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Cha JS, Athanasiadis DI, Asadi H, Stefanidis D, Nussbaum MA, Yu D. Evaluation of a passive arm-support exoskeleton for surgical team members: Results from live surgeries. JOURNAL OF SAFETY RESEARCH 2024; 89:322-330. [PMID: 38858056 DOI: 10.1016/j.jsr.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 08/16/2023] [Accepted: 02/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Musculoskeletal symptoms and injuries adversely impact the health of surgical team members and their performance in the operating room (OR). Though ergonomic risks in surgery are well-recognized, mitigating these risks is especially difficult. In this study, we aimed to assess the impacts of an exoskeleton when used by OR team members during live surgeries. METHODS A commercial passive arm-support exoskeleton was used. One surgical nurse, one attending surgeon, and five surgical trainees participated. Twenty-seven surgeries were completed, 12 with and 15 without the exoskeleton. Upper-body postures and muscle activation levels were measured during the surgeries using inertial measurement units and electromyography sensors, respectively. Postures, muscle activation levels, and self-report metrics were compared between the baseline and exoskeleton conditions using non-parametric tests. RESULTS Using the exoskeleton significantly decreased the percentage of time in demanding postures (>45° shoulder elevation) for the right shoulder by 7% and decreased peak muscle activation of the left trapezius, right deltoid, and right lumbar erector spinae muscles, by 7%, 8%, and 12%, respectively. No differences were found in perceived effort, and overall scores on usability ranged from "OK" to "excellent." CONCLUSIONS Arm-support exoskeletons have the potential to assist OR team members in reducing musculoskeletal pain and fatigue indicators. To further increase usability in the OR, however, better methods are needed to identify the surgical tasks for which an exoskeleton is effective.
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Affiliation(s)
| | | | - Hamed Asadi
- Purdue University, West Lafayette, IN, United States
| | | | | | - Denny Yu
- Purdue University, West Lafayette, IN, United States
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Gonzales A, Barbieri DF, Carbonell AM, Joseph A, Srinivasan D, Cha J. The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members' perspectives and workflow simulation. ERGONOMICS 2024; 67:674-694. [PMID: 37478005 DOI: 10.1080/00140139.2023.2240045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023]
Abstract
Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.
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Affiliation(s)
- Alec Gonzales
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | | | - Alfredo M Carbonell
- Department of Surgery, Prisma Health - Upstate, Greenville, South Carolina, USA
- University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA
| | - Anjali Joseph
- School of Architecture, Clemson University, Clemson, South Carolina, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Jackie Cha
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
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Letvak S, Apple B, Jenkins M. Factors Affecting Perioperative Nurse Adherence to Ergonomic Safety Measures. AORN J 2024; 119:210-221. [PMID: 38407344 DOI: 10.1002/aorn.14097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 02/27/2024]
Abstract
AORN has identified safety risks unique to the perioperative setting and has developed ergonomic safety measures to help prevent musculoskeletal injuries and disorders. Little is known about adherence to these safety measures or the perceived barriers and facilitators to adherence. This study used a cross-sectional survey to determine the prevalence of pain and occurrence of musculoskeletal injuries and disorders. We asked perioperative staff members about their perceived barriers and facilitators to adherence with safety measures. A total of 155 perioperative nurses in one health system completed the online survey (55% response rate). Most (93%) had experienced at least one musculoskeletal injury or disorder or related pain. Years worked as a perioperative nurse and having neck pain were associated with safety measure adherence. The most reported barrier to safety measure adherence was inadequate staffing. Study findings highlight the need for increased attention to the physical workload demands in the perioperative setting.
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Núñez-Cortés R, Espin A, Calatayud J, Pérez-Alenda S, Cruz-Montecinos C, López-Bueno R, Vinstrup J, Jakobsen MD, Andersen LL. Can Vitality and Mental Health Influence Upper Extremity Pain? A Prospective Cohort Study of 1185 Female Hospital Nurses. Eur J Investig Health Psychol Educ 2023; 13:2192-2201. [PMID: 37887155 PMCID: PMC10606458 DOI: 10.3390/ejihpe13100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
Musculoskeletal disorders of the upper extremity are among the most common occupational problems affecting nurses. The aim of this study was to analyze the prospective association between vitality and mental health and increased upper extremity pain intensity in female hospital nurses during a 1-year follow-up. A prospective cohort of 1185 female nurses from 19 hospitals in Denmark was conducted using baseline and 12-month follow-up questionnaires to identify potential associations between levels of vitality and mental health (SF-36 subscales) with pain intensity (0-10 scale) in the shoulder, elbow and hand/wrist regions. Associations were modeled using cumulative logistic regression. The fully adjusted model included the variables of age, baseline pain, body mass index, smoking status, years of occupation, leisure time physical activity level, number of daily patient transfers/handlings, as well as recognition and influence at work. The mean age was 48.3 (SD: 10.4) years. In the fully adjusted model, significant associations between low vitality levels and the odds of shoulder pain (OR = 1.96; 95%CI: 1.43-2.68) and hand/wrist pain (OR = 2.32; 95%CI: 1.58-3.42) were observed. Likewise, moderate levels of mental health was associated with increased odds of shoulder pain at follow-up (OR = 1.50; 95%CI: 1.16-1.93). These results provide an important incentive for nursing managers to assess vitality and mental health among hospital nurses and to consider this factor in prevention strategies to ensure good worker health and, by extension, high-quality care.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8370000, Chile;
| | - Ander Espin
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46011 Valencia, Spain
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
| | - Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8370000, Chile;
- Division of Research, Development and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago 8370000, Chile
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
| | - Markus D. Jakobsen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (R.N.-C.); (A.E.); (R.L.-B.); (J.V.); (M.D.J.); (L.L.A.)
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Herlihy E, Antao B, Fawaz A, McDermott J, Patterson K, Nason G, O'Kelly F. Adapting lean methodology towards surgical tray rationalisation in inguinoscrotal day case surgery in the republic of Ireland. J Pediatr Urol 2023:S1477-5131(23)00107-9. [PMID: 37029012 DOI: 10.1016/j.jpurol.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/13/2023] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Lean methodologies have been used successfully in both industry and healthcare to reduce waste. The operating room (OR) and central supplies department (CSD) are areas associated with high hospital costs. The aim of this study was to employ Lean methodologies to support the rationalisation of surgical trays in paediatric inguinoscrotal surgery in order to reduce instrument wastage, processing times and overall costs in a European setting. METHODS This was a prospective, pilot observation and implementation study using Lean methodology including DMAIC (Define, Measure, Analyse, Improve and Control) cycles. Relevant tray set-up included trays for boys ≥12 months age undergoing open elective inguinoscrotal surgery. A comparative analysis of two phases, pre and post-standardization was then carried out with respect to operating times, instrument set-up times, tray weights, and costs. Instruments that were used <40% of the time were eliminated from the surgical tray. RESULTS Rationalization of the inguinoscrotal tray led to a 34.7% reduction in tray size, with a concomitant time-reduction of >2 min per case. The average overall instrument utilisation rate increased from 56% to 80% across users. Cost savings were projected at €5380.40 per annum based on current changes. There were no differences in operative time, or adverse outcomes. DISCUSSION At the hospital level, the reduction in variation, and rationalisation of this single surgical tray could lead to both operational (Tray assembly process; Operating rooms; Ergonomic functionality) as well as economic (Sterilisation; Instrument repair; Purchases) financial and ergonomic improvements for the healthcare system. The reduction in time taken to count and sterilise instruments can lead to a potential manpower saving involving a redistribution of activities to other areas which may require them. CONCLUSION Surgical tray rationalisation is emerging Lean concept with overlap across a number of specialities, and represents a technique by which to manage costs, and improve supply chain efficiency without any adverse effect in patient healthcare outcomes.
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Affiliation(s)
- E Herlihy
- Division of Paediatric Surgical Services, Beacon Hospital and University College Dublin, Ireland
| | - B Antao
- Division of Paediatric Surgical Services, Beacon Hospital and University College Dublin, Ireland; Department of Paediatric Surgery, Childrens Health Ireland, Crumlin, Dublin, Ireland
| | - A Fawaz
- Division of Paediatric Surgical Services, Beacon Hospital and University College Dublin, Ireland
| | - J McDermott
- Division of Paediatric Surgical Services, Beacon Hospital and University College Dublin, Ireland
| | - K Patterson
- Department of Urological Surgery and Renal Transplantation, Beaumont Hospital, Dublin, Ireland
| | - G Nason
- Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - F O'Kelly
- Division of Paediatric Surgical Services, Beacon Hospital and University College Dublin, Ireland; Division of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Arnoux B, Farr A, Boccara V, Vignais N. Evaluation of a Passive Upper Limb Exoskeleton in Healthcare Workers during a Surgical Instrument Cleaning Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3153. [PMID: 36833846 PMCID: PMC9962376 DOI: 10.3390/ijerph20043153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Healthcare workers are highly affected by work-related musculoskeletal disorders, particularly in the lower back, neck and shoulders, as their occupational tasks expose them to biomechanical constraints. One solution to prevent these musculoskeletal disorders may be the use of a passive exoskeleton as it aims to reduce muscle solicitation. However, few studies have been carried out directly in this field to assess the impact of the use of a passive upper limb exoskeleton on this population. (2) Methods: Seven healthcare workers, equipped with electromyographic sensors, performed a tool cleaning task with and without a passive upper limb exoskeleton (Hapo MS, Ergosanté Technologie, France). Six muscles of the upper limbs were analysed, i.e., anterior deltoid, biceps brachii, pectoralis major, latissimus dorsi, triceps brachii and longissimus thoracis. A subjective analysis of the usability of the equipment, the perception of effort and discomfort, was also carried out using the System Usability Scale and the Borg scale. (3) Results: The longissimus thoracis was the most used muscle during this task. We observed a significant decrease in the muscular solicitation of the anterior deltoid and latissimus dorsi when wearing the exoskeleton. Other muscles were not significantly impacted by the device. (4) Conclusions: the passive exoskeleton used in this study allowed the reduction in muscular load on the anterior deltoid and latissimus dorsi without negative effects on other muscles. Other field studies with exoskeletons are now necessary, particularly in hospitals, to increase our knowledge and improve the acceptability of this system for the prevention of musculoskeletal disorders.
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Affiliation(s)
- Bastien Arnoux
- CIAMS, Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Anaïs Farr
- CIAMS, Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Vincent Boccara
- LIMSI CNRS, Université Paris Sud XI, CEDEX, 91403 Orsay, France
| | - Nicolas Vignais
- CIAMS, Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d’Orléans, 45067 Orléans, France
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Jacquier-Bret J, Gorce P. Prevalence of Body Area Work-Related Musculoskeletal Disorders among Healthcare Professionals: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:841. [PMID: 36613163 PMCID: PMC9819551 DOI: 10.3390/ijerph20010841] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Healthcare professionals perform daily activities that can lead to musculoskeletal disorders (MSDs). The objective of this review was to summarize these MSDs by body areas in relation to healthcare professions. The underlying question is, worldwide, whether there are areas that are more exposed depending on the occupation or whether there are common areas that are highly exposed to MSDs. This issue has been extended to risk factors and responses to reduce MSDs. The review was conducted according to the PRISMA guidelines between February and May 2022. Google scholar and Science Direct databases were scanned to identify relevant studies. Two authors independently reviewed, critically appraised, and extracted data from these studies. Overall and body area prevalence, risk factors, and responses to MSDs were synthetized by occupational activity. Among the 21,766 records identified, 36 covering six healthcare professions were included. The lower back, neck, shoulder and hand/wrist were the most exposed areas for all healthcare professionals. Surgeons and dentists presented the highest prevalence of lower back (>60%), shoulder and upper extremity (35-55%) MSDs. The highest prevalence of MSDs in the lower limbs was found for nurses (>25%). The main causes reported for all healthcare professionals were maintenance and repetition of awkward postures, and the main responses were to modify these postures. Trends by continent seem to emerge regarding the prevalence of MSDs by healthcare profession. Africa and Europe showed prevalence three times higher than Asia and America for lower back MSDs among physiotherapists. African and Asian nurses presented rates three times higher for elbow MSDs than Oceanians. It becomes necessary to objectively evaluate postures and their level of risk using ergonomic tools, as well as to adapt the work environment to reduce exposure to MSDs with regard to the specificities of each profession.
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Aydin A, Atiç R. Negative effects of the COVID-19 pandemic on the musculoskeletal system and depression in healthcare professionals. J Back Musculoskelet Rehabil 2023; 36:1273-1283. [PMID: 37458009 DOI: 10.3233/bmr-220229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, it is thought that healthcare workers are most exposed to musculoskeletal disorders. However, there are limited studies in the literature examining the musculoskeletal disorders among healthcare workers during the COVID-19 pandemic. OBJECTIVE The aim of this study was to examine musculoskeletal problems and psychological disorders in healthcare personnel working at Dicle University Faculty of Medicine and Research Hospitals during the COVID-19 pandemic and to come up with solutions for rehabilitation. METHODS The Cornell Musculoskeletal Disorder Questionnaire (CMDQ) was used to assess musculoskeletal problems in the past week. Additionally, Beck depression inventory (BDI) was used to evaluate the psychological state of the participants. Questions on demographic characteristics, habits, the presence and localisation of musculoskeletal system (MSS) diseases, severity and duration of pain, chronic diseases, trauma history and working conditions were included in the questionnaire prepared by the researchers. RESULTS The study included 74 nurses, 42 residents, 26 specialists, 24 technicians, 16 dentists, 12 physiotherapists, and 26 other allied health personnel. Dentists had the highest total CMDQ score (160.73) whereas resident doctors had the lowest total CMDQ score (98.33). Low back, neck and back pain were the most common MSS problems. BDI was highest in nurses and 70.27% of the nurses were women. The total workplace ergonomics score was found to be 25.91%, and the visual analogue scale (VAS) was highest in nurses (6.72). CONCLUSIONS While MSS pain is concentrated on the waist, neck and back regions in all healthcare workers. We concluded that the uncertainty associated with the pandemic, delay in preventive measures such as vaccination and medication, rapid and strong transmission of the disease and increasing number of deaths have led to an increase in stress, depression and burnout among healthcare workers.
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Affiliation(s)
- Abdulkadir Aydin
- Ataturk Vocational School of Health Services, Dicle Univercity, Diyarbakir, Turkey
| | - Ramazan Atiç
- Department of Orthopedics and Traumatology, Faculty of Medicine, Dicle Univercity, Diyarbakir, Turkey
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Thakur K, Madhav Kuber P, Abdollahi M, Rashedi E. Why multi-tier surgical instrument table matters? An ergonomic analysis from mento-physical demand perspectives. APPLIED ERGONOMICS 2022; 105:103828. [PMID: 35777184 DOI: 10.1016/j.apergo.2022.103828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
Using traditional back tables (BT) in operating rooms (OR) can lead to high physical/cognitive demand on nurses due to repetitive manual material handling activities. A multi-tier table (MTT) has been developed to relieve such stressors by providing extra working surfaces to avoid stacking the instrument trays and facilitate access to surgical tools. In this study, sixteen participants performed lifting/lowering and instrument findings tasks on each table, where kinematics, kinetics, subjective, and performance-related measures were recorded. Results indicated that MTT required lesser shoulder flexion (p-value<0.001), ∼14% lower shoulder loads (0.012), task completion time (<0.001), and cognitive/physical workloads (<0.004). Although peak low-back demands were ∼15% higher using MTT, the number of lifts to complete the same task was 60% lower, leading to lower cumulative demand on the low-back musculature. Utilizing MTT in OR could reduce demand and increase nurses' efficiency, leading to reduced risk of WMSDs and the total time of surgery.
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Affiliation(s)
- Ketan Thakur
- Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Pranav Madhav Kuber
- Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Masoud Abdollahi
- Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Ehsan Rashedi
- Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA.
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Holland H, Kong A, Buchanan E, Patten C. Breast Surgery Cost Savings Through Surgical Tray Instrument Reduction. J Surg Res 2022; 280:495-500. [PMID: 36067536 DOI: 10.1016/j.jss.2022.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/29/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Removing unnecessary instruments from surgical trays used in the operating room conserves resources and time. We aimed to assess the cost savings impact of breast surgical tray instrument reduction. METHODS Breast surgeons at a single institution reviewed the standard surgical tray used for lumpectomies and mastectomies and removed underutilized instruments to create a breast-specific tray. This tray was used for all breast surgeries performed throughout the 2019 calendar year. Data for breast-specific tray usage, instrument reprocessing costs, and instrument maintenance costs for inspection, sharpening, aligning, and lubricating were retrospectively obtained. RESULTS The breast-specific tray was reduced from 82 to 65 instruments. The cost of reprocessing each instrument is $1.69. After 30 tray sterilizations, each tray was sent for maintenance at a cost of $2.00 per instrument. With 10 breast-specific trays in circulation, the trays were used a total of 656 times during the calendar year. Each tray was sent for maintenance an average of two times during this time period. Thus, instrument reduction resulted in $18,847 in instrument reprocessing and $680.00 in maintenance savings, with total annual cost savings of $19,527. CONCLUSIONS Optimizing surgical trays by removing unused instruments yields significant cost savings and contributes to improved efficiency in the sterile processing department. As efforts to eliminate wasteful practices and reduce costs within the health care system continue, opportunities remain for standardization of trays across all surgical departments and institutions.
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Affiliation(s)
- Hannah Holland
- Department of Surgery, Surgical Oncology Breast and Endocrine Division, Medical College of Wisconsin, Wauwatosa, Wisconsin
| | - Amanda Kong
- Department of Surgery, Surgical Oncology Breast and Endocrine Division, Medical College of Wisconsin, Wauwatosa, Wisconsin
| | - Erin Buchanan
- Department of Surgery, Surgical Oncology Breast and Endocrine Division, Medical College of Wisconsin, Wauwatosa, Wisconsin
| | - Caitlin Patten
- Department of Surgery, Surgical Oncology Breast and Endocrine Division, Medical College of Wisconsin, Wauwatosa, Wisconsin.
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Souza GAD, Cardoso VDF, Barros FCD, Trondoli LHPDC, Moriguchi CS, Sato TDO. Correlation between standing posture during work and low back and lower limb pain among cleaners and caregivers of older adults. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20028429022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Maintaining a standing posture during work has been associated with musculoskeletal symptoms. Few studies, however, assess the standing time using objective measures. Thus, this study aimed to verify whether standing time at work is associated with lower back and lower limb pain in the last seven days and last 12 months in caregivers of older adults and cleaners. This is a cross-sectional study. Standing time at work was quantified using inclinometers attached to the workers’ thigh and spine. Musculoskeletal symptoms were assessed using the Nordic Musculoskeletal Questionnaire. Data were analyzed using the point-biserial correlation coefficient (rpb) between standing time at work and the presence of musculoskeletal symptoms. The analyses were performed using the SPSS software, adopting 5% significance level. Workers spend most of their time standing still (41.3%) or walking (39.3%). The presence of symptoms in the lower back was positively correlated with standing time (rpb=0.52; p<0.05). Walking time was negatively correlated with symptoms at the hip in the last 12 months (rpb=−0.53; p<0.05) and running time with symptoms at the hip, in the last seven days, (rpb=−0.43; p<0.05) and the lower back (rpb=−0.43; p<0.05). Longer standing time was correlated with the presence of symptoms in the lower back. Meanwhile, less time walking and running were correlated with the presence of musculoskeletal symptoms in the hips and lower back.
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Souza GAD, Cardoso VDF, Barros FCD, Trondoli LHPDC, Moriguchi CS, Sato TDO. Correlação entre a postura em pé durante o trabalho e dor na coluna lombar e nos membros inferiores em trabalhadoras da limpeza e cuidadoras de idosos. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20028429022022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO A postura em pé durante o trabalho tem sido associada a sintomas musculoesqueléticos. Entretanto, há poucos estudos que avaliam o tempo em pé utilizando medidas objetivas. Assim, o objetivo deste estudo foi verificar se o tempo em pé no trabalho está associado com dor na coluna lombar e nos membros inferiores nos últimos sete dias e 12 meses em cuidadoras de idosos e trabalhadoras da limpeza. Trata-se de estudo transversal, em que o tempo em pé no trabalho foi quantificado por meio de inclinômetros fixados na coxa e na coluna vertebral, e os sintomas musculoesqueléticos foram avaliados por meio do Questionário Nórdico de Sintomas Osteomusculares. Os dados foram analisados por meio da correlação ponto bisserial (rpb) entre o tempo em pé no trabalho e a presença de sintomas musculoesqueléticos. As análises foram realizadas por meio do software SPSS e o nível de significância adotado foi de 5%. Verificou-se que as trabalhadoras passam a maior parte do tempo em pé paradas (41,3%) ou andando (39,3%). Houve correlação positiva entre a presença de sintoma na lombar e o tempo em pé (rpb=0,52; p<0,05) e correlação negativa entre o tempo andando e sintomas no quadril (rpb=−0,53; p<0,05) nos últimos 12 meses e o tempo correndo e sintomas no quadril (rpb=−0,43; p<0,05) e na coluna lombar (rpb=−0,43; p<0,05) nos últimos sete dias. O maior tempo em pé foi correlacionado com a presença de sintomas na lombar; enquanto o menor tempo andando e correndo foram correlacionados com a presença de sintomas no quadril e na coluna lombar.
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Krishnan KS, Raju G, Shawkataly O. Prevalence of Work-Related Musculoskeletal Disorders: Psychological and Physical Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9361. [PMID: 34501950 PMCID: PMC8430476 DOI: 10.3390/ijerph18179361] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 01/20/2023]
Abstract
Purpose-This study aimed to estimate the prevalence and risk factors of MSD pain in various anatomical regions among nurses. Method-A cross-sectional study involving a self-administered questionnaire by registered nurses with clinical experience. Data was collected using convenience sampling after obtaining informed consent. The results were drawn from a total of 300 nurses. Results-The nurses presented with occasional mental exhaustion (44.3%) and often physical exhaustion (44.0%). Almost all (97.3%) the nurses complained of having work-related pain during the last 12 months. Body parts with the most pain were the lower back (86.7%), ankles (86.7%), neck (86.0%), shoulders (85.0%), lower legs (84.7%) and upper back (84.3%). The pain frequency was rated as occasional pain for the neck and upper back, pain was often felt for the rest of the parts. Nurses complained of severe pain in the lower back (19.7%), right shoulder (29.7%) and left shoulder (30.3%). The frequency of having musculoskeletal symptoms in any body region was increased with age, lower education level, female gender, high BMI, job tenure and lifestyle. Conclusions-Nurses' WRMSD complaints should be taken seriously to curb further risk and musculoskeletal hazards.
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Affiliation(s)
| | - Gunasunderi Raju
- School of Distance Education, Universiti Sains Malaysia, Gelugor 11800, Malaysia;
| | - Omar Shawkataly
- UniKL MICET Lot 1988, Kawasan Perindustrian Bandar Vendor, Taboh Naning, Alor Gajah 78000, Malaysia;
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Clari M, Godono A, Garzaro G, Voglino G, Gualano MR, Migliaretti G, Gullino A, Ciocan C, Dimonte V. Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and META-analysis. BMC Musculoskelet Disord 2021; 22:226. [PMID: 33637081 PMCID: PMC7908783 DOI: 10.1186/s12891-021-04057-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/08/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND To evaluate the prevalence of work-related musculoskeletal disorders (WRMSDs) in perioperative nurses and to explore their association with personal characteristics. METHODS Medline, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library and Joanna Briggs Institute Database were systematically searched. A meta-analysis calculating event rates, and relative 95% Confidence Intervals (CI) was performed for each musculoskeletal body region. The contribution of perioperative nurses' sex, age, and BMI was assessed through a meta-regression. RESULTS Twenty-two studies, considering 3590 perioperative nurses, were included in the systematic review. The highest prevalence of WRMSDs was found for the lower-back (62%; 95% CI 0.54-0.70), followed by knee (47%; 95% CI 0.36-0.59), shoulder (44%; 95% CI 0.37-0.51), waist (42%; 95% CI 0.31-0.53), neck (39%; 95% CI 0.29-0.51), ankle-feet (35%; 95% CI 0.22-0.51), upper-back (34%; 95% CI 0.25-0.44), hand-wrist (29%; 95% CI 0.20-0.40), and elbow (18%; 95% CI 0.12-0.26). Meta-regression showed that sex, age, and BMI were not significant predictors of low-back disorders (p = 0.69; R2 = 0). CONCLUSIONS WRMSDs represent a high prevalence issue among perioperative nurses. Perioperative nurses, in general, are steadily exposed to both physical and temporal risk factors. Further studies should be addressed to identify specific interventions aimed at reducing the burden of WRMSDs including ergonomic education and physical rehabilitation. Our data could be used in future studies as a reference to assess the risk of WRMSDs in other health-care professionals' population.
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Affiliation(s)
- Marco Clari
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy
| | - Giacomo Garzaro
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy. .,Città della Salute e della Scienza di Torino University Hospital, Turin, Italy.
| | - Gianluca Voglino
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy
| | - Maria Rosaria Gualano
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy
| | - Giuseppe Migliaretti
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy
| | - Attilia Gullino
- Città della Salute e della Scienza di Torino University Hospital, Turin, Italy
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy.,Città della Salute e della Scienza di Torino University Hospital, Turin, Italy
| | - Valerio Dimonte
- Department of Public Health and Pediatrics, University of Torino, Via Zuretti 29, 10126, Turin, Italy.,Città della Salute e della Scienza di Torino University Hospital, Turin, Italy
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Getie K, Kahsay G, Kassaw A, Gomera G, Alamer A, Hailu T. Ankle and Foot Pain and Associated Factors Among Nurses at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia: Cross-Sectional Study. J Pain Res 2021; 14:83-92. [PMID: 33500657 PMCID: PMC7826044 DOI: 10.2147/jpr.s283580] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/23/2020] [Indexed: 12/02/2022] Open
Abstract
Background Ankle–foot pain is a significant public health problem in nurse professionals and has great burdens to the individuals, healthcare systems, and community at large. However, there is limited evidence on the prevalence of ankle–foot pain and its associated factors among nurses in Ethiopia. Thus, the finding of this study will help to address health problems resulting from ankle–foot pain among nurses. Purpose The aim of this study was to determine the prevalence and associated factors of ankle–s–foot pain among nurse working in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. Patients and Methods An institutional-based cross-sectional study was conducted on a total of 366 nurses, and a simple random sampling technique was used to recruit study participants. Data were collected by using a self-administered adapted standardized Nordic questionnaire. Descriptive statistics and a bivariate logistic regression model were done to identify factors associated with ankle–foot pain. Those variables with a P-value less than 0.05 with 95% CI in multivariate model were taken as statistically significant. Finally, AOR with 95% confidence interval at a P-value of <0.05 was reported. Results The prevalence of self-reported ankle–foot pain among nurses was 43.7% (95% CI=38.5–49.1). Older age (AOR=7.669, 95% CI=2.316−25.390), low shoe comfort (AOR=4.215, 95% CI=2.031–8.745), multiple foot conditions (AOR=6.102 95% CI=1.959–19.008), working night shifts (AOR=2.047, 95% CI=1.098−3.816), high physical demand (AOR=3.487, 95% CI=1.988–6.116), and nurses working in the intensive care unit (AOR=2.402, 95% CI=1.219–4.732) showed a statistically significant association with ankle–foot pain. Conclusion This study indicated that the prevalence of ankle–foot pain is commonly reported among nurses working in Ayder Comprehensive Specialized Hospital. Therefore, awareness and prevention of ankle and foot pain in nurses should be prioritized to reducing risk factors. Nurses should give attention to comfortable footwear, and further longitudinal research is recommended.
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Affiliation(s)
- Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebreslassie Kahsay
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Alemu Kassaw
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gidey Gomera
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abayneh Alamer
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tesfay Hailu
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Tavakkol R, Kavi E, Hassanipour S, Rabiei H, Malakoutikhah M. The global prevalence of musculoskeletal disorders among operating room personnel: A systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197333. [PMID: 33049927 PMCID: PMC7578944 DOI: 10.3390/ijerph17197333] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 02/03/2023]
Abstract
Background: Nursing staff working in the operating room are exposed to risk factors that can cause musculoskeletal disorders (MSDs) and work-related disabilities. The use of ergonomics principles can help with the prevention of MSDs. This study aimed to examine the effect of an ergonomics educational program on MSDs among nursing staff working in the operating room. Methods: In this pragmatic parallel group quasi-randomized controlled clinical trial, 74 nursing staff working in the operating rooms of two teaching hospitals participated. The hospitals were randomly assigned to either the intervention or the control group and all nursing staff working in the operating room of each hospital were invited to take part in this research. They were initially assessed for the prevalence and risk of MSDs by using the Nordic questionnaire and the rapid entire body assessment (REBA) checklist. The intervention group received the ergonomics educational program and were assessed in two-week intervals over a period of three months. At the end of the study, the risk and prevalence of MSDs were compared between the intervention and control groups. Results: Statistically significant differences were reported between the groups in terms of the prevalence and risk of MSDs. The overall risk of MSDs decreased in the intervention group after the educational program (p = 0.03). The reduction in the prevalence of MSDs in the different parts of the body in the intervention group was as follows: ankle (p = 0.005), hand/wrist (p = 0.041), low back (p = 0.000), the neck (p = 0.003), hip (p = 0.001) and shoulder (p = 0.043). Conclusion: The education of nursing staff about ergonomics can influence the prevalence and risk of MSDs. Therefore, it should be incorporated into the degree education and on-the-job training initiatives for nurses working in the operating theatre in order to reduce workplace injuries and associated absences, and increase the quality of care delivered by them. This clinical trial has been registered in the Iranian Registry of Clinical Trials: IRCT2015081823677N1.
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18
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Tavakkol R, Karimi A, Hassanipour S, Gharahzadeh A, Fayzi R. A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel. J Multidiscip Healthc 2020; 13:735-741. [PMID: 32801736 PMCID: PMC7402850 DOI: 10.2147/jmdh.s259245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/01/2020] [Indexed: 12/04/2022] Open
Abstract
Musculoskeletal disorder is one of the major health issues and is recognized as the second most common occupational disease. The aim of the present study was to investigate the different aspects of musculoskeletal disorders in operating room personnel. The present study was conducted to evaluate the prevalence of MSDs among operating room personnel, in January 2020. In this study, the authors explored 30 articles from five databases including Medline/PubMed, ProQuest, Scopus, Embase, and Google Scholar. The present study found that physical, psychological, and demographic characteristics including age, gender, work experience, and smoking were the most important risk factors for these disorders. Musculoskeletal disorders were also prevalent in different areas of the body, with the highest prevalence being in the lumbar region. In addition, regular exercise and physical activity, the use of stretching and gentle exercise to reduce physical pressure, regard to the principles of ergonomics in the workplace, regular physical examinations, and awareness of the risk factors for these disorders. Therefore, operating room officials need to promote operating room programs focused on reducing musculoskeletal disorders and increase the awareness of the personnel about the risk factors by conducting training courses.
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Affiliation(s)
- Reza Tavakkol
- Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Ashkan Karimi
- Operating Room Group, School of Paramedical, Hamadan University of Medical Science, Hamadan, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Gharahzadeh
- Operating Room Department, North Khorasan University of Medical Science, Bojnord, North Khorasan, Iran
| | - Reza Fayzi
- Department of Operating Room, School of Paramedical, Kermanshah University of Medical Science, Kermanshah, Iran
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Cha JS, Monfared S, Stefanidis D, Nussbaum MA, Yu D. Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room. HUMAN FACTORS 2020; 62:377-390. [PMID: 31593495 PMCID: PMC10027361 DOI: 10.1177/0018720819879271] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The objective of this study was to identify potential needs and barriers related to using exoskeletons to decrease musculoskeletal (MS) symptoms for workers in the operating room (OR). BACKGROUND MS symptoms and injuries adversely impact worker health and performance in surgical environments. Half of the surgical team members (e.g., surgeons, nurses, trainees) report MS symptoms during and after surgery. Although the ergonomic risks in surgery are well recognized, little has been done to develop and sustain effective interventions. METHOD Surgical team members (n = 14) participated in focus groups, performed a 10-min simulated surgical task with a commercial upper-body exoskeleton, and then completed a usability questionnaire. Content analysis was conducted to determine relevant themes. RESULTS Four themes were identified: (1) characteristics of individuals, (2) perceived benefits, (3) environmental/societal factors, and (4) intervention characteristics. Participants noted that exoskeletons would benefit workers who stand in prolonged, static postures (e.g., holding instruments for visualization) and indicated that they could foresee a long-term decrease in MS symptoms with the intervention. Specifically, raising awareness of exoskeletons for early-career workers and obtaining buy-in from team members may increase future adoption of this technology. Mean participant responses from the System Usability Scale was 81.3 out of 100 (SD = 8.1), which was in the acceptable range of usability. CONCLUSION Adoption factors were identified to implement exoskeletons in the OR, such as the indicated need for exoskeletons and usability. Exoskeletons may be beneficial in the OR, but barriers such as maintenance and safety to adoption will need to be addressed. APPLICATION Findings from this work identify facilitators and barriers for sustained implementation of exoskeletons by surgical teams.
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Affiliation(s)
- Jackie S Cha
- 311308 Purdue University, West Lafayette, Indiana, USA
| | - Sara Monfared
- 12250 Indiana University School of Medicine, Indianapolis, USA
| | | | | | - Denny Yu
- 311308 Purdue University, West Lafayette, Indiana, USA
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20
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Yasak K, Vural F. Assessment of the Environmental and Physical Ergonomic Conditions of ORs in Turkey. AORN J 2019; 110:517-523. [DOI: 10.1002/aorn.12841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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21
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Clari M, Garzaro G, Di Maso M, Donato F, Godono A, Paleologo M, Dimonte V, Pira E. Upper Limb Work-Related Musculoskeletal Disorders in Operating Room Nurses: A Multicenter Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2844. [PMID: 31395811 PMCID: PMC6720415 DOI: 10.3390/ijerph16162844] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 11/20/2022]
Abstract
This study aimed to evaluate the association between personal and job characteristics and the risk of upper limb work-related musculoskeletal disorders (WMSDs) among operating room nurses (ORNs). To this end, we collected data from 148 ORNs working at 8 Italian hospitals and measured any upper limb disabilities experienced in the previous year using the Italian version of the disabilities of the arm, shoulder and hand (DASH) questionnaire. The associations between personal and job characteristics and risk of upper limb WMSDs were estimated by unconditional logistic regression models. The prevalence of upper limb WMSDs was 45.9%. Multivariate analysis showed the "female gender" and "monthly hours spent working as a scrub nurse" to be directly associated with a higher DASH score (adjusted OR for gender = 5.37, 95% CI: 1.65-17.51, p < 0.01; adjusted OR for monthly hours as scrub nurse = 3.09, 95% CI: 1.33-7.19, p < 0.01). Overall, our findings indicate that a full-time job (>120 h/month) as a scrub nurse significantly increases the risk of developing upper limb WMSDs among female ORNs. Thus, to reduce such risk in this particularly sensitive population, we recommend urgent implementation of ergonomic interventions on surgical equipment alongside job rotation and medical surveillance programs.
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Affiliation(s)
- Marco Clari
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Giacomo Garzaro
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy.
| | - Matteo Di Maso
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, 20133 Milan, Italy
| | - Francesca Donato
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Mario Paleologo
- Directorate of Allied Health Professionals, Città della Salute e della Scienza di Torino University Hospital, 10126 Turin, Italy
| | - Valerio Dimonte
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
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Anderson J, Granat MH, Williams AE, Nester C. Exploring occupational standing activities using accelerometer-based activity monitoring. ERGONOMICS 2019; 62:1055-1065. [PMID: 31058582 DOI: 10.1080/00140139.2019.1615640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
Prolonged standing at work is required by an estimated 60% of the employed population and is associated with a high prevalence of musculoskeletal disorders. 'Standing' is expected to encompass a range of activities of varying intensity. This study aimed to define a range of 'standing' work-based activities; and objectively explore differences between 'standing' occupations. The following movements were defined using a triaxial accelerometer (ActivPAL) through recordings of known movements (n = 11): static standing, weight-shifting, shuffling, walking and sitting. Movements over a working day were defined for chefs (n = 10), veterinary surgeons (n = 7) and office workers (n = 9). Despite veterinary surgeons and chefs spending a similar time in an upright posture, veterinary surgeons spent 62% of this time standing statically whereas chefs split their time between all the movements. Overall, this study provides the first attempt to define 'standing' activities, allowing the differentiation of activities between occupations spending similar periods of time upright. Practitioner Summary: This study identified a range of work-based 'standing' activities of varying intensity. Differences in activity were recorded between two occupations spending a similar time in an upright posture (veterinary surgeons and chefs). A broader definition of standing activities could be important when considering factors related to musculoskeletal disorders at work.
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Affiliation(s)
- Jennifer Anderson
- a School of Health Sciences , University of Salford , Salford , United Kingdom
| | - Malcolm H Granat
- a School of Health Sciences , University of Salford , Salford , United Kingdom
| | - Anita E Williams
- a School of Health Sciences , University of Salford , Salford , United Kingdom
| | - Christopher Nester
- a School of Health Sciences , University of Salford , Salford , United Kingdom
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Lowndes BR, Abdelrahman AM, Thiels CA, Mohamed AO, McConico AL, Bingener J, Hallbeck MS. Surgical team workload comparison for 4-port and single-port laparoscopic cholecystectomy procedures. APPLIED ERGONOMICS 2019; 78:277-285. [PMID: 29960648 DOI: 10.1016/j.apergo.2018.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 05/15/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
Advanced minimally invasive procedures may cause postural constraints and increased workload and stress for providers. This study compared workload and stress across surgical team roles for 48 laparoscopic cholecystectomies (4-port vs single-port) using a task load index (NASA-TLX), a procedural difficulty question, and salivary stress hormones. Statistical analyses were performed based on the presence intra-cluster correlation within team roles, at α=0.05. The single-port technique resulted in an 89% increase in physical workload for the surgeon and 63% increase for the assistant (both p<0.05). The surgeon had significantly higher salivary stress hormones during single-port surgeries. The degree of procedural difficulty was positively correlated between the surgeon and most roles: resident (r=0.67), assistant (r=0.81), and technician (r=0.81). There was a statistically significant positive correlation between the surgeon and assistant for all selfreported workload measures (p<0.05). The single-port technique requires further improvement to balance surgical team workload for optimal patient safety and satisfaction.
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Affiliation(s)
- Bethany R Lowndes
- Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Amro M Abdelrahman
- Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Cornelius A Thiels
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Department of Surgery, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Amani O Mohamed
- Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Department of Surgery, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Andrea L McConico
- Department of Surgery, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Juliane Bingener
- Department of Surgery, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - M Susan Hallbeck
- Department of Health Sciences Research, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Department of Surgery, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.
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Ahmadi E, Masel DT, Schwerha D, Hostetler S. A bi-objective optimization approach for configuring surgical trays with ergonomic risk consideration. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/24725579.2019.1620383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Ehsan Ahmadi
- Department of Industrial and Systems Engineering, Russ College of Engineering and Technology, Ohio University, Athens, USA
| | - Dale T. Masel
- Department of Industrial and Systems Engineering, Russ College of Engineering and Technology, Ohio University, Athens, USA
| | - Diana Schwerha
- Department of Industrial and Systems Engineering, Russ College of Engineering and Technology, Ohio University, Athens, USA
| | - Seth Hostetler
- Center for Healthcare Systems Re-engineering Department, Geisinger Health System, Danville, USA
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Schnittker R, Marshall SD, Horberry T, Young K. Decision-centred design in healthcare: The process of identifying a decision support tool for airway management. APPLIED ERGONOMICS 2019; 77:70-82. [PMID: 30832780 DOI: 10.1016/j.apergo.2019.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/15/2018] [Accepted: 01/19/2019] [Indexed: 06/09/2023]
Abstract
Current decision support interventions for airway management in anaesthesia lack the application of Human Factors Engineering; leading to interventions that can be disruptive, inefficient and error-inducing. This study followed a decision-centred design process to identify decision support that can assist anaesthesia teams with challenging airway management situations. Field observations, Critical Decision Method interviews and focus groups were conducted to identify the most difficult decisions and their requirements. Data triangulation narrowed the focus to key decisions related to preparation and planning, and the transitioning between airway techniques during difficulties. Five decision-support interventions were identified and positively rated by anaesthesia team members in relation to their perceived effectiveness. An organized airway equipment trolley was chosen as the most beneficial decision support intervention. This study reiterated the key importance of both Human Factors Engineering and data triangulation when designing for healthcare.
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Affiliation(s)
- R Schnittker
- Monash University Accident Research Centre, 21 Alliance Lane, Building 70, Monash University, Clayton Campus, 3800, Victoria, Australia; Department of Anaesthesia and Perioperative Medicine, Central Clinical School, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Victoria, Australia.
| | - S D Marshall
- Department of Anaesthesia and Perioperative Medicine, Central Clinical School, Monash University, Level 6, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Victoria, Australia.
| | - T Horberry
- Monash University Accident Research Centre, 21 Alliance Lane, Building 70, Monash University, Clayton Campus, 3800, Victoria, Australia.
| | - K Young
- Monash University Accident Research Centre, 21 Alliance Lane, Building 70, Monash University, Clayton Campus, 3800, Victoria, Australia.
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MacDonald V, Keir PJ. Assessment of Musculoskeletal Disorder Risk with Hand and Syringe use in Chemotherapy Nurses and Pharmacy Assistants. IISE Trans Occup Ergon Hum Factors 2018. [DOI: 10.1080/24725838.2018.1502698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Peter J. Keir
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Chiwaridzo M, Makotore V, Dambi JM, Munambah N, Mhlanga M. Work-related musculoskeletal disorders among registered general nurses: a case of a large central hospital in Harare, Zimbabwe. BMC Res Notes 2018; 11:315. [PMID: 29776452 PMCID: PMC5960155 DOI: 10.1186/s13104-018-3412-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/07/2018] [Indexed: 08/24/2023] Open
Abstract
Objective Worldwide, work-related musculoskeletal disorders (WMSDs) are a common cause of morbidity affecting occupational individuals such as health-care professionals. However, nothing is known about WMSDs in hospital nurses in Zimbabwe. This study was conducted to provide cross-sectional evidence of the 12-month prevalence, consequences and factors associated with WMSDs among 208 nurses at Parirenyatwa Group of Hospitals (PGH). Results The response rate for the study was 55.7%. The median age for the participants was 32.0 years (interquartile range = 29–36 years). The lifetime prevalence of WMSDs in nurses was 95.7% (n = 112). The first episodes were experienced in the first 5 years of working (n = 59, 52.7%). However, 82.1% (n = 96) nurses experienced WMSDs in the last 12 months. Low back pain was the most common WMSDs reported (n = 55, 67.9%). WMSDs were significantly associated with qualification attained, postgraduate ergonomic training and working experience. Overall, 87.5% (n = 84) nurses experienced at least one of the consequences of WMSDs. Cognisant of the limitations of the study, the present study found that WMSDs are a common occurrence among nurses at PGH. This creates a need for prompt hospital education programs aimed at raising awareness among nurses on the existence of WMSDs and the consequences at PGH. Electronic supplementary material The online version of this article (10.1186/s13104-018-3412-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Chiwaridzo
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe.
| | - V Makotore
- Howard Hospital, P.O Box 190, Glendale, Zimbabwe
| | - J M Dambi
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
| | - N Munambah
- Rehabilitation Department, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
| | - M Mhlanga
- Department of Nursing Science, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
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Valdez RS, McGuire KM, Rivera AJ. Qualitative ergonomics/human factors research in health care: Current state and future directions. APPLIED ERGONOMICS 2017; 62:43-71. [PMID: 28411739 DOI: 10.1016/j.apergo.2017.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 06/07/2023]
Abstract
The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care.
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Affiliation(s)
- Rupa Sheth Valdez
- Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Hospital West Complex, Charlottesville, VA 22908, USA.
| | - Kerry Margaret McGuire
- Habitability and Human Factors Branch, NASA's Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA.
| | - A Joy Rivera
- Knowledge and Systems Architect Team, Information Management Services, Children's Hospital of Wisconsin, 9000 W. Wisconsin Ave., Milwaukee, WI 53226, USA.
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A Multidisciplinary Workplace Intervention for Chronic Low Back Pain among Nursing Assistants in Iran. Asian Spine J 2017; 11:419-426. [PMID: 28670410 PMCID: PMC5481597 DOI: 10.4184/asj.2017.11.3.419] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/04/2016] [Accepted: 12/13/2016] [Indexed: 11/13/2022] Open
Abstract
Study Design Interventional research with a 6-month follow-up period. Purpose We aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory. Overview of Literature WRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP. Methods We included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data. Results The comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (p<0.001) and no significant change in control groups. There was no significant difference in the disability scores between the two groups (p=0.07). Conclusions We showed that our multidisciplinary intervention could reduce the intensity of WRLBP among nurse aides, making them suitable for implementation in programs to improve WRLBP among nursing assistants working in hospitals.
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Abstract
Background Surgical performance, provider health, and patient safety can be compromised when workload demands exceed individual capability on the surgical team. The purpose of this study is to quantify and compare intraoperative workload among surgical team members. Methods Observations were conducted for an entire surgical day for 33 participating surgeons and their surgical team at one medical institution. Workload (mental, physical, case complexity, distractions, and case difficulty) was measured for each surgical team member using questions from validated questionnaires. Statistical analyses were performed with a mixed effects model. Results A total of 192 surgical team members participated in 78 operative cases, and 344 questionnaires were collected. Procedures with high surgeon mental and physical workload included endovascular and gastric surgeries, respectively. Ratings did not differ significantly among surgeons and residents, but scrub nurses physical demand ratings were 14–22 (out of 100) points lower than the surgeons, residents, and surgical assistants. Residents reported the highest mental workload, averaging 19–24 points higher than surgical assistants, scrub nurses, and circulating nurses. Mental and physical demands exceeded 50 points 28–45 % of the time for surgeons and residents. Workload did not differ between minimally invasive and open techniques. Conclusion The workload questionnaires are an effective tool for quantifying intraoperative workload across the surgical team to ensure mental and physical demands do not exceed thresholds where performance may decrease and injury risk increase. This tool has the potential to measure the safety of current procedures and drive design of workload interventions.
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Bakola H, Zyga S, Stergioulas A, Kipreos G, Panoutsopoulos G. Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 989:21-37. [PMID: 28971414 DOI: 10.1007/978-3-319-57348-9_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.
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Affiliation(s)
- Helen Bakola
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece.
| | - Sofia Zyga
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Apostolos Stergioulas
- Department of Sports, Organization and Management, University of Peloponnese, Tripoli, Greece
| | - George Kipreos
- Department of Sports, Organization and Management, University of Peloponnese, Tripoli, Greece
| | - George Panoutsopoulos
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
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Anderson J, Williams AE, Nester CJ. A narrative review of musculoskeletal problems of the lower extremity and back associated with the interface between occupational tasks, feet, footwear and flooring. Musculoskeletal Care 2016; 15:304-315. [PMID: 28032439 DOI: 10.1002/msc.1174] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
At least 50% of workers are exposed to the risk of musculoskeletal disorders (MSD) due to spending prolonged hours standing at work. There is a lack of information regarding issues with the feet, solutions to the problem, and links between MSD, feet, footwear and flooring. The present article provides a narrative review of the research in this area, based on 31 papers. Workers who stand for large proportions of the working day had a level of MSD considerably greater than a normal population. Muscle co-activation, blood pooling, muscle fatigue and individual characteristics are all associated with MSD. Altering flooring provided mixed results, while footwear appeared to have the potential to affect MSD, although the dearth of literature limited the conclusions that could be drawn. Despite their inextricable link, literature regarding the relationship between occupational tasks, MSD, footwear and flooring remains limited and future studies will benefit from rigorously designed protocols.
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Affiliation(s)
- Jennifer Anderson
- Centre for Health Sciences Research, University of Salford, Salford, UK
| | - Anita E Williams
- Centre for Health Sciences Research, University of Salford, Salford, UK
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Vural F, Sutsunbuloglu E. Ergonomics: an important factor in the operating room. J Perioper Pract 2016; 26:174-178. [PMID: 29328758 DOI: 10.1177/1750458916026007-804] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 02/29/2016] [Indexed: 06/07/2023]
Abstract
There is a mutual interaction between health and the workplace. Health affects the capacity to work and working conditions affect a worker's health. Operating rooms (ORs) are stressful, complex settings in which there are ergonomic risk factors, such as lifting/moving heavy equipment. Work-related musculoskeletal disorders (WRMSDs) can arise due to unhealthy ergonomic conditions. Our study showed that nurses had been absent from work and/or retired early due to WRMSDs. Good ergonomic conditions in ORs increase nurses' occupational health and safety, their job satisfaction and performance. These factors contribute to patient care outcomes in a positive way.
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Affiliation(s)
- Fatma Vural
- Nursing Faculty Dokuz Eylul UNiversity, Izmir, Turkey
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Bin Homaid M, Abdelmoety D, Alshareef W, Alghamdi A, Alhozali F, Alfahmi N, Hafiz W, Alzahrani A, Elmorsy S. Prevalence and risk factors of low back pain among operation room staff at a Tertiary Care Center, Makkah, Saudi Arabia: a cross-sectional study. Ann Occup Environ Med 2016; 28:1. [PMID: 26835129 PMCID: PMC4731917 DOI: 10.1186/s40557-016-0089-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 01/05/2016] [Indexed: 12/19/2022] Open
Abstract
Background Low Back Pain (LBP) is the commonest musculoskeletal disorder and an important occupational hazard among healthcare workers (HCWs) that peaks among Operating Room (OR) staff. This cross-sectional study aimed to assess the prevalence, characteristics, and risk factors of low back pain among operating room (OR) staff in a tertiary healthcare center in Makkah, Saudi Arabia. Methods A 39-item self-administered questionnaire was distributed to all available OR staff. Data about personal, sociodemographic, general risk factors OR specific risky activities, and LBP characteristics were obtained. Descriptive, crosstabs, and univariate and multivariate logistic regression tests were employed. Results Out of the 143 distributed questionnaires, 84 % were received. LBP prevalence was 74.2 %. No statistically significant associations were detected between LBP and any of the general risk factors (p >0.05). However, most of the OR risky activities were significantly associated with the occurrence of LBP (p <0.05) e.g. lifting objects above the waist, rotating torso while bearing weight, transferring patients onto bed or chair, pulling a patient up the bed, and repositioning a patient in bed. These significant associations were preserved after adjustment for gender, perceived stress at work, educational level, and receiving education about LBP. Rest and analgesics were reported to be the most common relievers. Conclusions LBP is a common health issue among KAMC OR staff. OR risky activities were found to contribute to this problem. We suggest designing educational interventional programs to teach OR staff the best way to prevent this problem.
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Affiliation(s)
| | - Doaa Abdelmoety
- Clinical Research Management Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Waleed Alshareef
- Otolaryngology Resident, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | | | | | - Wael Hafiz
- Umm Al Qura University, Makkah, Saudi Arabia
| | | | - Soha Elmorsy
- Research Center, King Abdullah Medical City, Makkah, Saudi Arabia ; Pharmacology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Arvidsson I, Gremark Simonsen J, Dahlqvist C, Axmon A, Karlson B, Björk J, Nordander C. Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. BMC Musculoskelet Disord 2016; 17:35. [PMID: 26781760 PMCID: PMC4717636 DOI: 10.1186/s12891-016-0883-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 01/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is usually assumed that musculoskeletal pain is associated with both the physical workload and the psychosocial work environment, as well as with personal and lifestyle factors. This study aims to ascertain the prevalence of musculoskeletal pain in women with varying or different occupational exposures, and to explore the associations between musculoskeletal pain and the occupational and personal factors. METHODS A questionnaire on physical, psychosocial and individual factors was answered by 1591 women in five occupational groups with contrasting occupational exposures (teachers, anaesthetic, theatre, and assistant nurses, and sonographers). The outcome measure was musculoskeletal pain (in a new model based on frequency and intensity of complaints the preceding year) from the neck, shoulders, hands, lower back and feet. RESULTS Neck pain was equally frequent among teachers, assistant nurses and sonographers, and less frequent in anaesthetic and theatre nurses. The sonographers experienced the highest prevalence of shoulder pain, while the assistant nurses were the most affected in the wrists and hands, lower back, and feet. The teachers reported the highest scores in most of the psychosocial dimensions. The theatre nurses scored highest in strenuous work postures and movements (mechanical exposure index, MEI), and the assistant nurses in physical activity and lifting (physical exposure index, PHYI). Multivariable models in the total population showed that both the physical workload and the psychosocial work environment were associated with pain in all body regions, though different factors affected different regions. Pain in the neck, shoulders, hands and lower back was strongly associated with a high MEI and high job demands, while pain in the feet was associated with a high PHYI and a high BMI. A young age was associated with pain in the neck, and an older age was associated with pain in the hands and feet. Lack of time for personal recovery was associated with pain in the shoulders and lower back. CONCLUSIONS The occupational groups were affected differently and need different protective measures. For the teachers, the psychosocial work environment should be improved. The surgical staff and sonographers require measures to mitigate lifting and constrained postures.
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Affiliation(s)
- Inger Arvidsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Björn Karlson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
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Van L, Chaiear N, Sumananont C, Kannarath C. Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia. J Occup Health 2015; 58:107-17. [PMID: 26597050 DOI: 10.1539/joh.15-0100-fs] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The main objectives of this cross-sectional descriptive study were to identify the prevalence of musculoskeletal symptoms and workstation biomechanical risk levels for garment workers in Kandal Province, Cambodia. METHODS This cross-sectional descriptive study used multistage sampling techniques to select 714 workers from three garment factories among 22 medium-size factories (250-1,000 workers). Face-to-face interviews and direct observation using the rapid upper limb assessment scale (RULA) were used to collect data. RESULTS The response rate was 98.3% (702/714), and the majority (89.3%) of the respondents were female. Ninety-two percent (95% CI=90.0-94.0) of the workers reported musculoskeletal symptoms in at least one body region in the previous 12 months and 89.0% (95% CI=86.7-91.3) of the workers reported such symptoms in the past seven-day period. The neck, shoulder, and lower back were the most affected body regions. In addition, the RULA data showed that 81.2% of the workers' postures were rated as action level 3, indicating that investigation and change were required soon, and that 7.5% their postures were rated as action level 4, indicating that investigation and change were required immediately. CONCLUSIONS Cambodian garment workers reported a high prevalence of musculoskeletal symptoms in upper body regions, and their workplaces were rated as high risk ergonomically.
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Affiliation(s)
- Leap Van
- Department of Community Medicine, Faculty of Medicine, Khon Kaen University
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Moazzami Z, Dehdari T, Taghdisi MH, Soltanian A. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses. Glob J Health Sci 2015; 8:26-34. [PMID: 26925897 PMCID: PMC4965644 DOI: 10.5539/gjhs.v8n7p26] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 10/28/2015] [Indexed: 11/15/2022] Open
Abstract
Background: One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Methods: Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and 6 months after the intervention. A four-week ergonomics educational intervention based on TTM variables was designed and conducted for the nurses in the intervention group. Results: Following the intervention, a higher proportion of nurses in the intervention group moved into the action stage (p < 0.05). Mean scores of self-efficacy, pros, experimental processes and correct body posture were also significantly higher in the intervention group (p < 0.05). No significant differences were found in the cons and behavioral processes, except for self-liberation, between the two groups (p > 0.05) after the intervention. Conclusions: The TTM provides a suitable framework for developing stage-based ergonomics interventions for postural behavior.
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Affiliation(s)
- Zeinab Moazzami
- School of Health, Tehran University of Medical Sciences, Tehran, Iran.
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Maldonado-Macías A, Realyvásquez A, Hernández JL, García-Alcaraz J. Ergonomic assessment for the task of repairing computers in a manufacturing company: A case study. Work 2015; 52:393-405. [PMID: 26409363 DOI: 10.3233/wor-152118] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Manufacturing industry workers who repair computers may be exposed to ergonomic risk factors. OBJECTIVES This project analyzes the tasks involved in the computer repair process to (1) find the risk level for musculoskeletal disorders (MSDs) and (2) propose ergonomic interventions to address any ergonomic issues. METHODS Work procedures and main body postures were video recorded and analyzed using task analysis, the Rapid Entire Body Assessment (REBA) postural method, and biomechanical analysis. RESULTS High risk for MSDs was found on every subtask using REBA. Although biomechanical analysis found an acceptable mass center displacement during tasks, a hazardous level of compression on the lower back during computer's transportation was detected. CONCLUSIONS This assessment found ergonomic risks mainly in the trunk, arm/forearm, and legs; the neck and hand/wrist were also compromised. Opportunities for ergonomic analyses and interventions in the design and execution of computer repair tasks are discussed.
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Affiliation(s)
- Aidé Maldonado-Macías
- Department of Industrial and Manufacturing Engineering, Ciudad Juarez Autonomous University, Ciudad Juarez, Chihuahua, Mexico.,Graduate Studies and Research Division, Ciudad Juarez Institute of Technology, Ciudad Juarez, Chihuahua, Mexico
| | - Arturo Realyvásquez
- Department of Industrial and Manufacturing Engineering, Ciudad Juarez Autonomous University, Ciudad Juarez, Chihuahua, Mexico
| | - Juan Luis Hernández
- Department of Industrial and Manufacturing Engineering, Ciudad Juarez Autonomous University, Ciudad Juarez, Chihuahua, Mexico
| | - Jorge García-Alcaraz
- Department of Industrial and Manufacturing Engineering, Ciudad Juarez Autonomous University, Ciudad Juarez, Chihuahua, Mexico
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Stolt M, Suhonen R, Virolainen P, Leino-Kilpi H. Lower extremity musculoskeletal disorders in nurses: A narrative literature review. Scand J Public Health 2015; 44:106-15. [PMID: 26355119 DOI: 10.1177/1403494815602989] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 02/03/2023]
Abstract
AIMS The aim of the narrative review was to describe and analyze lower extremity musculoskeletal disorders (MSDs) in nurses and to identify factors associated with these disorders. The ultimate goal was to promote lower extremity health in nurses by recognizing factors that could improve their well-being at work. METHODS A systematic search on the Medline, CINAHL, and PsychInfo databases was conducted, producing altogether 945 citations, of which 35 were selected for this review. The studies were analyzed by content analysis. RESULTS Nurses have different MSDs in their lower extremities, with which the knee, foot, and ankle being most commonly affected. These problems are often correlated, and problems in the ankle can first appear as knee problems. CONCLUSIONS Musculoskeletal disorders in lower extremities and their resulting disability are common within the nursing workforce worldwide, representing a major cause of sick leave absence and often leading to long-term absence.
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Affiliation(s)
- Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Petri Virolainen
- Department of Orthopedics and Traumatology, Turku University Hospital, Turku, Finland Department of Orthopaedics and Traumatology, University of Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland Turku University Hospital, Turku, Finland
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Nützi M, Koch P, Baur H, Elfering A. Work-Family Conflict, Task Interruptions, and Influence at Work Predict Musculoskeletal Pain in Operating Room Nurses. Saf Health Work 2015; 6:329-37. [PMID: 26929846 PMCID: PMC4682021 DOI: 10.1016/j.shaw.2015.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 02/18/2015] [Accepted: 07/31/2015] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study is to examine the prevalence of musculoskeletal complaints in Swiss operating room (OR) nurses, and to investigate how work–family conflict, work interruptions, and influence at work are related to lumbar and cervical back pain. Methods Participants in this correlational questionnaire study included 116 OR nurses from eight different hospitals in Switzerland. Results We found that 66% of the OR staff suffered from musculoskeletal problems. The most prevalent musculoskeletal complaints were lumbar (52.7%) and cervical pain (38.4%). Furthermore, 20.5% reported pain in the mid spine region, 20.5% in the knees and legs, and 9.8% in the hands and feet. Multiple linear regression analyses showed that work–family conflict (p < 0.05) and interruptions (p < 0.05) significantly predicted lumbar and cervical pain in OR nurses, while influence at work (p < 0.05) only predicted lumbar pain. Conclusion These results suggest that reducing the work–family conflict and interruptions at work, as well as offering opportunities to influence one's workplace, help to promote OR nurses' health.
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Affiliation(s)
- Marina Nützi
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Patricia Koch
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Health, Bern, Switzerland
| | - Achim Elfering
- Department of Psychology, University of Bern, Bern, Switzerland; National Centre of Competence in Research, Affective Sciences, University of Geneva, CISA, Geneva, Switzerland
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Harcombe H, Herbison GP, McBride D, Derrett S. Musculoskeletal disorders among nurses compared with two other occupational groups. Occup Med (Lond) 2014; 64:601-7. [DOI: 10.1093/occmed/kqu117] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Reed LF, Battistutta D, Young J, Newman B. Prevalence and risk factors for foot and ankle musculoskeletal disorders experienced by nurses. BMC Musculoskelet Disord 2014; 15:196. [PMID: 24902582 PMCID: PMC4061517 DOI: 10.1186/1471-2474-15-196] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/07/2014] [Indexed: 11/25/2022] Open
Abstract
Background Nurses are at high risk of musculoskeletal disorders (MSDs). Although the prevalence of MSDs of the lower back, upper limbs, neck and shoulders have been reported previously in nursing, few studies have evaluated MSDs of the foot and ankle. This study evaluated the prevalence of foot and ankle MSDs in nurses and their relation to individual and workplace risk factors. Methods A self-administered survey incorporating the Nordic Musculoskeletal Questionnaire (NMQ) was distributed, over a nine-week period, to all eligible nurses (n = 416) working in a paediatric hospital in Brisbane, Australia. The prevalence of MSDs for each of the NMQ body regions was determined. Bivariate and multivariable logistic regression analyses were conducted to examine the relationships between activity-limiting foot/ankle MSDs and risk factors related to the individual (age, body mass index, number of existing foot conditions, smoking history, general physical health [SF36 Physical Component Scale], footwear features) or the workplace (level of nursing position, work location, average hours worked, hours worked in previous week, time since last break from work). Results A 73% response rate was achieved with 304 nurses completing surveys, of whom 276 were females (91%). Mean age of the nurses was 37 years (±10), younger than the state average of 43 years. Foot/ankle MSDs were the most prevalent conditions experienced by nurses during the preceding seven days (43.8%, 95% CI 38.2-49.4%), the second most prevalent MSDs to impair physical activity (16.7%, 95% CI 13.0-21.3%), and the third most prevalent MSD, after lower-back and neck problems, during the preceding 12 months (55.3%, 95% CI 49.6-60.7%). Of the nurse and work characteristics investigated, obesity, poor general physical health, existing foot conditions and working in the intensive care unit emerged as statistically significant (p < 0.05) independent risk factors for activity-limiting foot/ankle MSDs. Conclusions Foot/ankle MSDs are common in paediatric hospital nurses and resulted in physical activity limitations in one out of every six nurses. We recommend targeted education programs regarding the prevention, self-management and treatment strategies for foot/ankle MSDs. Further research is needed into the impact of work location and extended shift durations on foot/ankle MSDs.
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Affiliation(s)
- Lloyd F Reed
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
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Occhionero V, Korpinen L, Gobba F. Upper limb musculoskeletal disorders in healthcare personnel. ERGONOMICS 2014; 57:1166-1191. [PMID: 24840049 DOI: 10.1080/00140139.2014.917205] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The literature on upper limb musculoskeletal disorders (UL-MSD) in different groups of healthcare workers was reviewed: 65 relevant studies were collected. In dentists, the neck was the most frequently affected segment, with prevalences up to 73% and exceeding 50% in 7 out of 12 studies. In dental hygienists and in laboratory technicians, the hand/wrist had the highest prevalence in the majority of the studies. In nurses, the most seriously affected anatomic sites were the neck and shoulders. Physiotherapists had the lowest prevalence of UL-MSD. A high prevalence of upper limb disease, mainly carpal tunnel syndrome, was reported in dentists, dental hygienists, anesthesia nurses and endoscopists. The high prevalence of upper limb disorders/diseases reported in health personnel supports the hypothesis of a significant risk in these workers. However, the possible role of biomechanical overload, as much as that of stress or other personal factors, cannot be currently assessed. Practitioner Summary: Published studies support the hypothesis of a significant risk of upper limb musculoskeletal disorders in healthcare activities. The neck was the most frequently affected segment in dentists, the hand/wrist in dental hygienists and in laboratory technicians, and the neck and shoulders in nurses. Lower prevalence was reported in physiotherapists. A high prevalence of carpal tunnel syndrome was also observed in various healthcare activities.
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Affiliation(s)
- Vincenzo Occhionero
- a Department of Diagnostic , Clinical and Public Health Medicine, University of Modena and Reggio Emilia Italy , Modena , Italy
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Long MH, Bogossian FE, Johnston V. The Prevalence of Work-Related Neck, Shoulder, and Upper Back Musculoskeletal Disorders Among Midwives, Nurses, and Physicians: A Systematic Review. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130426-38] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Long MH, Bogossian FE, Johnston V. The Prevalence of Work-Related Neck, Shoulder, and Upper Back Musculoskeletal Disorders among Midwives, Nurses, and Physicians. Workplace Health Saf 2013; 61:223-9; quiz 230. [DOI: 10.1177/216507991306100506] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 03/25/2013] [Indexed: 11/16/2022]
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46
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Long MH, Bogossian FE, Johnston V. Functional consequences of work-related spinal musculoskeletal symptoms in a cohort of Australian midwives. Women Birth 2013; 26:e50-8. [DOI: 10.1016/j.wombi.2012.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 07/11/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
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Choi S. A Review of the Ergonomic Issues in the Laparoscopic Operating Room. JOURNAL OF HEALTHCARE ENGINEERING 2012. [DOI: 10.1260/2040-2295.3.4.587] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Carayon P, Bass E, Bellandi T, Gurses A, Hallbeck S, Mollo V. Socio-Technical Systems Analysis in Health Care: A Research Agenda. IIE TRANSACTIONS ON HEALTHCARE SYSTEMS ENGINEERING 2011; 1:145-160. [PMID: 22611480 PMCID: PMC3351758 DOI: 10.1080/19488300.2011.619158] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Given the complexity of health care and the 'people' nature of healthcare work and delivery, STSA (Sociotechnical Systems Analysis) research is needed to address the numerous quality of care problems observed across the world. This paper describes open STSA research areas, including workload management, physical, cognitive and macroergonomic issues of medical devices and health information technologies, STSA in transitions of care, STSA of patient-centered care, risk management and patient safety management, resilience, and feedback loops between event detection, reporting and analysis and system redesign.
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Affiliation(s)
- Pascale Carayon
- University of Wisconsin-Madison, Dept of Industrial & Systems Engr - CQPI, 1550 Engineering Drive, 3126 Engineering Centers Building, Madison, 53705 United States
| | - Ellen Bass
- University of Virginia, Systems and Information Engineering, 151 Engineer’s Way, P.O. Box 400747, Charlottesville, 22904 United States
| | - Tommaso Bellandi
- Centro Gestione Rischio Clinico e Sicurezza dei Pazienti, Patient Safety Research Lab, Palazzina 67a, Azienda Ospedaliera Universitaria Careggi, Largo Brambilla 3, Firenze, 50134 Italy
| | - Ayse Gurses
- Johns Hopkins University, Anesthesiology and Critical Care, Health Policy and Management, 1909 Thames Street, 2nd floor, Baltimore, 21231 United States
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Work-related Musculoskeletal Disorders When Performing Laparoscopic Surgery. Surg Laparosc Endosc Percutan Tech 2010; 20:49-53. [DOI: 10.1097/sle.0b013e3181cded54] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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