Long-Term Efficacy of an Ergonomics Program That Includes Patient-Handling Devices on Reducing Musculoskeletal Injuries to Nursing Personnel

University of Wisconsin-Milwaukee, P.O. Box 784, Milwaukee, WI 53201, USA.
Human Factors The Journal of the Human Factors and Ergonomics Society (Impact Factor: 1.69). 08/2012; 54(4):608-25. DOI: 10.1177/0018720812438614
Source: PubMed


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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Available from: Jay Kapellusch, Jan 16, 2016
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    • "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). "
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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, voicing
    Full-text · Article · Feb 2015 · Collegian Journal of the Royal College of Nursing Australia
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    • "These therapeutic activities may predispose therapists to workrelated injuries because of the awkward postures, high force levels and repetition with which activities are performed. Safe patient handling guidelines and equipment can reduce or eliminate manual patient handling, resulting in decreased prevalence of WRIs among health care providers (Collins et al., 2004; Garg et al., 2012; Kim et al., 2012; Nelson & Baptiste, 2004; Siddharthan et al., 2005; Spiegel et al., 2002). Therapists complete intensive ergonomic training and even work as occupational health providers, yet are hesitant to use safe patient handling technology (Darragh et al., 2013; Nelson et al., 2008). "
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    ABSTRACT: Background: Physical therapists in rehabilitation settings often perform heavy lifting, repetitive forceful tasks and endure long periods of static or awkward postures. These work conditions put therapists at increased risk of work-related injuries (WRIs). Methods: A cross-sectional survey was conducted among physical therapists (PTs) and physical therapist assistants (PTAs) at 14 randomly selected rehabilitation facilities to determine the prevalence and severity of work-related injuries in physical rehabilitation. Results: A majority of respondents reported their most severe pain or discomfort within the last year affected their back, lasted 24 hours to 1 week, occurred once every 2-6 months, and was rated as moderate on the 0 to 10 pain scale. The 1-year prevalence of WRIs among PTs and PTAs working in physical rehabilitation was 32%. Sixty percent (60%) of those reporting pain/discomfort had mechanical patient lifts available within their work area. Less than half reported using mechanical patient lifts before or during/after their work-related pain. Conclusion: More than 65% of rehabilitation PTs and PTAs experienced work-related pain due to therapeutic activities including patient handling and movement. It is critical to understand therapists’ technology usage barriers, redesign technology to meet end-user needs, and develop technology-based best practices that promote both worker safety and patient outcomes.
    Full-text · Article · Oct 2014
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    • "Hence the identification of elements crucial to consistent injury prevention has remained elusive [22] [23] [24] . A flotilla of ergonomic guidelines and policies intended to counter manual handling issues have produced only partial success to date [4] [12] [13] [25] "
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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.
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