The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units

Health status and ergonomics education: A comparison between student nurses and first-year nursing staff

AIMS

To (a) compare student nurses' health status and levels of ergonomics knowledge and awareness to those of first-year nursing staff and (b) investigate the association between nurses' ergonomic compliance and health status with their educational preparedness.

DESIGN

This cohort study compared ergonomics awareness and knowledge, and health status of nurses when they were students and after their first-year working in medical facilities.

METHODS

In total, 133 4th-year student nurses completed a survey; 45 of them completed a second survey after working 1 year in a medical facility. Their health status was compared over time using repeated-measures ANOVA. Correlation tests were used to analyse associations between ergonomics knowledge and awareness, health status, demographic variables and educational preparedness.

RESULTS

Respondents in both surveys displayed weak knowledge of ergonomic principles significantly associated with increased pain intensity and educational preparedness.

PATIENT CONTRIBUTION

Ergonomics training should be expanded during nursing studies and first-year training to prevent long-term health disorders.

Efficacy of an Omaha system-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders (WMSDs) - A randomized controlled study

Purpose

Heavy biomechanical loadings at workplaces may lead to high risks of work-related musculoskeletal disorders. This study aimed to explore the efficacy of an Omaha System-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders among frontline nurses.

Materials and methods

From July to October 2020, 94 nurses with self-reported pain in one of the three body parts, i.e., neck, shoulder, and low back, were selected and were randomly divided into two groups. The intervention group received a newly developed remote program, where the control group received general information and guidance on health and life. Program outcome was evaluated by a quick exposure check approach.

Results

After 6 weeks, the intervention group exhibited significantly less stress in the low back, neck, and shoulder/forearms, compared to the control group (p < 0.05). In addition, the occurrence of awkward postures, such as extreme trunk flexion or twisting, was also significantly reduced (p < 0.05).

Conclusions

The newly developed Omaha System-based remote intervention program may be a valid alternative to traditional programs for frontline nurses during the COVID-19 pandemic, reducing biomechanical loadings and awkward postures during daily nursing operations.

A multicomponent quasi-experimental ergonomic interventional study: long-term parallel four-groups interventions

BACKGROUND

Musculoskeletal disorders (MSDs) are known as one of the main problems affecting the health of industrial workers and can lead to lost working days, functional disability of workers and wasting the financial resources of an organization. Therefore, the present study aimed to evaluating the effect of ergonomic interventions on reducing MSDs and improving working posture in the in a foundry industry workers.

METHODS

A field multicomponent cross-interventional study was conducted on workers working in a foundry industry. In this study, 117 male workers were divided into 4 groups, including a control group, a group with specialized ergonomics training, a group with workstation intervention, and a group simultaneously undergoing training and workstation intervention. All 4 groups were evaluated during a period of baseline, 6 and 12-months follow- up. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used.

RESULTS

The results showed that the implemented interventions in the shoulder/arm, back and stress level were effective and the difference in the final score was significant among different groups (P-value > 0.05). In addition, the interventions led to a significant decrease in the QEC scores and musculoskeletal symptom scores in the neck, shoulder, lower back, knee, and lower leg regions among different groups (P-value > 0.05).

CONCLUSION

The results showed that workstation modification and training and workstation intervention simultaneously had a greater effect on MSDs and improving working posture compared to training alone.

What affects musculoskeletal risk in nursing assistants and orderlies?

BACKGROUND: There are many musculoskeletal disorders in staff members at health centres, given the specific characteristics of their work. OBJECTIVE: The objective was to analyse the postural risk of patient handling tasks performed by nursing assistants and orderlies, as well as task factors, individual or organisational, that may be associated with increased postural risk. METHOD: This is a cross-sectional observational study. Analysis was done on 170 postures in five different tasks performed by 39 participants at three hospitals in Andalusia (Spain). The questionnaires collected sociodemographic variables, the task done, and REBA were used for assessment of postural risk. RESULTS: Overall the average REBA score was 9.0±2.4. Moving the patient to the head of the bed was the task with the highest risk (9.8). Handling involving more than two participants at once increased postural risk. Using mechanical aids were associated with high risk in the legs. Logistic regression analyses showed that age, stature, and not having adjustable beds available were associated with postural risk (p < 0.05). CONCLUSION: Health centre staff perform many tasks with high musculoskeletal disorder risk. Age, stature of the participants, and adjustment of bed height were associated with postural risk.

Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature

INTRODUCTION

Work-related musculoskeletal disorders (WMSDs) are among the main causes of injury and pain in healthcare professionals. Previous reviews provided a fragmented view of the interventions available for WMSDs. This review aims to provide a comprehensive description of interventions for preventing and reducing work-related musculoskeletal injuries and/or pain among healthcare professionals, and to assess the methodological quality of studies.

METHODS

A systematic literature review was performed, based on the Effective Public Health Practice Project process. A comprehensive search was conducted on six peer-reviewed databases and manually. The methodological quality of the studies included was rated as weak, moderate, or strong. The studies were organized based on the 2019 classification of the interventions by Oakman and colleagues.

RESULTS

Twenty-seven articles were included reporting individual (n = 4), task-specific (n = 4), work organization and job design (n = 2), work environment (n = 1), and multifactorial (n = 16) interventions. Overall quality rating was strong for 6 studies, moderate for 16, and weak for 5. Individual interventions such as neuromuscular and physical exercise were effective in reducing pain. Task-specific and work organization interventions could prevent certain injuries. Significant reduction of both injuries and pain resulted from multifactorial interventions, which were reported by the majority of strong (n = 5) and moderate (n = 10) quality articles.

CONCLUSIONS

This review provides healthcare professionals with evidence-based information to plan interventions targeted towards reducing WMSDs. In particular, more efforts are needed to implement and extend effective multifactorial interventions. Moreover, studies about each professional healthcare target group are needed.

PRACTICAL APPLICATION

Our results can guide policy-makers, healthcare managers and professionals to choose the best strategies to prevent and reduce WMSDs and to shape continuous education programs. This study prompts clinicians to develop inter-professional collaborations and to practice physical activities in order to reduce WMSDs.

Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial

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.

Ergonomic Stressors Among Pregnant Healthcare Workers: Impact on pregnancy outcomes and recommended safety practices

Workplace environment can have a considerable impact on the physical, psychological and maternal health of pregnant healthcare workers. This article aimed to summarise the impact of work-related ergonomic stressors on pregnancy outcomes for healthcare workers, along with potential interventions to resolve these stressors. A narrative review analysis using the Pearl Growing Strategy was conducted between February 2019 and June 2020 to identify English-language articles published between 2000 and 2020. A total of 89 studies were identified from the SCOPUS (Elsevier, Amsterdam, Netherlands), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) databases and Google Scholar (Google LLC, Menlo Park, California, USA). The results indicated that poor work-related ergonomics had detrimental effects on pregnancy outcomes, resulting in spontaneous abortions, preterm delivery, low birth weight babies and infertility. Policymakers and employers should conduct ergonomic assessments and implement appropriate practices to ensure the safety of pregnant healthcare workers.

The effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers in the traditional metal casting industry

This research aimed to evaluate the effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers of the traditional metal casting industry that manually pour molten metal into molds. The workers' physical complaints are typically in the form of musculoskeletal complaints, which include (1) an activity aspect, (2) a physical aspect, and (3) a motivational aspect. The method used in this research was stratified random sampling. The subjects (n = 127) were divided into three groups, namely, the process cement department (PCD) group, the loam department (LD) group, and the black sand department (BSD) group. The evaluation was carried out using questionnaires based on musculoskeletal complaints and fatigue. Meanwhile, an assessment of musculoskeletal complaints and fatigue was conducted one month before the ergonomic intervention, and then during follow-ups at one and eight months after the ergonomic intervention. The results showed that the average reduction in musculoskeletal complaints and fatigue experienced by the workers in the LD group was lower than that of the workers in the PCD and BSD groups at one and eight months after the ergonomic intervention. The positive effects of the ergonomic intervention on musculoskeletal complaints were evident in terms of the back, waist, left and right thighs, right knee, right ankle, and left foot (p < 0.05). The positive effects of the ergonomic intervention on the level of activity-based fatigue were felt in the body and legs, and the feeling of wanting to lie down decreased. The motivational fatigue experienced by the workers manifested as difficulty in thinking, concentrating, and controlling behavior, while the physical fatigue experienced by the workers was in the form of headaches, back pain, excessive thirst, and feeling unwell (p < 0.05). It can be concluded that ergonomic intervention can reduce both musculoskeletal complaints and fatigue, especially by conducting a morning briefing, using ergonomic ladles when pouring molten metal into molds, and consuming nutritious food during break times.

Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial

Background: Nursing staff working in the operating room are exposed to risk factors that can cause musculoskeletal disorders (MSDs) and work-related disabilities. The use of ergonomics principles can help with the prevention of MSDs. This study aimed to examine the effect of an ergonomics educational program on MSDs among nursing staff working in the operating room. Methods: In this pragmatic parallel group quasi-randomized controlled clinical trial, 74 nursing staff working in the operating rooms of two teaching hospitals participated. The hospitals were randomly assigned to either the intervention or the control group and all nursing staff working in the operating room of each hospital were invited to take part in this research. They were initially assessed for the prevalence and risk of MSDs by using the Nordic questionnaire and the rapid entire body assessment (REBA) checklist. The intervention group received the ergonomics educational program and were assessed in two-week intervals over a period of three months. At the end of the study, the risk and prevalence of MSDs were compared between the intervention and control groups. Results: Statistically significant differences were reported between the groups in terms of the prevalence and risk of MSDs. The overall risk of MSDs decreased in the intervention group after the educational program (p = 0.03). The reduction in the prevalence of MSDs in the different parts of the body in the intervention group was as follows: ankle (p = 0.005), hand/wrist (p = 0.041), low back (p = 0.000), the neck (p = 0.003), hip (p = 0.001) and shoulder (p = 0.043). Conclusion: The education of nursing staff about ergonomics can influence the prevalence and risk of MSDs. Therefore, it should be incorporated into the degree education and on-the-job training initiatives for nurses working in the operating theatre in order to reduce workplace injuries and associated absences, and increase the quality of care delivered by them. This clinical trial has been registered in the Iranian Registry of Clinical Trials: IRCT2015081823677N1.