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.
"However the potential impact of these developments received little attention until the emergence of MSD symptoms within the nursing workforce (Collins & Menzel, 2006). This prompted the education of nurses in 'good body mechanics', an approach devoid of empirical evidence, alongside judgements about the competency and integrity of injured nurses (Collins & Menzel, 2006; Garg & Kapellusch, 2012). Medical and educational paradigms have continued to dominate manual handling injury prevention strategies (Charney et al., 2010; HSE, 2007; Koppelaar, Knibbe, Miedema, & Burdorf, 2013). "
[Show abstract][Hide abstract] 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, voicing
Collegian Journal of the Royal College of Nursing Australia 02/2015; 22(1):61-70. DOI:10.1016/j.colegn.2013.11.005 · 1.18 Impact Factor
"Hence the identification of elements crucial to consistent injury prevention has remained elusive    . A flotilla of ergonomic guidelines and policies intended to counter manual handling issues have produced only partial success to date     "
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] ABSTRACT: Mechanical sit-to-stand devices assist patient transfers and help protect against work-related injuries in rehabilitation environments. However, observational differences between patient's movements within devices compared to normal sit-to-stand transfers deter clinician use. This study compared kinematics and muscle demands during sit-to-stand transfers with no device (ND), and device-assisted during which participants exerted no effort (DA-NE) and best effort (DA-BE). Coefficient of multiple correlations (CMCs) compared kinematic profiles during each device-assisted condition to ND. Compared to DA-NE, CMCs were higher during DA-BE at the hip, knee, and ankle. However, DA-BE values were lower than DA-NE at the trunk and pelvis due to the device's mechanical constraints. In general, all joints' final DA-NE postures were more flexed than other conditions. Electromyographic was significantly lower during DA-NE compared to ND for all muscles except lateral hamstring, and during DA-BE compared to ND for gluteus maximus, gastrocnemius, and soleus. Verbal encouragement (DA-BE) significantly increased medial hamstring, vastus lateralis, gastrocnemius, soleus and tibialis anterior activation compared to DA-NE. In conclusion, device-assisted sit-to-stand movements differed from normal sit-to-stand patterns. Verbally encouraging best effort during device-assisted transfers elevated select lower extremity muscle activation and led to greater similarity in hip, knee and ankle movement profiles. However, trunk and pelvis profiles declined.
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