The influence of architecture and organization of the treatment process on the results of treatment was demonstrated in the Land of the Rising Sun in 1992. Back then Japanese chambers accommodated from 6 to 8 beds, and single chambers for severe patients were extremely small. Japanese ergonomists justified the need to expand the area for patient care.
In studies conducted in France the problem was size of 45 out of 75 wards for inpatients. The most frequent problems were: lack of space for furniture, difficulty in maneuvering when transferring a patient, the need to make hospital multifunctional beds out of a clean room for putting a person on a gurney, difficult access to all parts of the body for manipulation, small doors, difficulty movement between hospital multifunctional beds.
The average area per bed is a major problem and it decreases as the number of beds increases, amounting to 12.98 m2, 9.84 m2, 9.60 m2, 8.49 m2 and 7.25 m2 in wards with, respectively, one, two, and so on beds. A more accurate indicator of usable area for staff was obtained after subtracting the area of the hospital multifunctional bed itself (from 1.8 to 2.0 m2) and equipment. The French Department of Health prescribes a usable floor space of 16 m2 in a single-bed room and 22 m2 for a double-bed room. The Quebec Department of Health recommends 17.8 m2 and 36 m2, respectively. In Russia, the values differing by department, but are in the range from 6 to 13 m2.
The inconvenient for staff is the lack of nursing chairs in the wards. Chairs available, usually only in the rest rooms, which personnel do not use during the work process. In the 13 offices there was no room for rest at all, and in 4 offices storerooms were used for this purpose. There were no seats even for visitors in 30 wards.
Our company can offer, for example, modern hospital multifunctional beds and numerous accessories that facilitate the care of patients.
Suggestions were made to improve beds into hospital multifunctional beds (Teyssier-Cotte, Rocher and Mereau 1987) and trolleys for transportation of meals (Bouhnik et al. 1989), but their effect was also limited. Tintori at al. (1994) investigated height-adjustable hospital multifunction beds with an electric lifting mechanism. Trunk lifts column lifters were rated by staff and patients as satisfactory, but mattress lifts were very inconvenient, since more than eight pedal presses were required to adjust the position of the bed, each exceeding the standard effort for the foot. Pressing the handle, located at the head, when talking to him, is more convenient than pressing the pedal eight times on the foot of the bed. Due to lack of time, lifts for bedsore mattresses were often not used.
The electronically controlled lift of hospital multifunctional beds effectively reduces the number of accidents.
Van der Star and Voogd at 1992 studied health workers serving 30 patients on prototypes of hospital multifunctional beds for more than six weeks. Studies of the worker’s position, the height of the working surface, the physical interaction between nurses and patients, and the size of the working space were compared with data collected over seven weeks in the same ward, but before the introduction of experimental beds. The use of new hospital multifunctional beds reduced the total time spent in uncomfortable positions, and the process of washing patients from 40 to 20%. For cleaning the bed, these figures were 35% and 5%, respectively. Patients themselves could change their position with the help of electric control buttons.
The April Project scientific program assessed the interaction of working conditions, work organization, courses on back problems and improvement of physical fitness. Upon its completion in the hospitals in Sweden each ward, which has two hospital multifunction beds, was equipped with elevators for patients on the ceiling.
In Quebec an approach was developed from 1988 to 1991 to analyze the working conditions that cause problems of lumbodynia (Villeneuve 1922). This study led to changes in the working environment in 120 wards and to a 30% reduction in the frequency and severity of occupational injuries. In 1994, an analysis of the profitability carried out by the association showed that systematic improvement of the lifts mounted on the ceiling would reduce the number of industrial accidents and increase productivity, compared to the use of floor lifts.
The application of European standard EN90 / 269 of May 29, 1990 on back problems is an example of an excellent starting point for such an approach.
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