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Abdul Halim NSS, Mohd Ripin Z, Yusuf A, Ridzwan MIZ. Efficacy of lifting devices for wheelchair transfers: a systematic review and meta-analysis. ERGONOMICS 2024:1-12. [PMID: 38994766 DOI: 10.1080/00140139.2024.2375360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
A high prevalence of work-related musculoskeletal disorders (WMSDs) has been reported among nurses as a result of the injuries caused by patient transfer and handling. This review examines the impact of motorised and non-motorised lifting devices on reducing physical stress during wheelchair transfers among nurses. Systematic electronic database searches were performed, and the review was prepared according to the PRISMA guidelines. The results of 20 studies on biomechanical stresses related to WMSDs were synthesised qualitatively, and 13 were analysed quantitatively using meta-analysis. Motorised lifting devices significantly decreased biomechanical stress among nurses [SMD -0.68; 95% CI -1.02 to -0.34], whereas non-motorised counterparts showed no significant change [SMD - 0.23; 95% CI -0.59 to 0.13]. This study underscores the effectiveness of motorised lifting devices in mitigating WMSD risk during wheelchair transfers. The findings provide practical guidance for hospital administrators, policymakers, and experts seeking suitable devices to prevent WMSDs in nursing professionals. Practitioner Summary: This study investigated the impact of motorised and non-motorised lifting devices on nurses during wheelchair transfers. Findings revealed that motorised devices significantly reduce biomechanical stress, while non-motorised devices showed limited effectiveness. The research emphasises the superior role of motorised devices in preventing WMSDs during wheelchair transfers among nurses.
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Affiliation(s)
- Nur Shuhaidatul Sarmiza Abdul Halim
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Zaidi Mohd Ripin
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal, Malaysia
| | - Azlina Yusuf
- Exercise & Sports Science Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohamad Ikhwan Zaini Ridzwan
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal, Malaysia
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Wiggermann N, Francis R, Solomon A. Individual and organizational factors associated with injury history and patient handling behaviors: Results from a nationwide survey of healthcare workers. APPLIED ERGONOMICS 2024; 118:104251. [PMID: 38417228 DOI: 10.1016/j.apergo.2024.104251] [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: 08/15/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/01/2024]
Abstract
With proper compliance, safe patient handling and mobility (SPHM) programs reduce musculoskeletal disorders (MSDs). To better understand individual, environmental, and organizational factors associated with both the adoption of SPHM and prevalence of MSDs, a nationwide online survey was administered. 973 healthcare workers (HCWs) completed the survey, for which 59.6% reported past work-related MSDs or pain. Among those with pain or injury, 33.3% changed roles, 79.7% worked while injured, and only 30.9% reported workers' compensation claims. Less than half of HCWs agreed that SPHM equipment is readily available, and most considered manually handling patients weighing over 91 kg acceptable. Equipment availability, ceiling lift availability, supervisor encouragement, and annual training were associated with increased use of SPHM equipment. Availability of SPHM equipment reduced the likelihood of injured nurses changing roles. Despite overall agreement that SPHM programs are beneficial, common clinical practice remains insufficient to adequately protect HCWs from risk of injury.
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Affiliation(s)
| | - Ruth Francis
- American Nurses Association, 8515 Georgia Avenue, Suite 400, Silver Spring, MD, 20910, USA
| | - Aieda Solomon
- American Nurses Association, 8515 Georgia Avenue, Suite 400, Silver Spring, MD, 20910, USA
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Suzuki G, Kanayama H, Arai Y, Iwanami Y, Kobori T, Masuyama Y, Yamamoto S, Serizawa H, Nakamichi Y, Watanabe M, Honda M, Okuni I. Early Mobilization Using a Mobile Patient Lift in the ICU: A Randomized Controlled Trial. Crit Care Med 2024; 52:920-929. [PMID: 38317369 PMCID: PMC11093479 DOI: 10.1097/ccm.0000000000006219] [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] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To ascertain whether a mobile patient lift facilitates early mobilization in ventilated ICU patients. DESIGN A single-center, open-label, randomized controlled trial. SETTING An academic ICU in Tokyo. PATIENTS Eighty patients were admitted to ICU and expected ventilation for at least 48 hours. INTERVENTIONS In the intervention group, in addition to the rehabilitation protocol received by the control group, patients were assisted in sitting, standing, transfers, and walking using the mobile patient lift. MEASUREMENTS AND MAIN RESULTS The intervention group predominantly stood faster than the control group (1.0 vs. 3.0 d, p < 0.01). The Intervention group also had significantly higher Functional Status Score-ICU scores at ICU discharge. However, the Medical Research Council score and Barthel index at discharge, length of ICU stay, and number of ventilator-free days did not differ between the two groups. CONCLUSIONS The use of mobile patient lifts facilitates the earlier standing of patients on ventilators. This may contribute to patients improved physical function in the ICU. TRIAL REGISTRATION The study protocol was registered with the University Hospital Medical Information Network (UMIN) under the registration number UMIN000044965. Registered July 30, 2021.
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Affiliation(s)
- Ginga Suzuki
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Hiromi Kanayama
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Yoshiaki Arai
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Yuji Iwanami
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Toshimitsu Kobori
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Yuka Masuyama
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Saki Yamamoto
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Hibiki Serizawa
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Yoshimi Nakamichi
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Masayuki Watanabe
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Mitsuru Honda
- Critical Care Center, Toho University Omori Medical Center, Omori Nishi, Ota-ku, Tokyo, Japan
| | - Ikuko Okuni
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Omori Nishi, Ota-ku, Tokyo, Japan
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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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Law MJJ, Ridzwan MIZ, Ripin ZM, Abd Hamid IJ, Law KS, Karunagaran J, Cajee Y. Evaluation of a motorised patient transfer device based on perceived workload, technology acceptance, and emotional states. Disabil Rehabil Assist Technol 2024; 19:938-950. [PMID: 36334271 DOI: 10.1080/17483107.2022.2134472] [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: 04/13/2022] [Revised: 08/03/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE The high prevalence of musculoskeletal disorders (MSDs) among healthcare workers is partly attributed to the low adoption of patient transfer assistive devices. This study aimed to evaluate the nurses' perceived workload, technology acceptance, and emotional states during the use of the sliding board (SB) and mechanical intervention in the form of a Motorised Patient Transfer Device (MPTD). METHODS The SB and MPTD activities were performed by seven nurses on a simulated patient. The nurses' facial expressions were recorded during the trial. The NASA Task Load Index and technology acceptance questionnaire were also assessed. RESULTS The MPTD significantly reduced the mean overall NASA-TLX score by 68.7% (p = 0.004) and increased the overall acceptance score (median = 8.30) by 21.2% (p = 0.016) when compared to the SB (median = 6.85). All the subjects reported positive feelings towards MPTD. However, facial expression analysis showed that the nurses had a significantly higher peak density of fear while using MPTD (p = 0.016). Besides, there was no improvement in the negative valence and contempt emotion compared to the SB. CONCLUSION Overall, nurses showed positive perceptions and acceptance of MPTD even when they experienced negative emotions.IMPLICATIONS FOR REHABILITATIONThe Motorised Patient Transfer Device (MPTD) reduced the perceived workload of nurses and showed a higher acceptance level compared to the commonly used baseline device (SB).Factors that attributed to the nurses' negative emotions can be used to improve technology and patient transfer processes.More training should be given to familiarise the health practitioners with the new assistive device to reduce their fear of technology.
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Affiliation(s)
- Mitchelle J J Law
- Neurorehabilitation Engineering and Assistance Systems Research, School of Mechanical Engineering, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohamad Ikhwan Zaini Ridzwan
- Neurorehabilitation Engineering and Assistance Systems Research, School of Mechanical Engineering, Universiti Sains Malaysia, Penang, Malaysia
| | - Zaidi Mohd Ripin
- Neurorehabilitation Engineering and Assistance Systems Research, School of Mechanical Engineering, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Kim Sooi Law
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - Jeevinthiran Karunagaran
- Neurorehabilitation Engineering and Assistance Systems Research, School of Mechanical Engineering, Universiti Sains Malaysia, Penang, Malaysia
| | - Yusuf Cajee
- Freedom Med International Sdn. Bhd, Penang, Malaysia
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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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Qureshi SM, Greig MA, Bookey-Bassett S, Purdy N, Kelly H, vanDeursen A, Neumann WP. Computer simulation as a macroergonomic approach to assessing nurse workload and biomechanics related to COVID-19 patient care. APPLIED ERGONOMICS 2024; 114:104124. [PMID: 37657241 DOI: 10.1016/j.apergo.2023.104124] [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: 01/19/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
This study uses Digital Human Modelling (DHM) and Discrete Event Simulation (DES) to examine how caring for COVID-19-positive (C+) patients affects nurses' workload and care-quality. DHM inputs include: nurse anthropometrics, task postures, and hand forces. DES inputs include: unit-layout, patient care data, COVID-19 status & impact on tasks, and task execution-logic. The study shows that reducing nurses' biomechanical workload increases mental workload and decreases direct patient care, potentially leading to stress, burnout, and errors. Compared to pre-pandemic conditions, when nurses were assigned five C+ patients, cumulative bilateral shoulder moments and lumbar load decreased by 38%, 36%, and 46%, respectively. However, this was accompanied by increases in mental workload (242%), task waiting-time (70%), and missed-care (353%). These effects were driven by the large increase in required infection control routines. Combining DHM and DES can help evaluate workplace/task designs and provide valuable insights for healthcare system design-policy setting and operational management decision-making.
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Affiliation(s)
- Sadeem Munawar Qureshi
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (formerly Ryerson University), Toronto, Ontario, Canada.
| | - Michael A Greig
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (formerly Ryerson University), Toronto, Ontario, Canada
| | - Sue Bookey-Bassett
- Daphne Cockwell School of Nursing, Toronto Metropolitan University (formerly Ryerson University), Toronto, Canada
| | - Nancy Purdy
- Daphne Cockwell School of Nursing, Toronto Metropolitan University (formerly Ryerson University), Toronto, Canada
| | - Helen Kelly
- University Health Network, Toronto, Ontario, Canada
| | | | - W Patrick Neumann
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (formerly Ryerson University), Toronto, Ontario, Canada
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Broderick V, Barrett B, Phillips S, Cowan L, Friedman Y, McKinney A, Chavez M, Lind J, Bradley S, Kaplan H, Bulat T. Staff Low Back Injury Risk During Assisted Falls Virtual Reality Simulations. Workplace Health Saf 2023; 71:304-310. [PMID: 36695160 DOI: 10.1177/21650799221148665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Assisted falls occur when staff try to minimize the impact of falls by slowing a patient's descent. Assisting a patient fall may decrease patient injury risk, but biomechanical risk of injury to staff has not been evaluated. Assisted falls virtual reality (VR) simulations were conducted to examine staff low back injury risk during common assisted falls scenarios. METHODS VR simulations of a toilet to wheelchair transfer were developed with a male patient avatar for three assisted falls scenarios: standing up from toilet, sitting down on wheelchair, and ambulation. Patient avatar weight was modified to reflect normal, underweight, and overweight adult patients. The average spinal compression force at L5/S1 was calculated for each participant with five trials per three scenarios while utilizing physical ergonomic techniques and compared to the safe spinal compression limit of 3,400 Newtons (N). FINDINGS Six staff participants completed 90 VR simulations in total. The average calculated spinal compression force ranged from 7,132 N to 27,901 N. All participant trials exceeded the safe spinal compression limit of 3,400 N for every assisted falls scenario and avatar weight despite application of ergonomic techniques including wide stance, knees bent, and backs straight. CONCLUSIONS/APPLICATION TO PRACTICE Staff are at risk for low back injury if they assist falls regardless of the adult patient weight and application of ergonomic techniques. Safer alternatives like the implementation of mobility screening tools and safe patient handling and mobility technology are needed to help prevent assisted falls to decrease injury risk to both patients and staff.
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Affiliation(s)
- Vianna Broderick
- James A. Haley Veterans' Hospital and Clinics.,University of South Florida
| | | | | | - Linda Cowan
- James A. Haley Veterans' Hospital and Clinics
| | | | | | | | - Jason Lind
- James A. Haley Veterans' Hospital and Clinics
| | | | | | - Tatjana Bulat
- James A. Haley Veterans' Hospital and Clinics.,University of South Florida
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Qureshi SM, Purdy N, Greig MA, Kelly H, vanDeursen A, Neumann WP. Developing a simulation tool to quantify biomechanical load and quality of care in nursing. ERGONOMICS 2022:1-18. [PMID: 35975403 DOI: 10.1080/00140139.2022.2113921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Nursing is a high musculoskeletal disorder (MSD) risk job with high workload demands. This study combines Digital Human Modelling (DHM) and Discrete Event Simulation (DES) to address the need for tools to better manage MSD risk. This novel approach quantifies physical-workload, work-performance, and quality-of-care, in response to varying geographical patient-bed assignments, patient-acuity levels, and nurse-patient ratios. Lumbar loads for 86 care-delivery tasks in an acute care hospital unit were used as inputs in a DES model of the care-delivery process, creating a shift-long time trace of the biomechanical load. Peak L4/L5 compression and moment were 3574 N and 111.58 Nm, respectively. This study reports trade-offs in all three experiments: (i) increasing geographical patient-bed assignment distance decreased L4/L5 compression (8.8%); (ii) increased patient-acuity decreased L4/L5 moment (4%); (iii) Increased nurse-patient ratio decreased L4/L5 compression (10%) and moment (17%). However, in all experiments, Quality of care indicators deteriorated (20, 19, and 29%, respectively). Practitioner Summary: This research has the potential to support decision-makers by developing a simulation tool that quantifies the impact of varying operational and design-policies in terms of biomechanical-load and quality of care. The demonstrator-model reports: as geographical patient-bed distance, patient-acuity levels, and nurse-patient ratios increase, biomechanical-load reduces, and quality of care deteriorates.
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Affiliation(s)
- Sadeem Munawar Qureshi
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Nancy Purdy
- Daphne Cockwell School of Nursing, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Michael A Greig
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | | | | | - W Patrick Neumann
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
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Jakobsen MD, Vinstrup J, Andersen LL. Factors associated with high physical exertion during healthcare work: Cross-sectional study among healthcare workers. Work 2022; 71:881-888. [DOI: 10.3233/wor-213647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: High physical exertion during healthcare work is a documented risk factor for musculoskeletal pain, long term sickness absence and disability pension. Understanding the underlying factors of physical exertion is important to make the necessary preventive efforts in the working environment. OBJECTIVE: This study investigates factors associated with high physical exertion during healthcare work. METHODS: A total of 2047 Danish health care workers replied to a questionnaire about work and health. Associations (odds ratios; OR) of physical exertion (outcome variable) with the number of patients and self-reliant patients, frequency and type of assistive device use, BMI, leisure time activity, smoking, and age were modelled using mutually adjusted binary logistic regression. RESULTS: Factors associated with high physical exertion (OR and 95% CI) were high frequency of daily patient transfers 1.35 (1.23 – 1.48), less self-reliant patients 0.74 (0.62 – 0.89), less frequent use of necessary assistive devices 1.82 (1.50 – 2.21), as well as more frequent use of sliding pieces 1.23 (1.04 – 1.46), wheelchairs 1.23 (1.02 – 1.49), bed adjustments 0.88 (0.77 – 1.00) and intelligent beds 0.83 (0.71 – 0.95) during patient transfer. Age and lifestyle factors (BMI, smoking, and leisure time physical activity) were not associated with high physical exertion. CONCLUSIONS: The character of patient transfer specific healthcare work is associated with increased odds for high physical exertion whereas life-style factors are not. Thus, proper use of specific assistive devices and avoiding uneven distribution of difficult patients through appropriate planning may be protective strategies for lowering physical exertion during healthcare work.
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Affiliation(s)
- Markus D. Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Lars L. Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
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Suzuki G, Kanayama H, Ichibayashi R, Arai Y, Iwanami Y, Masuyama Y, Yamamoto S, Serizawa H, Nakamichi Y, Watanabe M, Honda M, Ebihara S. Early mobilisation using a mobile patient lift in the intensive care unit: protocol for a randomised controlled trial. BMJ Open 2022; 12:e057942. [PMID: 35264368 PMCID: PMC8915332 DOI: 10.1136/bmjopen-2021-057942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION It is important to prevent the deterioration of activities of daily living to improve the long-term prognoses of patients in the intensive care unit (ICU). The patients' conditions, along with the lack of human and technical resources, often become barriers to achieving early mobilisation after the introduction of mechanical ventilation. We plan to verify the usefulness of a mobile patient lift for early mobilisation. METHODS AND ANALYSIS We will conduct a single-centre, open-label, randomised controlled trial. The inclusion criteria are as follows: age ≥18 years, independent walking before admission and expected mechanical ventilation for at least 48 hours. The participants will be randomly divided into groups with (intervention group) or without (control group) a mobile lift protocol. A mobile lift will be used in the intervention group. The primary endpoint will be the number of days required to achieve an ICU mobility scale of ≥4 (standing position). The results of the two groups will be analysed using the Student's t-test. ETHICS AND DISSEMINATION This study will be conducted in accordance with the Declaration of Helsinki and with the approval of the Toho University Omori Medical Center Ethics Committee (approval number M20259). The results of this study will be presented internationally at academic conferences and published in the literature. TRIAL REGISTRATION NUMBER UMIN000044965.
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Affiliation(s)
- Ginga Suzuki
- Toho University Omori Medical Center, Tokyo, Japan
| | | | | | | | - Yuji Iwanami
- Toho University Omori Medical Center, Tokyo, Japan
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12
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Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial. SUSTAINABILITY 2022. [DOI: 10.3390/su14010583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: There is a high prevalence of musculoskeletal disorders among personnel working in the healthcare sector, mainly among nursing assistants and orderlies. Objective: The objective is to analyze the effectiveness of a multi-component intervention that included postural feedback in reducing musculoskeletal risk. Method: A total of 24 nursing assistants and orderlies in a hospital setting were randomly assigned to an intervention group or a control group. After collecting sociodemographic information, a selection of tasks was made and assessed using the REBA (rapid entire body assessment) method. A multi-component intervention was designed combining theoretical and practical training, including feedback on the postures performed by the professionals involved, especially those involving high musculoskeletal risk. This program was applied only to participants in the intervention group. Subsequently, eight months after the first assessment and intervention, the second assessment was carried out using the same method and process as in the first evaluation. Results: The results indicate that the musculoskeletal risk in the second assessment in the intervention group was significantly reduced. However, no significant changes were observed in the control group. Conclusion: The multi-component intervention applied can significantly reduce the musculoskeletal risk of nursing assistants and orderlies. In addition, it is a low-cost intervention with great applicability.
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Bernardes JM, Monteiro-Pereira PE, Gómez-Salgado J, Ruiz-Frutos C, Dias A. Healthcare workers' knowledge for safe handling and moving of the patient. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2105-2111. [PMID: 34261410 DOI: 10.1080/10803548.2021.1955484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives. Healthcare workers are at risk of injury during patient handling activities. There is a lack of research in safe patient handling. The objective of this study was to examine the knowledge level of safe patient handling among Brazilian healthcare workers and to analyze its associated factors. Methods. This cross-sectional study was performed in two hospitals and 47 outpatient facilities with 644 participants in Brazil. Healthcare workers completed a self-administered questionnaire about their working characteristics, history of lower back pain and knowledge of safe patient handling. Results. The mean score of safe patient handling knowledge was 11.89 out of 22 maximum points. More than half (59%) of the participants did not see the risk of their activity. Educational level, type of healthcare facility and outpatient clinics were associated with safe patient handling knowledge in the logistic regression model. Conclusion. There was a substantial deficit in safe patient handling knowledge. There is a need for courses and textbooks to move beyond ineffective preventive strategies and minimize the risk of manual patient handling. Healthcare workers are at risk of injury during patient handling activities. Nursing schools in developing countries must focus on researching this topic to ensure safe patient handling.
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Affiliation(s)
- João Marcos Bernardes
- Graduate Program in Collective/Public Health, Botucatu Medical School, São Paulo State University (UNESP), Brazil
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, Universidad de Huelva, Spain.,Safety and Health Postgraduate Program, Universidad Espíritu Santo, Ecuador
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, Universidad de Huelva, Spain.,Safety and Health Postgraduate Program, Universidad Espíritu Santo, Ecuador
| | - Adriano Dias
- Graduate Program in Collective/Public Health, Botucatu Medical School, São Paulo State University (UNESP), Brazil
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Vinstrup J, Jakobsen MD, Madeleine P, Andersen LL. Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study. BMC Musculoskelet Disord 2020; 21:715. [PMID: 33129282 PMCID: PMC7603727 DOI: 10.1186/s12891-020-03731-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/20/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs. METHODS By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure. RESULTS Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively. CONCLUSIONS Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.
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Affiliation(s)
- Jonas Vinstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, DK, Denmark.
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - Markus D Jakobsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, DK, Denmark
| | - Pascal Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, DK, Denmark
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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15
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Van Poel E, Ketels M, Clays E. The association between occupational physical activity, psychosocial factors and perceived work ability among nurses. J Nurs Manag 2020; 28:1696-1703. [DOI: 10.1111/jonm.13125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 07/10/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Esther Van Poel
- Department of Public Health and Primary Care Ghent University Ghent Belgium
| | - Margo Ketels
- Department of Public Health and Primary Care Ghent University Ghent Belgium
| | - Els Clays
- Department of Public Health and Primary Care Ghent University Ghent Belgium
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16
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Vinstrup J, Jakobsen MD, Madeleine P, Andersen LL. Biomechanical load during patient transfer with assistive devices: Cross-sectional study. ERGONOMICS 2020; 63:1164-1174. [PMID: 32362200 DOI: 10.1080/00140139.2020.1764113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
This study utilised a cross-sectional design to perform measurements of muscle activity as well as forward - and lateral trunk inclination angle during a full workday among 52 female healthcare workers from 16 different departments at five Danish hospitals. Using linear mixed models, the 95th percentile ranks of the normalised root mean square (nRMS) values were analysed for the different types of assistive devices. Compared to no assistive device (mean nRMS 27.9%, 95% CI 24.8%-31.0%), the use of intelligent beds (23.9%, CI 20.2%-27.6%) and ceiling-lifts (24.0%, CI 20.3%-27.7%) led to lower erector spinae nRMS values across all types of patient transfers. Conversely, the use of bedsheets (30.6%, CI 27.1%-34.2%), sliding-sheets (30.3%, CI 26.8%-33.9%) and sliding-boards (33.5%, CI 29.5%-37.6%) were associated with higher levels of erector spinae muscle activity.Consistent use of ceiling-lifts and intelligent beds reduces the physical workload and may thereby decrease the risk of musculoskeletal disorders among healthcare workers. Practioner Summary: Frequent patient transfer is associated with an increased risk of back pain and injury among healthcare workers. This analysis compares the level of physical load during patient transfer with commonly used assistive devices. The results show that use of the ceiling-lift and intelligent bed is associated with relatively low physical load during patient transfer. Abbreviations: RMS: root mean square; nRMS: normalized root mean square; EMG: electromyography; MSD: musculoskeletal disorder; LBP: low-back pain; VAS: visual analogue scale; MVC: maximal voluntary contraction.
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Affiliation(s)
- Jonas Vinstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Markus D Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Pascal Madeleine
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
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17
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Al-Qaisi SK, El Tannir A, Younan LA, Kaddoum RN. An ergonomic assessment of using laterally-tilting operating room tables and friction reducing devices for patient lateral transfers. APPLIED ERGONOMICS 2020; 87:103122. [PMID: 32501251 DOI: 10.1016/j.apergo.2020.103122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
Patient lateral transfers between two adjacent surfaces pose high musculoskeletal disorder risks for nurses and patient handlers. The purpose of this research was to examine the ergonomic benefits of utilizing the laterally-tilting function of operating room (OR) tables during such transfers - along with different friction-reducing devices (FRD). This method allows the patient to slide down to the adjacent surface as one nurse guides the transfer and another controls the OR table angle with a remote control. Sixteen nursing students and sixteen college students were recruited to act as nurses and patients, respectively. Two OR table angles were examined: flat and tilted. Three FRD conditions were considered: a standard blanket sheet, a plastic bag, and a slide board. Electromyography (EMG) activities were measured bilaterally from the posterior deltoids, upper trapezii, latissimus dorsi, and lumbar erector spinae muscles. The Borg-CR10 scale was used for participants to rate their perceived physical exertions. The efficiency of each method was measured using a stopwatch. Results showed that the tilted table technique completely replaced the physical efforts that would have been exerted by the pushing-nurse, in that muscle activation did not increase in the pulling-nurse. On the contrary, EMG activities of the pulling-nurse for most of the muscles significantly decreased (p < 0.05). The subjective Borg-ratings also favored the tilted table with significantly lower ratings. However, the tilted table required on average 7.22 s more than the flat table to complete the transfer (p < 0.05). The slide board and plastic bag were associated with significantly lower Borg-ratings and EMG activities for most muscles than blanket sheet, but they both were not significantly different from each other. However, they each required approximately 5 s more than the blanket sheet method to complete the patient transfer (p < 0.05). By switching from flat + blanket sheet to tilted + slide board, EMG activities in all muscles decreased in the range of 18.4-72.3%, and Borg-ratings decreased from about 4 (somewhat difficult) to 1 (very light). The findings of this study propose simple, readily available ergonomic interventions for performing patient lateral transfers that can have significant implications for nurses' wellbeing and efficiency.
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Affiliation(s)
- Saif K Al-Qaisi
- Department of Industrial Engineering and Management, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon.
| | - Adnan El Tannir
- Department of Industrial Engineering and Management, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Lina A Younan
- Rafic Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Roland N Kaddoum
- Department of Anesthesiology, American University of Beirut, Beirut, Lebanon
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18
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The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103719. [PMID: 32466147 PMCID: PMC7277889 DOI: 10.3390/ijerph17103719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023]
Abstract
Working at intensive care units (ICUs) is considered a risk factor for developing musculoskeletal complaints (MSC). This study was conducted between January 2017 and June 2019 in two ICUs of a university hospital. It was designed as a pre- and post-assessment of the intervention group (IG) (N = 27) compared with a control group (CG) (N = 23) to determine the effects of a multifaceted ergonomics intervention program in reducing MSC. The IG (N: 35) received a multifaceted ergonomic intervention program, which was implemented by an ERGO team over an 18 month period. Four ergonomic interventions were planned as follows: individual level interventions such as training; stretching exercises and motivation meetings; administrative intervention such as a daily 10 min stretching exercises break; engineering interventions such as lifting and usage of auxiliary devices. The CG (N:29) did not receive any intervention. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess MSC in both groups. At the start of the intervention, both groups were similar concerning the number of visits to doctors due to MSC, the number of sick leave days, and total CMDQ scores (p > 0.05 for all). Two factor repeated ANOVA measures were performed for between-groups and within-group analyses. The mean of the initial CMSDQ total scores in both groups increased significantly in the 18th month (p < 0.001). However, the interaction effect of group and time (between and within factors) was not significant (p = 0.992). Work-related MSC is a common occupational health problem among nurses. This study showed that individual-level interventions are not likely to succeed in eliminating manual patient lifting by nurses. Our results suggested that interventions without administrative measures might have limited success
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Skela‐Savič B, Dobnik M, Kalender‐Smajlović S. Nurses’ work characteristics and self‐assessment of the work environment—Explorative cross‐sectional study. J Nurs Manag 2020; 28:860-871. [DOI: 10.1111/jonm.13010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Brigita Skela‐Savič
- Angela Boškin Faculty of Health Care Angela Boškin Institute for Research in Healthcare Sciences Jesenice Slovenia
| | - Mojca Dobnik
- University Medical Centre Maribor Maribor Slovenia
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20
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Physical and Psychosocial Work Environmental Risk Factors for Back Injury among Healthcare Workers: Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224528. [PMID: 31731806 PMCID: PMC6887976 DOI: 10.3390/ijerph16224528] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 12/03/2022]
Abstract
The incidence of occupational back injury in the healthcare sector remains high despite decades of efforts to reduce such injuries. This prospective cohort study investigated the risk factors for back injury during patient transfer. Healthcare workers (n = 2080) from 314 departments at 17 hospitals in Denmark replied to repeated questionnaires sent every 14 days for one year. Using repeated-measures binomial logistic regression, controlling for education, work, lifestyle, and health, the odds for back injury (i.e., sudden onset episodes) were modeled. On the basis of 482 back injury events, a higher number of patient transfers was an important risk factor, with odds ratio (OR) 3.58 (95% confidence interval (CI) 2.51–5.10) for 1–4 transfers per day, OR 7.60 (5.14–11.22) for 5–8 transfers per day, and OR 8.03 (5.26–12.27) for 9 or more transfers per day (reference: less than 1 per day). The lack of necessary assistive devices was a common phenomenon during back injury events, with the top four lacking devices being sliding sheets (30%), intelligent beds (19%), walking aids (18%), and ceiling lifts (13%). For the psychosocial factors, poor collaboration between and support from colleagues increased the risk for back injury, with OR 3.16 (1.85–5.39). In conclusion, reducing the physical burden in terms of number of daily patient transfers, providing the necessary assistive devices, and cultivating good collaboration between colleagues are important factors in preventing occupational back injuries among healthcare workers.
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