Hospital bathroom ergonomics: Safety, usability and accessibility issues

The safety, usability and accessibility of hospital bathrooms are important requirements for both patients and assistant nurses. Most frequently noted the critical factors in rehabilitation wards, in determining optimal management of patients' motor impairments, are space and equipment adequacy. Moreover, a bathroom is an essential part of any living space, and as such, has the potential to greatly impact on the patient’s recovery process. Current regulations and universal design define criteria for the physical layout of hospital bathrooms. Nonetheless, their practical use often discloses inconsistencies with regard to space and equipment that may jeopardize safety and ergonomics of both patients and personnel. This study explores safety, usability and accessibility issues in hospital bathrooms with a participative ergonomic approach. 32 hospital bathrooms of an Italian rehabilitation ward were inspected according to space and furniture features, and their use was simulated by dependent and independent patients. Obstacles to independent use and assisted transfers were assessed by the patients and the assisting nurses by reports and by on-site observation of physical constraints. The most critical aspects in the bathrooms’ layout involved space (26% less than the recommended value), inaccessibility with devices (67% with wheelchair, 90% with mobile hoist), inadequate location and inconsistency of elements of hygiene. Inadequate space and missing elements create an unsafe environment which may damage both nurses and patients, by requiring unsuitable movements, awkward postures which increase the risk of fall or injury. Greater attention to the ergonomics of hospital bathrooms could improve safety, usability and accessibility for any user and could contribute to overcoming adverse situations that significantly affect daily hospital routine.