Discomfort in vehicle seats is a multifactorial problem with large increases in discomfort occurring during extended duration driving. Due to the nature of driver discomfort, previous research has found it difficult to accurately quantify long term driver discomfort via the use of objective measures. This paper reports a laboratory study that investigates a novel objective measure of long term driver discomfort and its correlation with subjective discomfort ratings. Analysis of driver's seat fidgets and movements was conducted over the duration of a 140 min drive on a driving simulator in addition to collecting subjective ratings of discomfort. It is shown that as subjects' subjective discomfort increases, the frequency of subjects' seat fidgets and movements increases congruently. A large correlation is observed between the subjective and objective measures of driver discomfort and provides the opportunity for long term discomfort evaluations to be made via remote monitoring; removing the need for subjective assessment.

This article summarises the findings of an international systematic review of patient handling. More than 880 papers were read, critically appraised and allocated a quality rating score. The evidence supports the provision of a minimal set of equipment for moving and handling patients, and multifactor intervention strategies based on risk assessment rather than those predominantly based on technique training. It is recommended that healthcare providers should review their current equipment provision and approach to managing risks and injuries associated with patient handling activities in the context of this research evidence.

Objective: This review aimed to evaluate all studies that have evaluated the biomechanical effects when using assistive devices. Introduction: The physical demands of patient handling activities are well known. One safety strategy for the reduction of the physical risks is use of assistive devices. Method: The search process identified articles published in English-speaking journals through Google Scholar, Medline, and ISI Web of Science. The included 56 studies contained a biomechanical assessment of a patient handling activity with assistive devices. Results: The biomechanical effects included four groups: changes in body posture (spinal, other joints), subjective assessment (force, effort, discomfort), measured force (hand force, ground reaction force, spine force, joint torque), and physiological measures. The evidence showed caregivers benefited from using lift hoists, air-assisted devices, and to a lesser extent friction reducing devices for lateral transfers and repositioning, while floor and ceiling lifts were most effective for patient transfers. Some gaps were noted in the evidence and other handling tasks such as sit-to-stand, turning patient in bed, limb lifting, and repositioning and some more high hazard activities like supporting people with limited balance and those that fall need to be investigated with respect to biomechanical outcomes. Conclusion: There is a growing level of biomechanical evidence to support the use of assistive devices for many patient-handling tasks, but the benefits of equipment use in some transfers remain uninvestigated. Practical Application: Evidence indicates the best way to lift patients safely is with floor or ceiling lifts, and air-assisted devices for lateral and repositioning tasks.

Background: the design and use of bed rails has been contentious since the 1950s with benefits including safety, mobility support and access to bed controls and disadvantages associated with entrapment and restraint. Objective: to explore which bed designs and patient characteristics (mobility, cognitive status and age) influence the likelihood of rails being used on UK medical wards. Method: the use of rails was surveyed overnight at 18 hospitals between July 2010 and February 2011. Results: data were collected on 2,219 beds with 1,799 included (occupied). Eighty-six percent had rails attached; 52% had raised rails (42% had all raised). Adjusted logistic regression results suggest a significantly increased likelihood of rail use for (i) electric profiling beds and ultra low beds; (ii) >80 years; (iii) described as having any level of confusion or mobility impairment. These variables together explained ∼55% of the variance in rail use. The most frequently mentioned reason for raising rails was ‘to prevent falls from the bed’ (61%) especially for patients described as confused (75%). Conclusion: there were indications that rails were being used inappropriately (as a restraint) for both confused patients and those needing assistance to mobilise.

Patient handling interventions are complex and multi-factorial. It has been difficult to make comparisons across different strategies due to the lack of a comprehensive outcome measurement method. The Tool for Risk Outstanding in Patient Handling Interventions (TROPHI) was developed to address this gap by measuring outcomes and comparing performance across interventions. Focus groups were held with expert patient handling practitioners (n = 36) in four European countries (Finland, Italy, Portugal and the UK) to identify preferred outcomes to be measured for interventions. A systematic literature review identified 598 outcome measures; these were critically appraised and the most appropriate measurement tool was selected for each outcome. TROPHI was evaluated in the four EU countries (eight sites) and by an expert panel (n = 16) from the European Panel of Patient Handling Ergonomics for usability and practical application. This final stage added external validity to the research by exploring transferability potential and presenting the data and analysis to allow respondent (participant) validation. Practitioner Summary: Patient handling interventions are complex and multi-factorial and it has been difficult to make comparisons due to the lack of a comprehensive outcome measurement method. The Tool for Risk Outstanding in Patient Handling Interventions (TROPHI) was developed to address this gap by measuring outcomes to compare performance across interventions.