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Wåhlin C, Buck S, Enthoven P, Andreassen M, Sandqvist J, Haraldsson P, Fock J, Strid EN. Risk assessment of healthcare workers' exposure to physical load in relation to patient handling and movement: a feasibility study of the instrument TilThermometer. BMC Musculoskelet Disord 2024; 25:399. [PMID: 38773516 PMCID: PMC11106945 DOI: 10.1186/s12891-024-07508-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/08/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health. The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs' perceptions and experiences of using the TilThermometer. METHODS This feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs' experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness. RESULTS The TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units' recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with questions evaluating usefulness. CONCLUSION The risk assessment provided risk profiles with potential to contribute to care units' development of a safe patient handling and movement practice. The findings suggest that the TilThermometer can be used to assess risks for physical exposure in relation to patient handling and movement in care units at hospital and nursing homes.
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Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Centre, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Clinical Medicine, Linköping University, Linköping, Sweden.
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Sebastian Buck
- Occupational and Environmental Medicine Centre, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Clinical Medicine, Linköping University, Linköping, Sweden
| | - Paul Enthoven
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational therapy, Linköping University, Norrköping, Sweden
| | - Jan Sandqvist
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational therapy, Linköping University, Norrköping, Sweden
| | - Patrik Haraldsson
- Occupational Safety and Health Care, Region Jönköping County, Jönköping, Sweden
- School of Health and Welfare, Academy for Improvement of Health and Welfare, Jönköping University, JönköpingJönköping, Sweden
| | - Jenni Fock
- Unit of Strategic Development, Linköping University Hospital, Linkoping, Region Östergötland, Sweden
| | - Emma Nilsing Strid
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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Brusco NK, Graven C, Boyd L, Kugler H, Dawes H, Rawson H, Clayton L, Tan S, Goodwin VA, Hall AJ, Taylor NF. Feasibility of implementing an innovative manual handling risk assessment training program for staff working in long-term care. Arch Public Health 2023; 81:53. [PMID: 37046289 PMCID: PMC10092908 DOI: 10.1186/s13690-023-01074-7] [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: 10/01/2022] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The Risk Assessment for moving Individuals SafEly (RAISE) program is a hospital-based manual handling nursing training program. RAISE involves upskilling on continual risk assessment during patient-assisted movements. RAISE aims to optimise staff and patient safety while providing the patient with movement and rehabilitation opportunities. Implementation of RAISE in the hospital setting has been established. The aim of this study was to explore the feasibility of implementing RAISE in the long-term care setting. METHODS We examined three feasibility domains: acceptability, practicality, and limited efficacy (observed nursing behaviour change which has the potential to reduce nursing injuries), using a prospective pilot pre-post design in the long-term care setting. Staff completed a 4-hour training session on RAISE delivered by two physiotherapists, followed by 8 h of supported behaviour change in the workplace. Staff acceptability and practicality of incorporating risk assessment strategies into manual handling approaches were explored through pre- and post-training staff surveys and a semi-structured interview. Resident acceptability of manual handling practices was explored via survey data collected after the RAISE training. Pre to post-training changes in staff knowledge and behaviour were examined through the pre- and post-training staff survey, and observation of staff assisting resident movement. RESULTS Two enrolled nurses and five residents participated. Staff reported the RAISE program was acceptable and practical to implement in the long-term care setting. There were no adverse events or safety concerns. Staff reported the RAISE program provided guidance and enhanced staff empowerment to make decisions during assisted resident movement. There were 26 observed resident-staff manual handling interactions recorded, with 13 pre-training and 13 post-training. Post-training, RAISE skills had improved and were completed 100% of the time, except for completing a physical risk assessment which improved from 46 to 85%, demonstrating limited efficacy. Residents reported it's important for staff to be trained on how to assist them to mobilise and they found the concept of the RAISE program acceptable. CONCLUSIONS This pilot study supports the feasibility of long-term care facilities participating in future studies testing the effectiveness and cost-effectiveness of the Risk Assessment for moving Individuals SafEly (RAISE) patient and resident manual handling program.
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Affiliation(s)
- Natasha K Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Victoria, Australia.
| | - Christine Graven
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Victoria, Australia
| | | | - Helen Kugler
- School of Allied Health Human Services and Sport, La Trobe University, Victoria, Australia
- Clinical Education and Research Institute, Cabrini Health, Malvern, Australia
| | - Helen Dawes
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Helen Rawson
- Nursing and Midwifery, Monash University, Victoria, Australia
| | | | | | | | - Abi J Hall
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Nicholas F Taylor
- Eastern Health, Box Hill, Australia
- School of Allied Health Human Services and Sport, La Trobe University, Victoria, Australia
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Wåhlin C, Buck S, Sandqvist J, Enthoven P, Fock J, Andreassen M, Strid EN. Evaluation of the implementation and effectiveness of a multifactorial intervention strategy for safe patient handling and movement in the healthcare sector: a study protocol of a cluster randomised controlled trial. BMJ Open 2023; 13:e067693. [PMID: 36737081 PMCID: PMC9900050 DOI: 10.1136/bmjopen-2022-067693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Healthcare workers with physically demanding work tasks, such as patient handling and movement (PHM), are at high risk of musculoskeletal disorders. To facilitate safe PHM and prevent musculoskeletal disorders, a combination of workplace interventions, including risk assessments, is needed. The aim of this study is to implement and evaluate a multifactorial intervention strategy for safe PHM and compare it with a single intervention strategy. METHODS AND ANALYSIS This cluster randomised controlled trial will compare a multifactorial intervention strategy with a single intervention strategy for safe PHM in workplaces in the Swedish regional and municipal healthcare systems. At least twelve healthcare units will be recruited. Care units belonging to arm A will receive: (1) guidelines for PHM, (2) training modules, (3) risk assessment with TilThermometer, (4) risk assessment with Downtown Fall Risk Index and (5) work environment mapping. Care units belonging to Arm B will receive interventions (1) and (5). The two strategies will be evaluated with regards to (1) the primary outcome of the applied strategies' intervention effectiveness (safety climate in relation to aspects of PHM) and (2) the primary implementation outcome (acceptability, appropriateness and feasibility). This study will also explore the implementation process and intervention fidelity, examine the influence of contextual factors and investigate participants' experiences of working with strategies for safe PHM. A mix of quantitative and qualitative methods will be used. The data collection is based on questionnaires, interviews and field notes of contextual factors. ETHICS AND DISSEMINATION The study is approved by the Swedish national ethical board (Dnr 2021-00578). Study results will be published in peer-reviewed journals, presented at conferences and distributed on social media. A lay summary and dissemination strategy will be codesigned with a reference group and participating healthcare units. TRIAL REGISTRATION NUMBER NCT05276180.
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Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Clinical Medicine, Linköping University, Linkoping, Sweden
- Unit of Intervention and Implementation Research for worker health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Buck
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Clinical Medicine, Linköping University, Linkoping, Sweden
| | - Jan Sandqvist
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational Therapy, Linköping University, Norrköping, Sweden
| | - Paul Enthoven
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Jenni Fock
- Unit of Stratgic Development, Linköping University Hospital, Region Östergötland, Linkoping, Sweden
| | - Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational Therapy, Linköping University, Norrköping, Sweden
| | - Emma Nilsing Strid
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Buck S, Sandqvist J, Nilsing Strid E, Knibbe HJJ, Enthoven P, Wåhlin C. Translation and cross-cultural adaptation of the risk assessment instrument TilThermometer for a Swedish version – patient handling in the healthcare sector. BMC Musculoskelet Disord 2022; 23:531. [PMID: 35658927 PMCID: PMC9164361 DOI: 10.1186/s12891-022-05474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Work-related musculoskeletal disorders are common in the healthcare sector due to exposure of physical demanding work tasks. Risk assessment is necessary to prevent injuries and promote a safety culture. The TilThermometer has proved to be useful in the Netherlands for assessing healthcare workers’ physical exposure to patient handling. The aim of this study was to translate the risk assessment instrument TilThermometer from Dutch to Swedish, perform cross-cultural adaptation, and evaluate its linguistic validity to a Swedish healthcare context.
Methods
Translation and validation process was performed according to following eight steps: 1) Translation (two translators), 2) Synthesis, 3) Back-translation (two back-translators), 4) Synthesis, 5) Linguistic review (one bilingual reviewer), 6) fifteen experts in a panel review according to Delphi-method, 7) Semi-structured interviewing eleven informants, analyzed using qualitative content analysis and step 8) discussion and input from creators of the instrument.
Results
A new Swedish version, the TilThermometer, was provided through the translation process (steps 1–5). The linguistic validity and usefulness were confirmed thru step 6 and 7. Consensus was reached in the expert review after two rounds, comments were analyzed and grouped into five groups. The qualitative content analyses of the interviews emerged in to three categories: 1) “User-friendly and understandable instrument”, 2) “Further development”, and 3) “Important part of the systematic work-environment management”.
Conclusion
In this study, the cross-cultural adaption and translation performed of the Swedish version of TilThermometer assured linguistic validity. This is this first phase before further testing the psychometrics aspects, inter-rater reliability and feasibility of TilThermometer. In the second phase TilThermometer will be implemented and evaluated together with other measures in the Swedish healthcare sector.
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Wåhlin C, Stigmar K, Strid EN. A systematic review of work interventions to promote safe patient handling and movement in the healthcare sector. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2520-2532. [PMID: 34789085 DOI: 10.1080/10803548.2021.2007660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPUSE The aim of this systematic review was to describe interventions which promote safe patient handling and movement (PHM) among workers in healthcare by reviewing the literature of their effectiveness for work and health-related outcomes. METHODS Data bases were searched for studies published 1997‒2018. Measures was operationalised broadly, capturing outcomes of work and health. Only Randomized controlled trials (RCTs) and cohort studies with control group were included. Quality was assessed using evidence-based checklists by Swedish Agency for Health Technology Assessment and Assessment of Social Services. RESULTS The systematic review included 10 RCTs and 19 cohort. Providing work equipment and training workers is effective: it can increase usage. Training workers to be peer coaches is associated with fewer injuries. Other effective strategies are participatory ergonomics and management engagement in collaboration with workers, facilitating safe PHM. CONCLUSIONS This systematic review suggests interventions for safe PHM with an impact of health-related outcomes should include access to work equipment, training as well as employer and employee engagement. The additional impact of multifaceted interventions is inconclusive. PRACTITIONER SUMMARY In clinical practice, there is a need for employers in healthcare to; 1) provide healthcare workers access to suitable work equipment. 2) provide training on how to use work equipment to prevent work-related injuries. Furthermore, the study also indicates that 3) training and appointing peer coaches can facilitate safe manual handling and movement (PHM) and, 4) It can be beneficial to involve workers in a participatory approach.
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Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, Lund, Sweden.,Skåne University Hospital, Region Skåne, Lund, Sweden
| | - Emma Nilsing Strid
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Wåhlin C, Lindmark U, Wagman P, Johnston V, Rolander B. Work and health characteristics of oral health providers who stay healthy at work – a prospective study in public dentistry. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.1905876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Centre, Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Lindmark
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Centre for Oral Health, Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petra Wagman
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Australia
| | - Bo Rolander
- Futurum, Academy for Health and Care, Region Jönköping, Jönköping, Sweden
- Department of Behavioral Science and Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Varpula J, Välimäki M, Lantta T, Berg J, Lahti M. Nurses' perceptions of risks for occupational hazards in patient seclusion and restraint practices in psychiatric inpatient care: A focus group study. Int J Ment Health Nurs 2020; 29:703-715. [PMID: 32086881 DOI: 10.1111/inm.12705] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
Seclusion and restraint are regularly used to manage patient aggression events in psychiatric inpatient care, despite occupational safety concerns. There is currently a lack of information on how nurses perceive the use of patient seclusion and restraint as a risk for occupational safety. The aim of this study is to describe the risks for occupational hazards in patient seclusion and mechanical restraint practices as well as ideas for improvement identified by nurses. A qualitative descriptive design was adopted, using focus groups comprising nurses (N = 32) working in psychiatric inpatient care. The data were analysed using inductive content analysis, and the results were reported using the consolidated criteria for reporting qualitative studies (COREQ). Four themes of risk for occupational hazards were identified: patient-induced, staff-induced, organization-induced, and environment-induced risks. One significant finding was that nurses described that their actions can strongly contribute to occupational hazards during seclusion and mechanical restraint practices. The nurses gave various ideas for how occupational safety could be improved during seclusion and mechanical restraint events, ideas involving staff, the organization, and environmental enhancements.
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Affiliation(s)
- Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Johanna Berg
- Turku University of Applied Science, Turku, Finland
| | - Mari Lahti
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University of Applied Science, Turku, Finland
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Muthukrishnan R, Maqbool Ahmad J. Ergonomic risk factors and risk exposure level of nursing tasks: association with work-related musculoskeletal disorders in nurses. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1715473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ramprasad Muthukrishnan
- Physiotherapy Division, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Jawairiya Maqbool Ahmad
- Physiotherapy Division, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
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