Long-Term Efficacy of an Ergonomics Program That Includes Patient-Handling Devices on Reducing Musculoskeletal Injuries to Nursing Personnel
ABSTRACT The aim of this study was to evaluate long-term efficacy of an ergonomics program that included patient-handling devices in six long-term care facilities (LTC) and one chronic care hospital (CCH).
Patient handling is recognized as a major source of musculoskeletal disorders (MSDs) among nursing personnel, and several studies have demonstrated effectiveness of patient-handling devices in reducing those MSDs. However, most studies have been conducted in a single facility, for a short period, and/or without a comprehensive ergonomics program.
Patient-handling devices along with a comprehensive ergonomics program was implemented in six LTC facilities and one CCH. Pre- and postintervention injury data were collected for 38.9 months (range = 29 to 54 months) and 51.2 months (range = 36 to 60 months), respectively.
Postintervention patient-handling injuries decreased by 59.8% (rate ratio [RR] = 0.36, 95% confidence interval [CI] [0.28, 0.49], p < .001), lost workdays by 86.7% (RR = 0.16, 95% CI [0.13, 0.18], p < .001), modified-duty days by 78.8% (RR = 0.25, 95% CI [0.22, 0.28], p < .001), and workers' compensation costs by 90.6% (RR = 0.12, 95% CI [0.09, 0.15], p < .001). Perceived stresses to low back and shoulders among nursing staff were fairly low. A vast majority of patients found the devices comfortable and safe. Longer transfer times with the use of devices was not an issue.
Implementation of patient-handling devices along with a comprehensive program can be effective in reducing MSDs among nursing personnel. Strategies to expand usage of patient-handling devices in most health care settings should be explored.
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ABSTRACT: Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive. This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses’ perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study. Thematic analysis revealed an overarching theme of 'power relations' with a subcategory of ‘(mis)power’ that comprised two subthemes, these being 'how to practice' and 'voicing practice issues'. Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the socio-political context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments. Keywords: critical methodology, emancipatory, manual handling, power relations, voicingCollegian Journal of the Royal College of Nursing Australia 02/2015; 22(1):61-70. DOI:10.1016/j.colegn.2013.11.005 · 0.84 Impact Factor
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ABSTRACT: Abstract Background: Manual handling is an integral part of the work of nursing however high injury rates persist. A clarification of the clinical practice issues related to manual handling is the first step towards reducing manual handling injuries. As historical, cultural and socio-political factors combine to shape nurses’ manual handling practices, it is vital that the dominant paradigms guiding manual handling interventions are critically analysed. If the complexities of the clinical environment are not considered during the development of manual handling safety programs, then injuries and deviations from recommended practices may continue. Methods: This paper discusses the findings from a qualitative research study conducted in 2012 on the manual handling experiences of thirteen nurses from two Australian states. The study explored nurses’ perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. The research was framed in a critical emancipatory methodology incorporating an intent to provide opportunities for reflective practice, enhanced awareness and the potential for empowerment. The two methods used in this study were semi-structured interviews and researcher reflective journaling. Findings: Thematic analysis produced an overarching theme of 'power relations' that revealed a subcategory of ‘(mis)power’ and further subthemes of 'how to practice' and 'voicing practice issues'. Specifically this paper discusses a dataset on the first subtheme, 'how to practice’ and the dialectical tensions experienced by nurses when undertaking manual handling activities. The findings suggest that the socio-political context of healthcare impacts upon nurses’ professional lives and produces discordance between manual handling policy and practice. The authors argue that manual handling issues may not be resolved without due consideration of these contextual influences on practice. Conclusion: Critical reflection and recognition of nurses' manual handling concerns can validate nurses’ experiences and make explicit previously taken-for-granted assumptions about manual handling. A clear understanding of the conditions that constrain nursing practice is a prerequisite for manual handling improvements in healthcare. The inclusion of nurses’ perspectives and experiences enables the generation of new insights to aid the development of interventions that are more readily embraced by clinicians. Furthermore, the reconceptualisation and identification of ways to restructure manual handling can empower nurses to act on the basis of this knowledge. The paper concludes with a discussion on the overall significance of conducting this study in relation to the development of sustainable manual handling practice changes within the existing healthcare context.01/2014; 4(1):218-228. DOI:10.5430/jnep.v4n1p218
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ABSTRACT: AIMS: This study evaluates the influence of individual and organisational factors on nurses' behaviour to use lifting devices in healthcare. METHODS: Interviews among nurses were conducted to collect individual characteristics and to establish their behaviour regarding lifting devices use. Organisational factors were collected by questionnaires and walk-through-surveys, comprising technical facilities, organisation of care, and management-efforts. Generalised-Estimating-Equations for repeated measurements were used to estimate determinants of nurses' behaviour. RESULTS: Important determinants of nurses' behaviour to use lifting devices were knowledge of workplace procedures (OR = 5.85), strict guidance on required lifting devices use (OR = 2.91), and sufficient lifting devices (OR = 1.92). Management-support and supportive-management-climate were associated with these determinants. CONCLUSION: Since nurses' behaviour to use lifting devices is influenced by factors at different levels, studies in ergonomics should consider how multi-level factors impact each other. An integral approach, addressing individual and organisational levels, is necessary to facilitate appropriate implementation of ergonomic interventions, like lifting devices.Applied ergonomics 12/2012; 44(4). DOI:10.1016/j.apergo.2012.11.005 · 1.33 Impact Factor