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The Ergonomics of Pushing and Pulling Medical Carts

By Team Altus | Published Jul 16, 2020 | 6 min read

Ergonomics is derived from the Greek words ergon (work) and nomos (principle or law)

Ergonomic medical carts are a key part of creating a healthy and safe work environment. The science of ergonomics focuses on decreasing fatigue, stress and discomfort by providing solutions that can adapt to a user’s unique ergonomic requirements.

Medical carts used by nurses carry medication, supplies and technology to document electronic medical records (EMRs) all to the patient bedside. With a combined weight of the cart and load (battery, monitors and misc. technology and supplies) medical carts can become heavy, creating an ergonomic obstacle. Don’t fret. In this article, you’ll earn the value of ergonomics, the factors that affect pushing and pulling, and a quick guide on how to select a push/pull medical cart.

The Economic – And Ergonomic – Value of Medical Carts

Nursing is a demanding profession and can take a toll on the body. A large portion of their job is utilizing their workstations, tasks being anything from administering patient medication, documenting EMRs, and checking on patient records all while pushing and pulling the cart from room to room, over the elevator threshold and down the hallway. In fact, nurses are known to walk over 5 miles per 12-hour shift.

The Economics of Ergonomics

Safety may not be a “revenue-generating department” but it is a “cost-cutting” department. Facilities that implement ergonomics programs see a 21% decrease in time lost due to occupational injuries. The investment from paying attention to ergonomics, health and safety of workplace conditions and actions will help a facility’s bottom line.

Workflow Efficiency & Safety

Ergonomic solutions promote workflow efficiency. By reducing awkward postures and forces, you reduce the time and effort it takes to complete a task. Medical carts that adapt to a user’s unique ergonomic requirement will not only increase productivity but increase the quality of care.

Nurse musculoskeletal disorders (MSDs)

Nurse musculoskeletal disorders (MSDs) are a condition that can affect your muscles, tendons, bones, ligaments, blood vessels and joints and any structure that support your limbs, neck and back. Examples include carpal tunnel syndrome, tendonitis and tension neck syndrome. MSDs risk factors can be from workplace actions and/or workplace conditions and overtime lead to pain, injury and potentially disability. To reduce these risks, hospitals need to make informed decisions on purchasing medical equipment, such as medical carts, that minimize exposure to risk factors.

Key Factors That Affect Pushing and Pulling

When designing ergonomic medical carts, manufacturers not only have to consider the weight of the product but the horizontal push force and casters. Key factors to consider that affect pushing and pulling are human properties, the task at hand, caster selection, cart design and environmental conditions.

  • Human properties (height, weight, etc.)
  • The task at hand (direction of movement, duration of pushing and pulling)
  • Caster selection (wheel design)
  • Cart design (handle height, type, and orientation, stability, size, weight)
  • Environmental conditions such as flooring (slope, type, characteristics)

Rolling Resistance: Forces That Resist Movement

Factors that Resist Rolling Movement


Inertia is the property of matter that remains at rest or in motion in the same straight line unless changed by an external force. In a medical cart’s case, inertia exists at the start of the cart being pushed from stationary causing a change in velocity and when the cart slows down and turns, causing an acceleration in a new direction.


Medical cart casters meeting the floor cause friction that resists movement between them. Smooth surfaces such as tile experience least resistance to rolling vs rougher surfaces such as carpet. The three locations in a caster where friction occurs is the axle-wheel, the swivel, and the ground-wheel.

  • Axel-wheel
  • The Swivel
  • Ground-wheel

Most modern casters utilize technology and materials that reduce friction.

Physical Barriers

A physical barrier is when the cater or environment becomes nonoptimal. For example, this could mean the caster deforms or there is debris on uneven surfaces on the floor. When a medical cart faces a physical barrier, its wheels must rollover the barrier. opt for a cart that utilized a soft, resilient wheel that can absorb shock. Resilient casters result in less vibration and are quieter compared to hard casters.

Human Factors that Affect Pushing and Pulling

There are many factors that affect the operator’s ability to safely and efficiently push and pull a medical cart. That’s why it’s so important to find a medical cart manufacturer that designs carts to fit a wide range of users. The three main design perspectives to determine design limits are psychophysics, biomechanics, and physiological approaches.

  • Biomechanics -Strength, force and posture guidelines
  • Physiology - Physical work capacity and fatigue
  • Psychophysics - Human perceptions

Handhold Factors

Medical carts usually feature a handhold to indicate where the user should hold and apply force to the cart. Handhold height, width, and type are all important factors to consider.

Body Posture Factors

Greater amounts of force happen in optimal postures vs. awkward postures. The muscles you use for force also play a factor in the amount of force, for example, your leg muscles vs your hand. Upright postures, balance, feet separated, and traction at the feet is usually the appropriate posture recipe in most instances.

Tasks Factors

The distance, frequency and duration of the task influences pushing and pulling. The amount of force a person can apply affects the time it takes to reach the distance. Increased repetition causes a person’s force capabilities to decrease over time. If the duration is an hour, the operator can push with a higher force compared to longer duration and lower force throughout the entire day.

A Guide to Choosing a Push/Pull Medical Cart

As a decision-maker, your goal is to make a decision that will create a safe and healthy work environment. There are five things to consider when making a medical cart purchasing decision

  1. The users (clinicians, service support)
  2. What the task is
  3. The environment
  4. Medical cart design
  5. Caster selection

Altus Medical Carts

Intuitive, well designed, powered carts for healthcare, education, or the office, with enough power for an entire shift. Altus offers free 30-day evaluation samples. Request a brand new cart today for more information!

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