Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks☆
Section snippets
Problem statement
Nurses have one of the highexst incidences of work related back injuries of any profession (Bureau of Labor statistics BLS, 2002), estimated at 12.6/100 full time workers (Bureau of Labor Statistics [BLS], 2003). This number is considered to be a low estimate, since underreporting of injuries in nursing is common (US Department of Health and Human Services (USDHHS), 1999). Data from over 80 studies across a number of countries indicated that back injury to nurses have a worldwide point
Background
Many patient handling tasks are considered to be high-risk, based on the magnitude of weight lifted, awkwardness and unpredictable nature of the load lifted (patient), and sustained awkward positions used to provide nursing care. Historically, patient handling injury-reduction strategies have been based on tradition and personal experience rather than scientific evidence. The most commonly approach is manual patient lifting, augmented with classes training in body mechanics, training in safe
Goals and objectives
The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care. Our first objective was to design and implement a multifaceted program that successfully integrated evidence-based practice, technology, and safety improvement. The second objective was to evaluate the impact of the program on injury rate, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and
Program description
A multifaceted program with six program elements was designed after examining international case studies within and outside the healthcare industry (Nelson, 2003; Nelson et al., 2003b). The program elements included: (1) ergonomic assessment protocol, (2) patient handling assessment criteria and decision algorithms, (3) peer safety leaders, known as a Back Injury Resource Nurses (BIRNS), (4) patient handling equipment based on needs identified in the ergonomic assessment, (5) after action
Methods
A pre/post design without a control group was used to evaluate the effectiveness of a patient care ergonomic program in 23 high risk units. Injury rates, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and patient acceptance, program effectiveness, and costs were compared for the nine month pre-intervention (May 2001–January 2002) and the nine month post-intervention (February 2002–October 2002) periods. Data were
Results
Injury rates: Post-intervention injury rate decreased in 15 of the 23 units, increased in 7 units and remained the same in 1 unit. Overall, the injury rate decreased from 24.0/100 caregivers at baseline and 16.9/100 caregivers post-intervention. Post-intervention injury rates were found to be significantly lower χ2(1, n=46)=4.42, p=0.036. Table 2 depicts the injury rates by unit.
Modified duty days: The number of modified duty days decreased significantly (p=.02) from 1,777 modified duty days
Discussion
Nurses have one of the highest incidences of musculoskeletal work related back injuries of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful. This study tested a newly developed patient care ergonomics program designed to create safer working environments for nurses who provide direct patient care.
This study is consistent with other field studies supporting the use of patient handling equipment as part of a
Conclusions and recommendations for future research
This multi-faceted program resulted in positive outcomes associated with injury rates, modified duty days, job satisfaction, self-reported safety in performing patient handling tasks, and cost. The program was well accepted by patients, nursing staff, and administrators. While the total number of lost workdays decreased by 18% post-intervention, this difference was not statistically significant. We believe the program was successful in the short term. Further research is needed to evaluate long
Acknowledgement
The authors would like to thank James W. Collins, Ph.D., MSME, Associate Director of Science, Division of Safety Research at the National Institute for Occupational Safety and Health (NIOSH) and Bernice Owen, Ph.D., RN for their thoughtful critique of this manuscript.
Disclaimer
The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration (VHA), Health Services Research & Development and New Program Initiatives. The views expressed in this article
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2021, International Journal of Industrial ErgonomicsCitation Excerpt :A patient lift eliminates the need to lift a patient with manual handling in transfer. Using a patient lift to assist in transfer can alleviate the physical burden of the work, reduce the risk of lower back disorders and other injuries associated with patient handling, and decrease the number of lost caregiver work days and the associated cost of compensation (Andersen et al., 2014; Charney et al., 2006; Chhokar et al., 2005; Collins et al., 2004; Engst et al., 2005; Garg and Kapellusch, 2012; Gold et al., 2017; Li et al., 2004; Milleret al., 2006; Nelson et al., 2006; Tompa et al., 2016; Vinstrup et al., 2020a, 2020b; Yassi et al., 2001). By implementing a patient lift during transfer, safety and a comfort are provided to the patient receiving care (Garg and Kapellusch, 2012; Owen et al., 2002; Zhuang et al., 2000).
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The study was supported by the Department of Veterans Affairs, Veterans Health Administration, New Program Initiatives #00-019-1.