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Leslie Pickett, PT Ergonomics and Injury Prevention Specialist Swedish Medical Center

Washington State Governor’s Industrial Safety & Health Conference Health Care Panel October 8, 2009. Ergonomics in the Healthcare Setting. Leslie Pickett, PT Ergonomics and Injury Prevention Specialist Swedish Medical Center Seattle, Washington. Electronic Medical Records (EMR):. Pros:.

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Leslie Pickett, PT Ergonomics and Injury Prevention Specialist Swedish Medical Center

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  1. Washington State Governor’s Industrial Safety & Health ConferenceHealth Care PanelOctober 8, 2009 Ergonomics in the Healthcare Setting Leslie Pickett, PT Ergonomics and Injury Prevention Specialist Swedish Medical Center Seattle, Washington

  2. Electronic Medical Records (EMR): Pros: Cons: Time consuming / learning curb Equipment installation challenges Adequate number of available computers Hygiene Training ERGONOMICS! • Paperless system: save time hunting for charts • Quick access to medical records, lab results, imaging • Productivity / efficiency for staff • Decreased medical errors • Improved Outcomes • Increased Patient Satisfaction

  3. EMR: Reasons for dissatisfaction • 80% of nurses surveyed were ambivalent or dissatisfied with EMR. • (Nursing Informatics Task Force 2005) REASONS: • No prior skills with computer • Poor ergonomics • Hardware / battery issues

  4. Poor Ergonomics • Ergonomics in hospital setting is mostly based on single user “office set up” ergonomics. • 24 / 7 user sites with need for adaptability

  5. Poor Ergonomics • Healthcare is the second riskiest occupational sector for a work related Musculoskeletal Disorder (MSD). • Research supports ergonomics in healthcare: • Healthcare facility in Ohio evaluated installing ergonomic equipment with ergonomic training given at the same time. • Results: Close to 50% decrease in MSD rate with training and installation. • (Fujishiro et al 2005, AM J. IND MED., 48:338)

  6. Five Rights of Computer Ergonomics • Right number of computers • Right location of computer • Right height adjustments • Right size monitor • Right resolution

  7. Right Number of Computers • No research to provide guidelines • 1 fixed in every room vs. mobile?

  8. Right Location of Computer • Nursing stations only vs. in room only??? • RN’s carrying around scrapes of paper with notes • Time lag in entering information • Physicians hunting down RN’s (instead of charts) to find info.

  9. Right Monitor Size • Eye changes starting in the 40’s. • Larger monitors help decrease eye strain and fatigue. • Decrease need to scroll down • Research shows increase in productivity with larger monitor.

  10. Right Computer Resolution The higher the resolution the smaller the text

  11. WOW – COW - COS • Mobile computing : > 20 manufacturers now vs. 3 15 years ago.

  12. WOW – COW - COS Problems: • Heavy to push • Small screen size • Cumbersome design (can’t get into a room) • Epidemiology problems • Can’t sit ergonomically • Cost

  13. WOW – COW - COS Solutions • Smaller footprint • Height adjustable surface = 99% of employees for both sit and stand • Battery Meter • 20” monitors • Dispensing Systems (i.e. Pixis) integrated • Reliable hardware and power charge

  14. Medication Dispensing System Challenges

  15. WOW – COW - COS • All stake holders should have a voice • Explore types of carts that meet your needs • Laptop vs. regular cart • Hand held tablets that also mount on carts

  16. COW – WOW – COS Ergonomics • Should fit at least 5th – 95th percentile • Keyboard • Standing height: 36-46” • Sitting height: 21-28” • Screen height (from top): • Standing height: 48-60” • Sitting height: 40-53”

  17. Cornell University Cart Evaluation Form • http://ergo.human.cornell.edu/cutools.html

  18. Patient Room or Wall Mounted Computers Challenges • Space • Positioning / Adjustability • Power and cables • Hygiene • Hardware Costs

  19. Wall Mounted Challenges

  20. Wall Mounted Challenges

  21. Wall Mounted Challenges

  22. Wall Mounted Guidelines • 50” track (best for sit / stand option) Keyboard: 28” mount from floor (28-39” range) • 34” track (primarily for standing) Keyboard: 36” from floor (36-47” range) • Medium height task stool must be used with 34” track.

  23. Other areas of concern in the Healthcare System • Imaging: PACS – Picture Archiving and Communications Systems • EICU • Surgery monitors for closed surgeries

  24. Employees are a hospital’s most valuable asset! Investment in good ergonomics keeps staff healthy and productive and facilitates good patient care!

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