Occupational back pain of nurses: Special problems and prevention

Occupational Medicine Branch, Department of Medicine, University of California, Los Angeles, USA.
Applied Ergonomics (Impact Factor: 2.02). 10/1988; 19(3):219-24. DOI: 10.1016/0003-6870(88)90140-8
Source: PubMed


An observational study was performed to asses the nature and relative frequency of special circumstances of nursing which might contribute to occupational back pain and of preventive methods unique to nursing practice. The activities of 63 nurses were observed and coded in a behavioral scoring system. The group included registered nurses, licensed vocational nurses, aides and orderlies, and they worked in several different nursing units including intensive care units, medical/surgical units, post-anesthesia room and delivery room. Physical obstruction to easy contact with patients and fragile, extended attachments to patients were the most frequently observed problems. Mechanical assist devices, although available, were rarely employed. Assistance by a second staff member was the most commonly used preventive method. Such information is valuable for worker training programme design, job design and guiding priorities for future research.

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    • "While some general approaches used for manual handling may be applicable to nursing, there are many aspects of patient manual handling that are unique to healthcare workers (Harber et al., 1988) and a number of studies have been conducted in order to investigate suitable interventions in this specific work force. Table 1 summarises intervention studies conducted using health care workers, with the goal of reducing injuries associated with manual handling. "
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    • "The maximum permissive load was estimated by Poulsen and J ¨ ogensen [22] who measured the muscle strength and back compression by using the NOISH equation. Harber et al. [15] further observed that handling patients in hospitals and related institutions was complicated by the special conditions that applied. These conditions included attachments to patients, obstructions in a confined space, fighting patients, unstable footings and slippery surfaces. "
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    ABSTRACT: This study presents the results of an evaluation of a patient handling aid commonly used for transferring patients from bed to toilet or other type of chairs. The results of the study showed that use of the patient handling aid (sling) increased the rate of perceived exertion at the lower back and the shoulder. Investigation of the muscular activity using electromyography in the shoulder and the lower back regions revealed that there was significant increase in the erector spinae activity in the lower back region. The increase in the back strain in the sling transfer was related to the increase in lumbar flexion resulting from the relatively smaller size of the sling. Trapezius muscle on the other hand did not indicate any difference in activity. The results of this study indicate that for positive outcomes there is a need for ergonomic evaluation of the sling and the postures adopted by the patient handler while transferring the patient with the sling.
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    • "Others have used direct observation (Harber et al., 1988b; Engels and Engels; Van der Beek et al., 1995; Lusted et al., 1996), but the information on the exact frequencies of transfers is limited. The results of Van der Beek et al. (1995) are worth mentioning. "
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    ABSTRACT: This article approaches the option of logging lifting activities by nurses in patient care. Practical problems in nursing limit the use of direct observation and measurements to assess exposure to lifting in real life settings. Indications were found that logs registering the frequency of manual handling could be an option in nursing. The development of a log is accounted for and its use during an intervention, introducing 40 patient hoists in home care, is described. The exposure to manual handling was reduced significantly in the intervention group (average number of patient transfers per nurse/week (ptn/w) 35–21). The control group remained stable (ptn/w 24–24). The reduction of exposure was only partly due to the hoists substituting manual transfers, suggesting the presence of an elimination effect. Possible explanations indicating that the hoists were partly responsible for this are:1.The patients’ relatives could now perform the transfers with the hoist;2.Hoists combine several manual transfers into one mechanical transfer;3.Hoists require only one operator for manual transfers that require two nurses.The log pointed to unpredicted elimination effects in addition to the substitution effects, and provided detailed information for evaluating the intervention.Relevance to industryAssessment of exposure to manual handling, using a frequency-oriented log, appears to provide relevant information for designing back pain prevention policies in nursing. Insight is given into the effects of an intervention using hoists. With some adaptations, the log could monitor ergonomic policies in nursing practice on a routine basis.
    International Journal of Industrial Ergonomics 08/1999; 24(4-24):445-454. DOI:10.1016/S0169-8141(99)00010-4 · 1.07 Impact Factor
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