Ergonomics
Ergonomics means developing the structures, work equipment, furniture and work methods at a worksite so that they best serve the characteristics, functions and abilities of the people. Ergonomics are used to improve human safety, health and well-being, as well as the disruption free and efficient operations of systems.
The definition of ‘ergonomics’ is extensive, as it covers not only physical ergonomics, but also cognitive and organisational ergonomics.
The objective is that the work can be performed without causing detrimental or dangerous stress on employee’s health or without the risk of an accident. The objective is to develop the work and the working conditions and plan in advance the work premises, equipment, processes and procurements so that they are suitable to as many users as possible.
Law obligates to ensure good work ergonomics
The Occupational Safety And Health Act (358/2002) obligates employers to ensure the healthy and safety of their employees. Employers must, for example, continuously monitor the work environment, the state of the work community and the safety of work methods. The effects of any measures implemented must be monitored. Individual technical changes are rarely enough; the work should be reviewed as a whole.
An employee’s duty is to:
- take care of themselves and their colleagues
- report any factors endangering health or the work, and
- follow instructions.
Matters related to work arrangements, such as job rotation, division of work, competence and functional work equipment, are useful for preventing musculoskeletal disorders. They also make it easier for employees suffering from musculoskeletal disorders to cope with their work.
Ergonomics and working positions and movements of the workstation
Work equipment selected, used and installed correctly will help to prevent detrimental stress and disorders of the musculoskeletal system. Special care has to be taken not to damage employees’ backs and to ensure that the risk of this would be as low as possible.
Workplace reviews and occupational health examinations give information that can be applied to developing the work and the working environment.
Occupational healthcare services are obligated to provide the workplace with data related to the healthiness and safety of the work that is easy to put to practice. For example, if an employee has a reduced work capacity, the occupational healthcare services will take part in planning the changes in the work and the work environment so that the employee can continue their work.
Working positions and lifts must be planned when designing the workstation. If possible, the work equipment must be adjustable and arrangeable based on its user. The work equipment must have functionalities that ensure that the work will not cause detrimental or hazardous stress to the employee’s health.
Manual lifts and transfers without an aid should be avoided or reduced. This is primarily done through work-related measures or by using lifting devices. Long-term working in a poor position should be avoided. This requires that the necessary patient lifts and height-adjustable beds, washing platforms and shower chairs are available.
If manual lifts and transfers cannot be replaced with mechanical devices, the workstations must be arranged so that the lifts and transfers are as safe as possible.
In treatment and nursing work, the employees need to pay attention to their own working positions. Reaching and bowing should be avoided. Instead, employees should aim to work so that their weight remains on their feet and their back remains straight. They can take hold of the edge of a bed or support their body against it, for example, to reduce the static stress on their back muscles.
Working at the floor level should be avoided and employees should squat down instead of bowing when necessary. When a nurse is assisting a patient to move, they should mostly work in a normal walking position to ensure better balance and smoother movements than when standing with their legs spread wider.
One or two workers lifting a patient by placing their hands under the patient’s arms (‘drag and lift’) has been proven to be biomechanically stressful to the employees and unpleasant to the patient. This can also damage the soft tissues of the shoulder areas of hemiplegic patients. Wrong assistive methods prevent the natural movements of a patient and their participation in their transfer..
Ergonomics in patient work at patients’ home
The assistive equipment for reducing physical stress is often not as readily available during home visits as in institutional care. It is easier for employees to follow the decrees of the Occupational Safety And Health Act in institutions, as these are usually owned or managed by their employer.
At patients’ homes, the situation is different: clients have a right of self-determination at home. Acquiring assistive lifting devices for a client in accordance with the obligations of the Occupational Safety And Health Act, for example, may not be possible if the client prohibits keeping the device at their home.
When assisting the elderly or people with disabilities, the needs for assistive devices will be determined case by case. If a client’s functional capacities deteriorate, the need for assistive devices should be reassessed. When a client’s functional capacities deteriorate, multi-disciplinary co-operation with assistive device services and healthcare and social care services is recommended.
Acquisition of an individual assistive device or commissioning one with a leasing agreement will benefit the client, but also everyone assisting them. The costs accrued due to the assistive device could be compensated as reduced absences of the assistive workers.
Compact assistive devices improve ergonomics
The compact assistive devices of home care kits can easily improve the ergonomics of assistive work. Compact assistive devices, such as sliding materials and boards facilitating transfers, and transfer belts or FlexiMoves supporting movement or gripping, will reduce the musculoskeletal loads of the assistive workers and improve their working positions. The materials chosen for the kit are easy to use and care for and can be quickly disinfected before the next client.
When working at a client’s home, the client’s right of self-determination and their domestic peace need to always be respected. When clearing space for working or when moving furniture, the client should be asked for permission and the items and furniture should also moved back to their places afterwards. More long-term solutions need to be discussed with the client and others living in the same household.
When performing assistive work at the client’s home, employees should pay attention to their working positions. When working at a floor level, for example, employees should bend their knees and temporarily work while squatting instead of bowing their back. With children, sitting on the floor with them, at their own level, is an interactive and equal way of working.
Cognitive ergonomics in nursing
The nature of nursing work has started to involve more and more cognitive work, which means that applying knowledge and the requirements of cognitive i.e. information processing have increased a great deal.
Nursing work has frequent interruptions and many simultaneous assignments. These are cognitive stress factors that hinder the workflow and decrease occupational well-being.
Improving cognitive ergonomics in nursing work is important. The objective is to plan the work so that the difficulty of the information processing of work assignments is in balance with the human abilities and limitations of information processing: performing the work smoothly without unnecessary stress must be made possible.
The Finnish Institute of Occupational Health has plenty of ergonomics solutions produced by different research and development projects that could be utilised at workplaces of social care and healthcare.
Good practices, tools and tips on cognitive work can be found on the website of the Finnish Institute of Occupational Health.