An exploration of undergraduate nursing and physiotherapy students’ views regarding education for patient handling

Occupational health and safety incidents at a university school of nursing: A retrospective, descriptive appraisal

Nursing is recognised internationally as a high-risk occupation for graduates and students. Developing an understanding of incident data may facilitate prevention of future adverse events. A descriptive, retrospective review of occupational health and safety incidents reported by personnel at an Australian university school of nursing was conducted, spanning a period of eight-and-a-half years. Classification of incident reports was determined using the existing electronic system with manual categorisation of data not suited to electronic analysis, such as narrative descriptions. In total, 142 incidents were reported, of which 135 were included in this study. Students reported 98 incidents on placement and 10 on campus. Frequently reported student incidents involved sharps, fainting, manual handling activities and workplace violence. Fifteen reports were hazard notifications. Reviewing data gathered over a prolonged duration provided useful patterns of information. Gaps in data and reporting system constraints were identified. Dual reporting systems may be barriers to providing an all-inclusive overview. Improving data collection methods could include recording demographic information such as year level, drop-down menus for commonly reported incidents to facilitate recording, and consideration of how best to capture events that involve multiple personnel.

CE: Original Research: Patient Handling and Mobility Course Content: A National Survey of Nursing Programs

: Purpose: Despite the evidence supporting safe patient handling and mobility (SPHM) practices, anecdotal evidence suggests that such practices are not universally taught in academic nursing programs. The primary goal of this cross-sectional descriptive study was to understand what nursing programs teach students about lifting, turning, transferring, repositioning, and mobilizing patients.

METHODS

Faculty from baccalaureate and associate's degree nursing programs in the United States were invited via e-mail to complete a 64-item survey questionnaire, which was accessible through an online link. Participants were also invited to send documents related to SPHM course content to the research team.

RESULTS

Faculty from 228 baccalaureate and associate's degree nursing programs completed the questionnaire. Most curricula included outdated manual techniques, taught reliance on body mechanics to reduce the risk of musculoskeletal injuries, and made use of nonergonomic aids such as draw sheets. Elements of SPHM in the curricula were less common, and nearly half of the respondents didn't know whether their affiliated clinical facilities had an SPHM program.

CONCLUSIONS

The survey results suggest many possibilities for improvement-such as partnering with faculty in physical and occupational therapy departments, clinical partnering, and working with equipment vendors-to better incorporate evidence-based SPHM principles and practices into nursing curricula.

Mobility care in nursing homes: development and psychometric evaluation of the kinaesthetics competence self-evaluation (KCSE) scale

BACKGROUND

Impaired mobility is a prevalent condition among care-dependent persons living in nursing homes. Therefore, competence development of nursing staff in mobility care is important. This study aimed to develop and initially test the Kinaesthetics Competence Self-Evaluation (KCSE) scale for assessing nursing staff's competence in mobility care.

METHODS

The KCSE scale was developed based on an analysis of the concept of nurses' competence in kinaesthetics. Kinaesthetics is a training concept that provides theory and practice about movement foundations that comprise activities of daily living. The scale contains 28 items and four subscales (attitude, dynamic state, knowledge and skills). Content validity was assessed by determining the content validity index within two expert panels. Internal consistency and construct validity were tested within a cross-sectional study in three nursing homes in the German-speaking region of Switzerland between September and November 2015.

RESULTS

The content validity index for the entire scale was good (0.93). Based on a sample of nursing staff (n = 180) the internal consistency results were good for the whole scale (Cronbach's alpha = 0.91) and for the subscales knowledge and skills (α = 0.91, 0.86), acceptable for the subscale attitude (α = 0.63) and weak for the subscale dynamic state (α = 0.54). Most items showed acceptable inter-item and item-total correlations. Based on the exploratory factor analysis, four factors explaining 52% of the variance were extracted.

CONCLUSION

The newly developed KCSE scale is a promising instrument for measuring nursing staff's attitude, dynamic state, knowledge, and skills in mobility care based on kinaesthetics. Despite the need for further psychometric evaluation, the KCSE scale can be used in clinical practice to evaluate competence in mobility care based on kinaesthetics and to identify educational needs for nursing staff.

Musculoskeletal pain symptoms among allied health professions' students: Prevalence rates and associated factors

BACKGROUND

Very few articles, comprehensively, investigated musculoskeletal pain symptoms (MPS) among wide variety of allied health professions (AHP) students.

OBJECTIVES

This study aimed to investigate the prevalence of MPS and their associated factors among different AHP majors' students.

METHOD

A cross-sectional design was conducted. A sample of AHP students from nine majors (n= 838, Mean age = 21.3 years) completed a validated structured self-administrated questionnaires including Nordic Musculoskeletal Questionnaire, Depression Anxiety Stress Scale (DASS 21), and specific questions regarding demographics and life style. MPS prevalence rate were compared between males and females and between majors. Logistic regression was conducted to identify predictors of MPS.

RESULTS

MPS in neck, lower back, and shoulder 12-month were the most prevalent (67.1%, and 61.4%, 58.8% respectively). MPS prevalence was significantly higher in females and statistically different among majors. MPS were significantly associated with increased clinical training load, mental stress symptoms, and smartphone average use time.

CONCLUSIONS

MPS in AHP students are prevalent and statistically higher among females. Students are advised to adhere to different conservative precautions and follow prevention programs. Future studies are needed to assess actual mechanisms causing MPS among AHP students and designing effective prevention programs specific to AHP students.

'Sometimes your safety goes a bit by the wayside' … exploring occupational health and safety (OHS) with student nurses

Because nursing is a high risk profession in terms of occupational health and safety (OHS), the topic of OHS is an important component of student nurse education and practice. Seeking ways to enhance curricular content and foster student health, safety and wellbeing is an ongoing pursuit. This pilot study explored nursing student perspectives about OHS in the clinical setting to develop an understanding of student views that could enlighten teaching about this topic within the undergraduate nursing course. Focus groups were held with pre-registration student nurses in two discrete cohort levels (first and third year). Themes were identified from the focus group discussion about trust, knowledge and responsibility. The students demonstrated a sound grasp of clinical hazards and associated administrative controls. Strengthening student awareness of higher order controls and their evaluation would augment their knowledge of legislative requirements. Students may benefit from learning about a risk management approach to OHS which would provide them with a structured basis for problem solving. This may assist them with clinical reasoning about health and safety issues and empower them in aspects of self-care.

An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students

PURPOSE

To explore knowledge and practice relating to patient handling among final year occupational therapy students in the Republic of Ireland.

METHOD

We conducted a survey of final year students in three out of four occupational therapy programs in the Republic of Ireland (n = 81). The survey measured students' knowledge of manual handling principles and techniques and explored their experiences and ability to apply this knowledge to clinical situations.

RESULTS

All students (n = 81) had undertaken training in patient handling. Just under half of students (n = 35, 43.2%) had received additional training outside of the university setting. Overall knowledge of safe patient handling principles techniques and risk assessment was low (Mean Score = 15.71/28; SD = 3.81). Participants who received additional training achieved a lower mean total score (M = 13.89, SD = 3.54) than those who only undertook university-based training (M = 18.11; SD = 2.66; t(79) = -5.87; p < 0.05). The majority of participants reported intermittent use of taught principles while on clinical practice placements (n = 50, 61.8%) Reasons for not using taught principles included; selection of alternative technique by supervisor (n = 30, 56.6%); lack of available equipment (n = 13, 24.5%) and lack of time (n = 13, 24.5%).

CONCLUSIONS

While occupational therapy students in Ireland receive training in safe patient handling they appear to have limited knowledge of best practice and experience difficulties in applying their learning to clinical situations. There is an urgent need to consider the effectiveness of current educational strategies in this area. Implications for Rehabilitation Safe patient handling is a key component in preventing musculoskeletal injury among rehabilitation professionals The extent to which pre-professional training prepares rehabilitation professionals to practice safe patient handling is unclear Occupational therapy students in this study had limited knowledge of safe patient handling and had difficulty applying their learning to clinical practice Alternative education models are required to support development of safe patient handling skills. Educators may wish to consider how safe patient handling can be embedded across curricula to avoid the challenges of once off instruction and massed practice.

Interprofessional teaching project with nursing and physical therapy students to promote caregiver and patient safety

Nurse educators must adjust curricula to meet the dynamic and critical changes in the health care environment, and to recognize the risk of injury our educational approach has on safety, team effectiveness, and culture change. Interprofessional collaboration and simulation are key components in the preparation of our students. Utilizing the interprofessional alliance model, an experience to promote collaborative relationships among nursing and physical therapy (PT) students to improve patient and caregiver safety was developed. Through this model, PT students taught safe patient-handling skills in a simulated setting to undergraduate nursing students. The majority of nursing students (N=351) from 2009–2014 strongly agreed or agreed that they were confident in the skills taught by the PT students and provided an overall course rating of outstanding or above average. This educational model, which includes simulation and safe patient handling, was a valuable addition to the curriculum, reinforcing the significance of developing collaborative relationships.

Interventions to reduce injuries when transferring patients: a critical appraisal of reviews and a realist synthesis

OBJECTIVES

There has been extensive investment in programmes to reduce injuries among health care staff caused by moving and handling patients or residents. Given conflicting evidence regarding the effectiveness of such programmes, the present paper conducted a critical appraisal of systematic reviews assessing the effectiveness of interventions in reducing back pain and injuries among healthcare staff. A realist synthesis was conducted on a second set of reports to identify best practices for moving and handling programmes.

DESIGN

A critical appraisal of systematic reviews and a realist synthesis to identify best practices for moving and handling programmes.

DATA SOURCES

A literature search of five databases (Medline, EMBASE, CINAHL, PsycINFO and ScienceDirect) located 150 reports assessing programme outcomes published in refereed journals between 2000 and 2013.

REVIEW METHODS

The critical appraisal included six systematic reviews. The realist synthesis included 47 studies that provided descriptive information about programme mechanisms.

RESULTS

Five of the six systematic reviews covered interventions involving either staff training or training and equipment supply. One review covered multi-component interventions. All concluded that training staff by itself was ineffective. There were differing conclusions regarding the effectiveness of training and equipment interventions and multi-component programmes. The reviews provided little information about the content of programme components. The realist synthesis noted the need for management commitment and support, and six core programme components; a policy requiring safe transfer practices, ergonomic assessment of spaces where people are transferred, transfer equipment including lifts, specific risk assessment protocols, adequate training of all care staff, and coordinators coaches or resource staff. These programme components are likely to be synergistic; omitting one component weakens the impact of the other components.

CONCLUSIONS

Five systematic reviews provided little information regarding the core components of effective programmes. Given the absence of experimental trials for multi-component programmes, the best available evidence for the effectiveness of multi-component programmes is from pre-post studies and large-scale surveys. The realist synthesis provided detailed information about the core components for effective programmes. Further studies, which include qualitative data, are needed to provide evidence about the specific mechanisms through which components contribute to effective patient handling programmes.

Impact of musculoskeletal symptoms on general physical activity during nursing education

Nursing education should prepare students for a lifelong professional career including managing clinical physical demands. Musculoskeletal symptoms, such as bodily pain, have been reported among nurses and nursing students but less is known about the impact of symptoms in daily activities. The aim was to explore the prevalence of self-reported musculoskeletal symptoms and their impact on general physical activity among nursing students. This cross-sectional study was based on a questionnaire to all undergraduate nursing students at one university. The prevalence of symptoms and physical impact during past 3 and 12 months was calculated for each study year. Odds ratio was analysed with logistic regression. Of 348 students 224 responded, 84% women, mean age 24.6 years (range 20-46). Of those 143 (64%) reporting symptoms during the past 12 months, 91 (64%) reported impact on physical activities. Most commonly reported were everyday activities such as transportations and prolonged sitting. The odds ratio for reporting symptoms was 1.8 for year 2 (95% CI: 0.9-3.5), and 4.7 for year 3 (95% CI: 2.1-10.7). The prevalence of musculoskeletal symptoms was high among nursing students and higher the final study year and not only resulted in discomfort but had an impact on the students' general physical activities.