Examination of hospital beds in terms of comfort

Hospital beds are one of the most interacted medical devices by patients from the first day of treatment till the day of discharge. Not only the patients but also the medical personnels such as nurses, cleaning staffs, and accompanying relatives of patients often interacts with the hospital beds. The quality of these interactions are defined and influenced by the perceieved amount of comfort among users. In the process of healing, hospital beds have significant roles. From the medical personnel's point of view hospital beds directly affects the interaction with the patients and work efficiency. Whether these interactions become efficient or inefficient highly depends on comfort of the hospital beds as well as the other parameters of the hospital beds. The amount of comfort that a user perceive from a product is highly depends on the personality of the users. Therefore, in order to measure the comfort of a product, data from users' experience have to be examined and analysed together with design criterias of the product. The concept of comfort influences the users of hospital beds both physically and psychologically. It also influences the work efficiency of medical personnels as they often deal with the hospital beds. Therefore, in the design process of hospital beds, both patient and medical personnel as well as accompanying relatives should be taken into consideration in order to determine comfort parameters. Moreover, determining these parameters helps us when measuring comfort of hospital beds. In the task of measuring comfort, there are two perspectives and parameter sets to be used: First set is the parameters that can be measured by experiments (temperature, pressure/press etc.) and the second set is the parameters that can be measured by conducting surveys and interviews (getting up easily from the bed, lie easily on the bed, safety of the bed, controllability of the bed). In this study, a semi-structured face-to-face interview which is one of the kinds of second perspective, was conducted. Firstly, from the literature, criteria for evaluating comfort in hospital beds together with other kinds of products (automobile seat, screwdriver, healthcare equipments etc.) and comfort evaluations among other disciplines (architecture, nursing) were identified. These criteria combined under 5 main comfort evaluation criteria as; functionality criteria, physical properties, physchological criteria, technological criteria and economical factors. Secondly, research done on identifying design components of hospital beds were investigated which revealed the design properties of hospital beds. The design properties gathered are side rails, operation principle, lock systems, bed control, head and foot boards, mattress platform, width and length of hospital beds, integrated drainage bag hooks and type and amount of various sleep positions of mattress platform. By considering these properties, a hospital bed categorization is proposed which were structured based on the operation principles of hospital beds, the form and movement capabilities of side rails, caster-lock systems and bed control properties. In this context, 9 kinds of hospital bed categories were obtained. Category number 1 contains hospital beds that are hydraulically operated, have one-piece and moving by being folded side rails, a central caster-lock system and crank handles to control and adjust the bed. Category number 2 contains hospital beds that are manually operated, have one-piece and moving by being folded side rails, a cross caster-lock system and crank handles to control and adjust the bed. Category 3 contains hospital beds that are manually operated, have one-piece and moving by being folded side rails, a central caster-lock system and crank handles to control and adjust the bed. Category 4 contains the hospital beds that are electrically operated, have one-piece and moving by being folded side rails, control panels integrated to the footboards, headboards and/or side rail panels to adjust and control the bed and a central caster-lock system. Category 5 contains the hospital beds that are electrically operated, have side rails one-piece and moving by sliding vertically, a portable remote control to adjust and control the bed and a central caster-lock system. Category 6 contains the hospital beds that are electrically operated, have side rails two-piece double sided and moving by sliding vertically, control panels integrated to the footboards, headboards and/or side rail panels to adjust and control the bed and a central caster-lock system. Category 7 contains the electrically operated hospital beds, have side rails two-piece double sided and moving by sliding vertically, both a portable remote control and control panels integrated to the footboards, headboards and/or side rail panels to adjust and control the bed and a central caster-lock system. Category 8 contains the electrically operated hospital beds, have side rails two-piece double sided and moving by sliding vertically, both a portable remote control and control panels integrated to the footboards, headboards and/or side rail panels to adjust and control the bed and a central caster-lock system. Category 9 contains the electrically operated hospital beds, have side rails two-piece double sided and moving by sliding horizontally, both a portable remote control and control panels integrated to the footboards, headboards and/or side rail panels to adjust and control the bed and a central caster-lock system. Afterwards, both the design features from literature survey and this categorization were examined on chosen local and foreign brands of hospital beds used in Istanbul University Istanbul Faculty of Medicine Hospital and Gaziantep University Sahinbey Research and Application Hospital, (five of them Mespa, Muka, Medical2000, Hillrom, Völker, Nitrocare), which were identified as the commonly used brands of hospital beds. Examination results showed that the chosen 11 beds were fit into the 9 category. Accordingly, features of these products influencing the technical and design aspects of them were evaluated. The results of these evaluations are combined to provide design criteria among hospital beds. At the end, the comfort parameters from literature study and from interviews were matched. The criteria coming from hospital bed design features are placed under the literature comfort evaluation criteria as sub-criteria. With the aim of testing these criteria, increasing the reliability and extending the criteria semi-structured interviews with nurses who are expert users about the comfort of hospital beds were conducted. After analyzing the interview data, it is seen that most of the nurses in that hospital use electrically operated hospital beds contrary to manually operated beds. It shows that hospitals go towards the products that follows new technology trends as a result of developing technologies and changing and increasing needs. Face-to-face semi-structured interviews were conducted with 15 nurses from General Surgery A and B services, Ear Nose and Throat Surgery Service, Cardiovascular Surgery Service, Liver Bile Ducts Surgery D Service, Urology Surgery Service, Thoracic Surgeon Service, Internal Medicine-Hematology Service, Internal Medicine- Endocrinology and Metabolic Diseases Service, Internal Medicine- Infectious Diseases Service, Internal Medicine-Romatology Service, Internal Medicine-Gastroenterology Service and Orthopedics And Traumatology Service in IU IFM Hospital. which have 17 open-ended questions, were conducted. Because the services contain only one or two nurses and need them in immediate treatment made it conduct the interviews interruptedly. Also in shift change times it happened to be a tall order to have the interviews. These interviews were recorded both taking notes and voice recording. Some of the nurses didn't want their speech to be recı-orded. In this case, it is tried to take detailed notes to help data analysis. The voice records are translated into transcriptions and by translating transcription into answer codes the expert user comfort evaluation criteria is derieved. In the matching process the ones that were resulted from interviews but could not be matched with the parameters from literature study, were identified as new different criteria. 12 new sub-criterias were revealed from the interview results and added to the former comfort evaluation criteria. After examining researches about the hospital beds in the literature, following comfort criteria were derieved: "bed control", "bed lock system", adjustable side rails, material of components, type and amount of various sleep positions, integrated drainage bag hooks, shape of side rails, adjustable hieght of the bed, product life, price of the bed, perceptual criteria, socio-cultural criteria, emotional criteria and esthetic criteria. Moreover, the sub-criteria gathered from interviews arethe following: portable head and foot boards, bed transfer, integrated fuctional areas on the bed, portable and adjustable iv hook, dimension of the bed, weight of the bed, features of mattress, maintanance, repair and spare parts, operation principle of the bed, improvement of the bed, being new/old of bed, factors generated by consumers. As a result, comfort evaluation criteria have become more generalizable and beneficial in the process of comfort evaluation of hospital beds. Afterwards, a control checklist is presented for the use of evaluating comfortof hospital beds. A total of 81 yes/no questions was created and prepared for the nurses. The questions in the control checklist was grouped in terms of main comfortevaluation criteria. For the "Functionality" criteria 33 questions, for the "Physical Properties" criteria 8 questions, for the "Physchological" criteria 9 questions, for the "Technological" criteria 25 questions and for the "Economical" criteria 5 questions are presented in the check list. This control checklist is thought to assist especially to the people who are responsible for purchasing hospital beds. In addition, it is a helpful document to evaluate the prototypes of hospital beds in the process of designing hospital beds. As a future work, this checklist is planned to be applied on hospital beds.