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: Objectives: There has been extensive investment in programmes to reduce injuries among health care staff caused by moving and handling patients or residents. Given conflicting evidence regarding the effectiveness of such programmes, the present paper conducted a critical appraisal of systematic reviews assessing the effectiveness of interventions in reducing back pain and injuries among healthcare staff. A realist synthesis was conducted on a second set of reports to identify best practices for moving and handling programmes. Design: A critical appraisal of systematic reviews and a realist synthesis to identify best practices for moving and handling programmes. Data sources: A literature search of five databases (Medline, EMBASE, CINAHL, PsycINFO and ScienceDirect) located 150 reports assessing programme outcomes published in refereed journals between 2000 and 2013. Review methods: The critical appraisal included six systematic reviews. The realist synthesis included 47 studies that provided descriptive information about programme mechanisms. Results: Five of the six systematic reviews covered interventions involving either staff training or training and equipment supply. One review covered multi-component interventions. All concluded that training staff by itself was ineffective. There were differing conclusions regarding the effectiveness of training and equipment interventions and multi-component programmes. The reviews provided little information about the content of programme components. The realist synthesis noted the need for management commitment and support, and six core programme components; a policy requiring safe transfer practices, ergonomic assessment of spaces where people are transferred, transfer equipment including lifts, specific risk assessment protocols, adequate training of all care staff, and coordinators coaches or resource staff. These programme components are likely to be synergistic; omitting one component weakens the impact of the other components. Conclusions: Five systematic reviews provided little information regarding the core components of effective programmes. Given the absence of experimental trials for multi-component programmes, the best available evidence for the effectiveness of multi-component programmes is from pre-post studies and large-scale surveys. The realist synthesis provided detailed information about the core components for effective programmes. Further studies, which include qualitative data, are needed to provide evidence about the specific mechanisms through which components contribute to effective patient handling programmes.International Journal of Nursing Studies 10/2014; 51(10):1381–1394. DOI:10.1016/j.ijnurstu.2014.03.007 · 2.25 Impact Factor
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ABSTRACT: The use of algorithms for safe patient handling in the acute care setting has been established and integrated into the standards of practice. This is not the case in the home care setting where the patient and caregivers are at risk for injury during patient transfers. Many factors need to be assessed before recommending a mechanical lift for home use. Some of the factors include the patient's weight-bearing status, cognitive level, and upper extremity strength, and the caregiver's ability to lift more than 35 pounds. All of these factors have been included in the clinical decision-making algorithm described in this article. Two case scenarios are presented to assist the reader with the analysis and application of the algorithm.Home healthcare nurse 03/2014; 32(3):172-80. DOI:10.1097/NHH.0000000000000025
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ABSTRACT: OBJECTIVE: The objective of the study was to identify which components of a system-wide safe patient handling (SPH) program reduced musculoskeletal injury (MSI) due to patient handling among nurses. METHODS: The 3-year longitudinal study from 2008 to 2011 used a pretest-posttest design. The study was conducted in the Veterans Health Administration, and all medical centers participated. The outcome was 2011 MSI incidence rates due to patient-related handling for nurses, expressed as injuries per 10 000 full-time employees. RESULTS: Three organizational risk factors, bed days of care, facility complexity level, and baseline MSI incidence rate, were significantly associated with MSI incidence rate and explained 21% of its variation. Five SPH components, including deployment of ceiling lifts and other new technologies, peer leader effectiveness, competency in SPH equipment use, facility coordinator link with safety committee, and peer leader training, uniquely accounted for an additional 23% of the total variation. CONCLUSIONS: Findings provide evidence to support the effectiveness of a multicomponent approach to SPH programs given contextual considerations.JONA The Journal of Nursing Administration 10/2014; 44(10):525-34. DOI:10.1097/NNA.0000000000000111 · 1.37 Impact Factor