechanical parameters at different heights of the hospital bed. The mean body mass indexes for the male population and female population were 25.7±4.1 kg/m2 and 25.7±4.1 kg/m2, respectively. The bed height was varied from 17 inches (43 cm) to 34 inches (86 cm), with an increment of one inch (2.54 cm). Two force plates installed on the floor collected the ground reaction forces (in x, y, and z direction) and the centre of pressures (in x and y direction). Perception of stability and difficulty were collected from the subject for each trial. Furthermore, it was also recorded whether subjects used hand support during each trial of ingress or egress (0, 1, or 2).Statistical analysis of the collected data was performed by comparing means in the form of two factor Analysis of Variance (ANOVA) with post-hoc t-tests in the form of Tukey to determine the significance between ingress/egress and bed height. Bed Height emerged as a significant factor in determining the ability of ingress and egress from a hospital bed. The results indicated that for medium bed heights (around 20-26 inches from the ground), ingress and egress were least difficult, most stable, and involved optimum ground reaction forces. Based on the resultant ground reaction forces and perceived stability and difficulty, it was concluded that ingress and egress from extremely low bed heights might not turn out as biomechanically effective; rather, low bed heights might be difficult and less stable for ingress and egress. The conclusion of this study can help the optimization of bed heights in healthcare settings to avoid ergonomic challenges for patients during ingress and egress to hospital beds.