Implementation of participatory organizational change in long term care to improve safety

The Effect of Interventions on Preventing Musculoskeletal Injuries Related to Nurses Work: Systematic Review

BACKGROUND

The 12-month prevalence of musculoskeletal disorders related to work (MDRW) in nurses rests between 71.8% to 84%, so it is urgent to develop preventive intervention programs with the purpose of avoiding negative physical, psychological, socioeconomic, and working aspects. There are several intervention programs aimed at preventing musculoskeletal disorders related to work for nurses, but few have successfully proven results. Despite the evidence pointing to the benefits of multidimensional intervention programs, it is essential to determine which interventions have positive effects on the prevention of this kind of disorder to create an effective intervention plan.

AIM

This review intends to identify the different interventions adopted in the prevention of musculoskeletal disorders related to work in nurses and to compare the effectiveness of these interventions, providing the appropriate and scientific basis for building an intervention to prevent musculoskeletal disorders in nurses.

METHOD

This Systematic Review was guided by the research question, "What are the effects of musculoskeletal disorders preventive interventions on nursing practice?" and carried out in different databases (MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials, SCOPUS, and Science Direct). Later, the results were submitted to the eligibility criteria, the appraisal quality of the papers, and the data synthesis was performed.

RESULTS

13 articles were identified for analysis. The interventions implemented to control the risk were: training patient-handling devices; ergonomics education; involving the management chain; handling protocol/algorithms; acquiring ergonomics equipment; and no-manual lifting.

CONCLUSIONS

The studies associated two or more interventions, the majority of which (11 studies) were training-handling devices and ergonomics education, therefore emerging as the most effective instruments in the prevention of MDRW. The studies did not associate interventions that cover all risk factors (individual, associated with the nature of the work, organizational, and psychological aspects). This systematic review can help with making recommendations for other studies that should associate organizational measures and prevention policies with physical exercise and other measures aimed at individual and psychosocial risk factors.

Using Participatory Ergonomics to Improve Health and Safety in Commercial Lobstering in the United States: 2 Case Studies

The lobster-harvesting industry has a high occupational injury incidence compared to land-based industries. Participatory ergonomics methods were used to partner with lobstermen to develop and implement ergonomic improvements. The model included training in ergonomics principles, a forum for ergonomics discussions, and a sequence of meetings planned to focus on problem identification, intervention, evaluation, and dissemination of findings. One crew initiated 3 specific actions: the introduction of a conveyor belt to assist material handling at a local lobstering pier, the installation of a star block at the space for hauling traps onto the boat, and the initiation of a design process for improved mechanical assistance for hauling traps onto the boat. The other crew took action to reduce force and postural exposures by creating a short video intended to disseminate ergonomic ideas to other lobstermen. The influence of important cultural norms was observed for future research and development in the community.

Interaction training – an enabler for improvement measures within the psychosocial risk assessment process

Purpose

The study objectives were to (1) identify if providing solution-focused interaction training enables managers and employees to develop and implement actions to improve their psychosocial work environment and (2) test a recontextualization of the psychosocial work environment as social structures affecting members of the workplace and verify if social interactions effectively change the local psychosocial work environment.

Design/methodology/approach

The intervention involved training managers, supervisors and employees in solution-focused interaction. This study used a controlled interrupted time-series design, with an intervention and control group (CG) and pre- and post-measurements.

Findings

The psychosocial work environment improved, indicating that the training led to better social interactions, contributing to changes in the social structures within the intervention group (IG). Collective reflection between participants in the take action phase was the key to success. The recontextualization uncovered these mechanisms.

Research limitations/implications

The present study supports a recontextualization of the psychosocial work environment as primarily decided by social structures that emerge in recurrent interactions within work teams. The same social structures also seem to be important for other features of the production system, like job performance.

Practical implications

Training designed to enable high-quality social interactions, like dialogue and collective reflection, has proven to be effective in changing social structures. Moreover, managers may need training in facilitating the collective reflection between participants. Increased focus on social interactions within work teams is suggested for future study of organizational change processes, psychosocial work environment and practical psychosocial work environment management.

Originality/value

The intervention was delivered in the preparation phase to enable an effective take action phase. Both phases are less studied in psychosocial risk assessments research. The recontextualization has never been fully used in psychosocial research.