Second only to truckers, nursing staff are at significant risk of back injuries-some career ending-most of which are attributed to patient handling. Potential risk factors for injuries in patient handling include: multiple lifts per shift (anything more than 20); an unnecessarily long distance from the patient to the staff worker (such as when the bed is too low); and any awkward postures required for the activity, such as reaching up and over a bed rail.

In response to the needs of hospital workers that care for children and babies, equipment manufacturers are starting to supply pediatric cribs and youth beds that now come fully equipped with Hi-Lo features to help reduce the stress and strain caused by lifting of these small patients in and out of youth beds and cribs. Leading the charge is HARD Manufacturing, based in Buffalo, NY. All of HARD's cribs and youth beds have adjustable bedspring heights from 28 to 38 inches, operated either manually or by electric motor.

"The crib's spring is double-deck: one deck is the support deck, and the top deck is the functioning deck," explains Bill Godin, PhD, a contributing designer to this new bed. "Whatever function you had in the regular cribs, such as Trendelenberg, Gatch, and Fowler, you can still get. The functioning deck does not change, but by moving the support deck up and down, the patient level can be adjusted to fit the needs of the healthcare worker."

What Hi-Lo beds do is simply position the mattress height of the crib at the location that best suits the healthcare worker and the job being performed. These can be kept low to the ground for patient safety, and then raised up when needed for interaction with the staff.

"Hi-Lo cribs are definitely a good idea," agrees Myers. "Nursing is our largest injury group across the institution, which is why we have a major initiative going forward right now to address their ergonomic concerns. Currently, all our cribs are of fixed height, which is why we are in the process of looking to replace them."