What are the international guidelines for pushing & pulling in healthcare?

Why pushing and pulling guidelines matter in healthcare

In healthcare environments, caregivers frequently push and pull equipment such as patient lifts, hospital beds, and trolleys. These repetitive tasks can lead to physical strain and musculoskeletal disorders if not performed within recommended ergonomic force values. That’s why understanding the international guidelines for pushing and pulling in healthcare is essential to ensure both employee safety and compliance with ergonomic standards.

ISO 11228-2: the standard for pushing and pulling tasks

The international guideline ISO 11228-2 outlines safety requirements and ergonomic recommendations for pushing and pulling tasks. This standard helps employers in healthcare and other sectors determine recommended ergonomic force values, work techniques, and risk assessment procedures when moving wheeled or sliding equipment.

According to ISO 11228-2, key factors that influence safe pushing and pulling include:

• The initial and sustained force required to move a load
• Body posture and hand positioning
• Frequency and duration of the task
• Floor surface and wheel resistance
• Environmental conditions (e.g. space constraints, slopes)

International ergonomic guidance such as ISO 11228-2 assesses pushing and pulling tasks based on factors including force, posture, frequency, distance, and duration rather than defining one universal maximum force limit. In practice, many ergonomic assessments use indicative force values derived from psychophysical research, typically around:

• 20–25 kg force (200–250 N) for initiating movement
• 10–15 kg force (100–150 N) for sustained movement

The acceptable force depends on workplace conditions, task frequency, operator characteristics, and the level of ergonomic protection required.

Why these guidelines matter in healthcare

In healthcare settings, tasks like moving a patient lift, trolley or bed without powered drive assistance can easily exceed these limits, especially in tight spaces like patient rooms or bathrooms. By following international pushing and pulling guidelines, healthcare organizations can:

• Reduce the risk of injuries such as shoulder and back strain
• Improve workplace ergonomics and employee safety
• Support long-term workforce sustainability
• Ensure compliance with occupational health and safety regulations

Safer solutions through innovation

To meet these ergonomic standards, powered drive assistance can be added to equipment using either built-in solutions or FieldFit retrofit modules. These technologies reduce manual effort and support compliance with ISO 11228-2 guidelines.