Ergonomically Designed Smart Hospital Bed with Attachable –

Detachable Stretchair

Sherrie Joy De Leon, Ron Jude Joshua Gripo, Benedict Ian Jimenez, Raycee Kim Tagle,
Engr. Felbert Castañaday & Engr. Jesa Ornopia
College of Engineering, Computer Studies and Architecture, Lyceum of the Philippines University - Cavite

Abstract— The purpose of this study is to develop medical equipment that can help the health-care workers in transferring the patient
from a hospital bed to other medical equipments such as a wheelchair and a stretcher effectively and without the very-high-risk of
injury involved with it. This semi-automatic integrated medical equipment can be used as a (1) Hospital Bed (2) Stretcher (3)
Wheelchair. The main objective of the study is to reduce the Musculoskeletal Disorder (MSD) that has a very-high-risk Rapid Entire
Body Assessment (REBA) score of (12) among healt-hcare workers who performs the said process. The proponents used the Rapid
Entire Body Assessment (REBA) to evaluate the whole-body postural MSD and risk associated with the job task. Under REBA ergonomic
assessment, the REBA score was reduced from a very-high-risk score of (12) to a medium-risk-score of (7) when the proposed
equipment was used. The system was tested to prove that the device is functioning effectively and safely for the target users. The
Accuracy, Funtionality, and User-Friendliness Test has been conducted. The device was proven accurate, fuly functional and is user-
friendly based on the test results undertaken.

Index Terms— Ergonomics, Hospital Bed, Musculoskeletal Disorder

INTRODUCTION
Health-care workers frequently moves patients from different med- rienced back pain. Filipino nurses encounter considerable health and
ical equipments such as from hospital bed to wheelchair and stretcher safety concerns that are similar to those encountered by nurses in other
for meal, hygienic or other purposes with such complicated physical job, countries.
they experience work-related issues on handling patients, majority of In addition to this issue, the researchers conducted a study among the
them experience back pains and musculoskeletal disorders. Healthcare healthcare workers of M.V Santiago Medical and Diagnostic Center lo-
workers are at risk for musculoskeletal disorders because of the numer- cated in Poblacion 3, Indang, Cavite which is specialized in medical con-
ous ergonomic hazards present in the workplace. Ergonomic hazards are sultation, fast and accurate diagnostic service, wellness services and
defined as a physical factor within the environment that may cause emergency services. In this study, the researchers were able to gather
harm to the musculoskeletal system such as repetitive movements and data through interviews, observations and survey questionnaire. The
manual patient handling. researchers considered twenty – five (25) respondents healthcare work-
ers who are involved in the process of lifting and transferring patient
In the Philippines, healthcare workers like nurses, nursing assistants and from hospital bed going to wheelchair and stretcher and they are Insti-
hospital porters are involved on patient handling activities like lifting tutional Worker Department (IWD) and nurses. It was found out from
and transferring of patients. In 2007, according to Occupational Health the collected survey questionnaires that 100% of those healthcare
and safety Issues among Nurses in the Philippines, work-related prob- workers revealed that the process and technique used in transferring
lems among a sample of nurses in the Philippines are described. A sur- patient from bed to stretcher and wheelchair are both manually and
vey was collected during Philippine Nurses Association 2007 convention does not use any lifting equipment. It was determined that this process
and measures included four categories: work-related demographics, contributes a big factor on having body pains from lifting and transfer-
occupational injury/illness, reporting behavior, and safety concerns. ring of patient from bed to stretcher or wheelchair, since the survey
Approximately Forty percent (40%) of nurses had experienced at least results tells that 100% of those healthcare workers who are involved in
one injury or illness in the past year, and Eighty percent (80%) had expe- the said process experiencing pain on different parts of their body. By
using Rapid Entire Body Assessment (REBA), Musculoskeletal Disorder
————————————————
factor was described on both processes, with a risk score of twelve (12)
• Sherrie Joy De Leon, Ron Jude Joshua Gripo, Ian Jimenez and Raycee Tagle is
currently pursuing undergraduate degree program in industrial engineering, which means very high risk and need to implement change.
electronics engineering, computer engineering and mechanical engineering re-
spectively in Lyceum of the Philippines University - Cavite, Philippines, Thus, the researchers came up with the idea of designing an ergonomi-
E-mail:
[email protected],[email protected],[email protected],tagler@y
cally smart hospital bed with attachable – detachable “Stretchair”. The
ahoo.com term “Stretchair” is the combination of stretcher and wheelchair, and
the stretcher which is the detachable part of the hospital bed can be
• With their thesis advisers Engr. Felbert Castañaday and Engr. Jesa Ornopia Jr assembled and transformed into a wheelchair. The equipment will help
who are both a teaching faculy in Lyceum of the Philippines University – Cavite.
Email: [email protected], [email protected] lessen the risk of Musculoskeletal Disorder (MSD) and provide a safer
and comfortable process of transferring patient without putting the
healthcare worker’s health at risk. the level of MSD risk.

Literature Review For design and technicalities, the proponents used an Arduino
According to surveys from by the Department of Labor’s Bureau of Mega Microcontroller to control the Stretchair’s function such as incli-
Labor Statistics (BLS), there are more than 35,000 back and other inju- nation and declination of backrest’s slope, emergency stop, magnetic
ries among nursing employees every year, severe enough that they locking mechanism, RFID access and registration of RFID cards. The pro-
might miss work. Nursing assistant and orderlies, each suffer roughly ponents had used a linear actuator to incline or decline the backrest’s
three time the rate of back and other musculoskeletal injuries as con- slope, it can push a maximum load of 1800 N. A fail-safe magnetic lock
is used to keep the Stretchair attached to the hospital bed, a 12V 26Ah
struction laborers. In terms of number of these injuries, BLS data shows
battery is used to power the Stretchair and the Arduino Mega controls
that nursing assistants are in the second to the highest Musculoskeletal
buttons that are connected to these functions.
Disorder (MSD) cases and rates, one reason why nursing employees get
this these injuries are by doing their everyday jobs of moving and lifting
After the design was completed, the proponents conducted a pre-
patients (Zwerdling et al.,2015). test and post-test on health-care workers that experienced the said
transferring process of patients. The proponents had used the REBA
The risk of back injury is a continuing problem for nurses. Pa- assessment tool and the Visual Analogue Scale tool to compare the level
tient‐handling tasks (e.g., transferring patients on and off stretchers, of risk and the amount of paint in using the Stretchair versus the tradi-
repositioning patients on OR beds) are a major precipitating factor to tional way of transferring the patient.
this problem. Educating nurses about body mechanics has not been the
answer to preventing back injuries; however, changing the physical de- Results and Discussion
mands of the job (ie, using an ergonomic approach) by using assistive The proponents had used the REBA worksheet and got a REBA
devices (eg, friction reducers) has been proven to decrease perceived score of (12), which means a very-high-risk score, and need to imple-
stress and injury rates and increase patient comfort. This article focuses ment change (See Figure 1 and Table 1). Based on the result, the female
on the problem of nurses' back and shoulder overexertion injuries and nurses and nursing profession had the highest frequency that are in-
explores the application of ergonomics in the perioperative setting (Ow- volve on the process of transferring patients and are experiencing pain
en. 2000). during transferring. Aside from profession and gender, ages of the
healthcare workers were also considered, majority of age of healthcare
Synthesis on this activity ranges from 26 to 29 and 30 to 35. According to article
The review of related literature by the researchers is a mix of entitled “Work related musculoskeletal disorders among hospital nurses
foreign and local articles. Based on the past studies and literature that in rural Maharashtra, India: A multi centre survey” , ages 25 to 35 of
had been gathered, the researchers believe that there is a huge risk in healthcare workers who are involved on transferring patients are more
terms of physical injury among healthcare workers by using the tradi- likely to carry, lift and transfer patients for they are the one who have
tional way of lifting and transferring of a patient. Therefore, the re-
enough strength and more capability on doing it compare to those per-
searchers considered all the related articles stated on the review of
sonnel aged 35 and above.
related literature as a guide in designing a new ergonomically designed
smart hospital bed with attachable- detachable stretchair (stretcher
The second part of the results shows the work experiences of forty
and wheelchair) to contribute to the improvement of the work experi-
– two (42) healthcare workers during Transferring and carrying of pa-
ences of the healthcare workers that are involve in the process of lifting
tients from Hospital bed going to Stretcher and to Wheelchair. It was
and transferring of patients. proved that there is pain present for both processes. It was also deter-
mined that this process contributes a big factor on having body pains
Methodology from lifting and transferring of patient from bed to stretcher or wheel-
In this research, the proponents first determine thelevel of risk and chair, since the survey results tells that 100% of those healthcare work-
the amount pain a typical health-care worker experience during the said ers who are involved in the said process experiencing pain on different
process of transferring a patient. The proponents had used the Rapid
parts of their body.
Entire Body Assessment tool (REBA) in determining the level of risk,
Visual Analogue Scale (VAS) for determining the amount of pain of all
the healthcare workers available in the hospital. Survey questionaires To determine the effectiveness of the proposed prototype, the re-
and interviews are used to gather and record these data. searchers conducted a Post and Pre – Test of the proposed Hospital bed
equipment through survey questionnaire among twenty – five (25)
REBA is an ergonomic assessment tool that uses systematic process Health care workers respondents of M.V Santiago Diagnostic and Medi-
to evaluate whole body postural MSD and risk associated with job task. cal Center. Some of the pre – test and post - test result was compared
The researchers used a single page worksheet to evaluate required or through statistical tool and analysis, and the interpretations will deter-
selected body posture, forceful exertions due to load, type of move- mine the effectiveness. By using the Stretchair’s function the device
ment or actions, repetitions, and coupling with regard in the process of significantly reduced the very-high-risk score of (12) to a medium-risk-
lifting and transferring patient from bed to stretcher or wheelchair. The score of (7) (See Fig.3), the Stretchair had eliminated the lifting process
researcher used a separated worksheet for the data in transferring pa- that typically injured most of our health-care workers. In terms of body
tients from bed to stretcher and another datafor transferring patient pain, the device reduced the body pain specially in the lower back by
from bed to wheelchair. Using the REBA worksheet, the researchers 96%.
assigned a score for each of the following body regions: wrist, forearm,
elbows, shoulders, neck, trunk, legs and knees. After the data for each For technical testing the proponents conducted a functionat-
region is collected and scored, tables on the form are then used to com- lity test, safety test and user-friendliness test. Based on the results the
pile the risk factor variables, generating a single score that represents Stretchair is 94% functional, 100% safe and 93.33% user-friendly.
 Be sure that the symbols in your equation have been de-
See the Stretchair’s design in Fig. 3 fined before the equation appears or immediately following.
Italicize symbols (T might refer to temperature, but T is the
unit tesla). Per IJSER, please refer to “(1),” not “Eq. (1)” or
“equation (1),” except at the beginning of a sentence: “Equa-
2.4 Copyright Form tion (1) shows ... .” Also see The Handbook of Writing for the
An IJSER copyright form must accompany your final sub- Mathematical Sciences, 1993. Published by the Society for Indus-
mission. You can get a .pdf, .html, or .doc version at trial and Applied Mathematics, this handbook provides some
http://computer.org/copyright.htm. Authors are responsible for helpful information about math typography and other stylistic
obtaining any security clearances. matters. For further information about typesetting mathemati-
For any questions about initial or final submission require- cal equations, please visit the IJSER styel guide:
ments, please contact one of our staff members. Contact in- http://www.ijser.org.
formation can be found at: http://www.ijser.org. Please note that math equations might need to be reformatted
from the original submission for page layout reasons. This in-
cludes the possibility that some in-line equations will be made
display equations to create better flow in a paragraph. If display
equations do not fit in the two-column format, they will also be
reformatted. Authors are strongly encouraged to ensure that
3 SECTIONS equations fit in the given column width.
As demonstrated in this document, the numbering for sections
upper case Arabic numerals, then upper case Arabic numerals, 6 HELPFUL HINTS
separated by periods. Initial paragraphs after the section title 6.1 Figures and Tables
are not indented. Only the initial, introductory paragraph has
a drop cap.

4 CITATIONS
IJSER style is to not citations in individual brackets, followed
by a comma, e.g. “[1], [5]” (as opposed to the more common
“[1, 5]” form.) Citation ranges should be formatted as follows:
[1], [2], [3], [4] (as opposed to [1]-[4], which is not IJSER style).
When citing a section in a book, please give the relevant page
numbers [2]. In sentences, refer simply to the reference number, as
in [3]. Do not use “Ref. [3]” or “reference [3]” At the beginning of a
sentence use the author names instead of “Reference [3],” e.g.,
“Smith and Smith [3] show ... .” Please note that references will
be formatted by IJSER production staff in the same order pro-
vided by the author.

5 EQUATIONS
If you are using Word, use either the Microsoft Equation Edi- Fig 1. REBA Assessment Worksheet Score of (12) for hospital bed
tor or the MathType add-on (http://www.mathtype.com) for to wheelchair and hospital bed to stretcher process.
equations in your paper (Insert | Object | Create New | Mi-
crosoft Equation or MathType Equation). “Float over text”
should not be selected. Table 1 REBA Score sheet
Number equations consecutively with equation numbers in
parentheses flush with the right margin, as in (1). First, use the Score Interpretation
equation editor to create the equation. Then, select the “Equa- 1 Negligible risk, no action required
tion” markup style. Press the tab key and write the equation 2-3 Low risk, change may be needed
number in parentheses. To make your equations more com- 4-7 Medium risk, further investigation and im-
pact, you may use the solidus ( / ), the exp function, or appro- plement change
priate exponents. Use parentheses to avoid ambiguities in de- 8-10 High risk, investigation and implement
nominators. Punctuate equations when they are part of a sen- change
tence, as in 11+ Very high risk, implement change
r2
 0
F ( r,  ) dr d = [ r2 / (2 0 )]
(1)

 exp( − | z j − zi | )  J 1 ( r2 ) J 0 (  ri ) d .
−1
0
 Table 2 Level of Pain in Different Parts of the Body
Experienced by the Respondents when Transfer-
ring/Carrying patients from hospital bed to Stretcher
and vice versa

Body parts Mean Std. Devia- Interpretation

tion
Neck 0.69 1.158 No Hurt
Shoulder 1.81 1.311 Hurts a little bit
Upper Back 2.64 1.032 Hurts a little more
Elbow 1.02 1.220 Hurts a little bit
Lower Back 2.60 1.191 Hurts a little more
Arm Wrist 2.12 1.596 Hurts a little more ABLE 1
Thigh 1.71 1.367 Hurts a little bit UNITS FOR MAGENTIC PROPERTIES
Knee 1.52 1.418 Hurts a little bit
Calf or Leg 1.57 1.417 Hurts a little bit
Feet or An- 1.38 1.481 Hurts a little bit
kle
Finger 1.10 1.226 Hurts a little bit Fig 2. Visual Analogue Scale

Fig 3. REBA Score using the Stretchair

Fig 3. Stretchair Design

Conclusion
In conclusion, using the new ergonomically design hospital
bed, Testing method showed good results as the Risk of Musculo-
skeletal disorder was reduced from a score of 12 which means very
high risk to a score of 7 which means medium risk, this comparison
only tells that the proposed project is effective on reducing pain
and risk of MSD among healthcare worker who are transferring pa-
color for certain journals. Please verify with IJSER that the tients.
journal you are submitting to does indeed accept color before The system can function normally depending on the user’s de‐
submitting final materials. Do not use color unless it is neces- sire and it is easy to use and learn, the results also shows that the
sary for the proper interpretation of your figures. system can do all its basic functions that the proponents expected
Figures (graphs, charts, drawing or tables) should be named that’s why the functionality test has resulted to 94% functionality
fig1.eps, fig2.ps, etc. If your figure has multiple parts, please performance.
submit as a single figure. Please do not give them descriptive
names. Author photograph files should be named after the au- Recommendation
thor’s LAST name. Please avoid naming files with the author’s The following are the list of recommendation that would like
first name or an abbreviated version of either name to avoid to suggest by the researcher for future improvement and innova-
confusion. If a graphic is to appear in print as black and white, it tions of “Ergonomically Designed Smart Hospital bed with attacha-
should be saved and submitted as a black and white file (gray- ble – detachable Stretchair”
scale or bitmap.) If a graphic is to appear in color, it should be • For the material used, research for another lightweight stainless
submitted as an RGB color file. materials.
• For the automation, research for alternative components that
would make the stretchair fully automated.
• Research for another mechanism that would make the prototype https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797477/#!po=15.32
adjustable to its minimum and maximum standard height. 26 US
[18] Bureau of Labor Statistics. (2015). Nonfatal Occupational Injuries and Ill-
• Add a railing to inner side part of the stationary bed for easer at-
nesses: Cases with days away from work. Retrieve from:
tachments of the Stretchair. https://www.bls.gov/iif/oshwc/osh/case/osch0053.pdf

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