David Damico, MA, CPE, APS
December 5, 2007

  1. Stress
    1. Muscles need to be at rest. When muscles are tense, there is a build up of lactic acid that causes pain. By relaxing the tense muscle for 10 minutes the blood flow and push the lactic acid out of the tense muscle.
    2. Stress minimizing activities reduce tension and therefore pain.
    3. Outside views reduce stress.
  2. Keyboards
    1. Keyboard should be at a -15 degree tilt. (The wrists are best at a -45 degree tilt, but at -45 degree the user can not see his hands.)
    2. Do not have the keyboard legs up – ever.
    3. Laptops cause the user to either have their neck bent down or their arms extended up. Both are bad positions.
    4. Wrist Wrest constricts the flow of blood in the veins when the user’s wrists are on the pad. The user should rest his palms on the Wrist Wrest.
    5. The middle of the letter keys (“G” and “H”) should be aligned with the center of the user. Not the center of the overall key board.
  3. Mice
    1. Mice with a palm rest, at 45 degree angle or at 90 degree angle reduce pressure on the wrist.
  4. Screen
    1. A person’s eye level should typically be aligned with the top of the screen. Different alignments need to be done for people with bifocals or progressive lenses.
  5. Lighting
    1. Lighting is directly related to back comfort. A person will move towards the monitor and not sit against the back of the chair when there is poor lighting.
    2. Older adults need 2 ½ times more contrast when seeing things like text on a monitor.
    3. The amount of task light depends on the age of the person. Task light is better than under bin lighting because it is more adjustable.
    4. Air diffusers over head can dry out a person’s contacts, causing eye strain.
  6. Chairs
    1. A chair must be adjusted to be ergonomic solution. If just given a chair and not adjusting it correctly does not help a user.
    2. A slightly reclined back of chair is better than a perfectly straight back chair.
    3. Armrest on chairs should not be used while using the keyboard. Armrests are for getting in and out of the chair, and rest breaks. Armrest should be adjustable if provided.
    4. No back lock on chairs allows movement so that the user can rock. Chairs should have a tension control or have the tension built into the chair.
    5. Head rest will be the new trend for chairs due to the stacking of monitors.
    6. Foot stool should be inherently unstable so that they can rock.
  7. LEED
    1. Proper ergonomic can be used as Innovation & Design credit for LEED. See listing or CIR on
  8. Health Care
    1. Electrical outlets location at 36” to 48” instead of 12” to reduce nurses bending down to plug in equipment.
    2. To reduce leg fatigue the floor should have more cushioning.
    3. At bar rail at the nurses station allows nurses to put their foot up while filling out documents. This help in blood circulation by allowing a change in body stance.
    4. New monitors allow only straight on view so screening of patient records requires less distance between interacting people.
    5. Decentralized work spaces minimizes travel distance ( i.e. more soil linen areas).
    6. Arrangement of monitors and other equipment in the workstation needs follow the work process.
    7. Angled roof plains reflect noise transfer or confidential conversations.
    8. White noise in not comfortable for visitors.
    9. The technology of touch screens in every patient room allows nurses to spend more time with the patient than filling out records at a centralized book.
    10.  A goal of increase patient care is to always have a nurse or doctor with a patient – real or virtual.