NCLEX Reviewer | Ergonomic Principles

• Ergonomics is concerned with designing the job to fit the worker as opposed to forcing the worker to fit the job.
• In ergonomic principles, the focus is on the worker’s joints, muscles, nerves, tendons, and bones.
• The goal of application of these principles is to reduce human error, fatigue, discomfort, and stress, and positively impact overall performance.

Following are its essential elements:
• principles of body mechanics
• posture
• lifting techniques
• positioning
• transfer
• assistive devices

• Maximize stability by using a wide base of support and keeping the center of gravity low.
• Prevent abnormal twisting of the spinal column by facing in the direction of the movement.
• Use both the arms and the legs to balance activity.
• Save work by rolling, turning, or pivoting rather than lifting.
• Use large muscles, for example, muscles of thigh, buttock, and shoulders rather than small muscles, for example, muscles of the spine and arms, which are more susceptible to injury.
• Obtain the assistance of other individuals as necessary.

• Begin by assessing the weight to be lifted to determine if additional assistance (human or mechanical) is needed.
• Tighten stomach muscles.
• Bend the knees.
• Keep weight to be lifted close to body.
• Maintain trunk erect and knees bent.
• Avoid twisting the body.

• When the body is in correct body alignment, it is considered to be balanced.
• The center of gravity is the point at which the mass is centered.
• When in a standing position, the center of gravity in humans is located at the center of the pelvis. The wider the base of support and the lower the center of gravity an individual maintains, the greater the stability.

• Maintenance of proper body alignment while in bed or sitting is important for reducing the risk of injury to the musculoskeletal system.
• Correct body alignment also contributes to a client’s psychological and physical well-being.
• Devices used to properly position clients include pillows, sandbags, splints, and bed boards.
• Five common positions are
—Fowler’s position in which head of the bed is elevated by 45—60 degrees and knees are slightly elevated without pressure,
—supine position, which involves resting on the back with legs extended such that feet are in plantar flexion and heels are touching the bed surface,
—side-lying position in which (lateral position) body rests on side with weight on the dependent hip and shoulder,
—Sims’ position in which weight is placed on the anterior ilium, humerus, and clavicle; upper shoulder and arm are internally rotated; and upper leg and thigh are adducted and internally rotated, and
—prone position in which the individual lies flat on the abdomen with the head turned to the side; shoulders, head, and neck are in an erect position; and feet are in plantar flexion.

• Transfer involves assisting a client to move between bed and chair or wheelchair or between bed and stretcher. Principles to consider are center of gravity, base of support, and maintaining balance.

Assistive devices include
• aids for transferring, repositioning, and lifting clients.
Some commonly used aids are
—gait belts,
—friction-reducing sheets, and
—mechanical chairs and lifts.
• aids for walking: These enhance the client’s balance and ability to bear weight. Some commonly used aids are
They need to extend from the floor to the client’s hip joint. Elbows need to be flexed about 30 degrees.
They need to extend from the floor to the client’s thigh joint.
Elbow needs to be flexed about 30 degrees.
Tip of cane should be placed 4 inches to the side of the foot.
Length of the crutches as well as the placement of the hand bars needs to be measured.
Crutches need to be three fingerbreadths below the axilla for length.
Elbow needs to be flexed at a 30-degree angle for the correct positioning of the hand bars.
Crutch gait is the gait a person assumes when using crutches.
The five crutch gaits are four-point gait, three-point gait, two-point gait, swing-to gait, and swing-through gait.
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