Evaluation of nursing students' work technique after proficiency training in patient transfer methods during undergraduate education

Evaluation of MSOT students' didactic knowledge and practice vs. real-time performance in manual patient transfers

BACKGROUND

Due to the nature of its occupations, the healthcare industry recognizes that manually lifting, transferring, and handling patients are high-risk activities and leading factors for work-related musculoskeletal disorders. Research studies highlight that students are not receiving adequate training in manual patient transfer.

OBJECTIVE

The objective of this study was to examine the procedural knowledge in patient transfer of second-year Master of Science in Occupational Therapy students and their practical skills in performing a manual patient transfer.

METHODS

This observational, cross-sectional study included 23 occupational therapy students. Students completed the transfer technique knowledge assessment and subsequently performed a real-time manual patient transfer.

RESULTS

No significant association was found between the participants' knowledge and performance in MPT (x2(2) = 0.578, p = 0.749). All students scored highly on the knowledge assessment (μ= 9.3, SD =±1.02); however, the performance on real-time manual patient transfer was moderate (μ= 11.57, SD =±3.37) for the majority of students.

CONCLUSION

A gap exists between the results of students' knowledge and practice versus real-time performance in manual patient transfer. The practical training students receive on manual patient transfers in the academic setting may not equip them with the necessary skills and techniques to perform safe transfers.

The relation between self-efficacy in patients with chronic obstructive pulmonary disease and caregiver burden

AIM

The study was conducted to examine the relation between self-efficacy in patients with chronic obstructive pulmonary disease (COPD) and caregiver burden.

MATERIAL AND METHODS

This descriptive, cross-sectional study included 200 patients with stage II and III COPD presenting to hospital between June and November in 2017 and their caregivers. Data were gathered with a questionnaire, COPD Assessment Test and COPD Self-Efficacy Scale from the patients. A questionnaire and Caregiver Burden Scale was used to collect data from the caregivers. Obtained data were analysed with the descriptive statistics numbers, percentages, mean, median and standard deviation. Spearman's correlation analysis was utilised to examine the relation between paired groups.

RESULTS

The mean age of the patients with COPD was 63.53 years and 51.1% of the patients were female. The mean age of the caregivers was 48.88 ± 14.09 years. 54.4% of the caregivers were aged 40-60 years, and 59.9% of the caregivers were female. The mean score was 26.97 ± 5.25 for COPD Assessment Test and 2.32 ± 0.43 for COPD Self-Efficacy Scale. Of all the caregivers, 64.8% had mild caregiving burden and 18.1% had moderate caregiving burden. The mean score for Caregiver Burden Scale had a significant, moderate relation with the mean score for the subscale physical effort in COPD Self-Efficacy Scale (r = -0.42; p < 0.01) and had a significant, weak, negative relation with the mean total score for COPD Self-Efficacy Scale and the mean scores for its subscales. There was a significant, moderate, positive relation between the mean scores for Caregiver Burden and COPD Assessment Test (r = 0.51; p < 0.001) and a significant, negative relation between the scores for COPD Self-Efficacy Scale and its subscales and the scores for CAT (r = -0.26 - r = -0.52; p < 0.05).

CONCLUSION

As self-efficacy in COPD patients increases, their health and daily lives are affected less by COPD and caregiver burden decreases.

Effects of a national safe patient handling program on nursing injury incidence rates

OBJECTIVE

The objective of the study was to identify which components of a system-wide safe patient handling (SPH) program reduced musculoskeletal injury (MSI) due to patient handling among nurses.

METHODS

The 3-year longitudinal study from 2008 to 2011 used a pretest-posttest design. The study was conducted in the Veterans Health Administration, and all medical centers participated. The outcome was 2011 MSI incidence rates due to patient-related handling for nurses, expressed as injuries per 10 000 full-time employees.

RESULTS

Three organizational risk factors, bed days of care, facility complexity level, and baseline MSI incidence rate, were significantly associated with MSI incidence rate and explained 21% of its variation. Five SPH components, including deployment of ceiling lifts and other new technologies, peer leader effectiveness, competency in SPH equipment use, facility coordinator link with safety committee, and peer leader training, uniquely accounted for an additional 23% of the total variation.

CONCLUSIONS

Findings provide evidence to support the effectiveness of a multicomponent approach to SPH programs given contextual considerations.

A systematic review of observational instruments used to assess nurses' skills in patient mobilisation

AIMS AND OBJECTIVES

The aim of this study was to identify and describe the existing observation instruments that are used to assess nurses' skills in patient mobilisation and to evaluate the psychometric properties of the included instruments.

BACKGROUND

Structured knowledge about instruments for assessing nurses' skills in patient mobilisation is limited.

DESIGN

Systematic review.

METHODS

Studies were identified via electronic database searches and reference lists and were included based on the eligibility criteria. Data regarding the type of instrument, the number of items/domains and the psychometric properties of the instruments were extracted, and the quality of the instruments were appraised according to Zwakhalen et al.'s (BMC Geriatrics, 2006) proposed criteria.

RESULTS

A total of 26 studies, reporting on 16 instruments, were included in this review. The instruments differed in terms of: (1) type of patient-mobilisation task, (2) focus of the instrument, (3) level of structure and (4) use by the observer. Most of the instruments were developed and used in evaluation studies that measured nurses' mobilisation techniques as an outcome of an educational intervention. The total quality score of the included instruments varied between 6-11 points out of a maximum quality score of 19.

CONCLUSION

Although patient mobilisation is part of nurses' everyday work, we suggest from the results of this review that no common consensus exists about the best way to perform patient-mobilisation tasks. The results from this study further show that no instrument measured all of the important aspects of effective patient mobilisation.

RELEVANCE FOR CLINICAL PRACTICE

Most of the instruments that were reviewed were able to detect differences in patient-mobilisation techniques. However, convincing evidence is lacking with regard to the content, psychometric properties and practicability of these instruments for use in clinical practice. We suggest the development and validation of a new comprehensive instrument.

It’s not about the hoist: A narrative literature review of manual handling in healthcare

The manual handling of people and objects is integral to the provision of nursing care to patients globally. Despite over 30 years of research intended to guide improvements for nurses’ safety, substantial rates of manual handling injuries persist internationally within the nursing profession. This paper reviews the contemporary international literature regarding manual handling interventions noting the unique context for injury prevention strategies within healthcare. The review includes the recognition of underlying assumptions inherent in the conceptualisation of manual handling and its management, and the preponderance of the post-positivist paradigm in this field.

The complexity of manual handling in healthcare has resulted in a theoretical shift from single factor interventions based on technique training towards an emerging multidimensional approach. However the key elements for sustainable solutions to reduce nurses’ manual handling injuries have not yet been identified and consensus is lacking regarding the implementation and appropriate evaluation of injury prevention programmes. Furthermore, whilst the literature is replete with data derived from surveys or insurance industry records of compensation claims, there is a dearth of literature exploring nurses’ manual handling experiences. The in-depth investigation of nurses’ perspectives on manual handling may uncover new knowledge critical to improvement of the manual handling issues.

Effects of educational intervention on joint angles of the trunk and lower extremity and on muscle activities during patient-handling tasks

OBJECTIVE

The objective of this study was to examine the effects of educational intervention on joint angles of the trunk and lower extremity and on muscle activities during patient-handling task.

METHODS

Thirty-two subjects (17 males and 15 females) volunteered for the study. They were classified into three groups: intervention group 1, comprised of first grade physical therapist students; control group, which included first grade occupational therapist students; intervention group 2, which comprised third grade physical therapist students. The educational intervention during the experimental period consisted of: (1) 12 regular classes and short-term clinical practice for the students of intervention group 1; (2) long-term clinical practice, relating to patient-handling task, for the students of intervention group 2. The following experiments were repeated before and after the educational intervention. Each subject was asked to transfer a male (55 kg) from one chair to a second chair (left to right) and then back again to the original chair (right to left). The flexion angles of the trunk, hip and knee joints were quantified by means of the dynamic three-dimensional biomechanical analysis. Muscle activities (% maximum voluntary contraction, %MVC) of biceps brachii, trapezius, rectus femoris and erector spinae muscles were measured using surface electromyography (EMG). The effects of group, gender, measurement time and side on joint angles of trunk and lower extremity, %MVC of four muscle activities and transfer time were assessed.

RESULTS

Although the EMG analysis could not clearly demonstrate any reduction of physical load to the low back, the flexion angles of the hip and knee joints of student subjects during the patient-handling task became larger and that of the trunk became smaller in the group given the educational intervention.

CONCLUSION

The finding of this study suggests that the posture of the study subjects changed to the squat lifting method, which is preferable for reducing the physical load to the lower back, as a result of the educational intervention.