Manual patient handling in the healthcare setting: a scoping review

Use of patient- handling devices and coworker assistance in long-term care settings: A cross-sectional study

Background

Although many patient handling activities require use of lifting devices and assistance from coworkers to ensure safety and efficiency, integrating these practices into the workplace remains challenging.

Objective

The objectives of this study were to examine the association of musculoskeletal symptoms with the use of patient -handling devices or coworker assistance and to identify factors associated with their adoption among direct care workers in long-term care facilities.

Methods

A cross-sectional study was conducted among 376 direct care workers recruited from 19 long-term care facilities in South Korea. Chi-square tests and analysis of variance with Tukey post-hoc analysis were used to assess differences in musculoskeletal symptom prevalence, frequency, and severity by patient handling methods. Multiple logistic regression was used to examine the relationship between the use of coworker assistance or patient -handling devices and demographic, job-related, physical, and psychosocial work factors and perception of management's safety priority.

Results

The majority of participants were female, married, and employed in non-permanent positions. Among the participants, 42.2% used both patient- handling devices and coworker assistance, 5.8 % used only patient- handling devices, 24.7 % used only coworker assistance, and 27.3 % used neither method. Workers who used both methods reported a significantly lower prevalence, frequency, and severity of musculoskeletal symptoms compared to those who relied on only one method or neither. Older and immigrant workers were less likely to use patient- handling devices. While workers perceiving management having a high priority for safety were more likely to use coworker assistance, immigrant, non-permanent, and overcommitted workers and those with longer years in long-term care showed lower tendencies to seek coworker assistance.

Conclusion

Despite the musculoskeletal benefits of using patient- handling devices and coworker assistance, their availability and adoption remain insufficient in long-term care facilities in Korea. These findings underscore the vital role that nursing leaders may play in promoting the adoption of combined patient handling methods, particularly among vulnerable worker groups. Empowerment strategies, such as fostering a supportive work environment and addressing barriers faced by overcommitted, long-tenured, and marginalized workers, may be essential to improving the safety and well-being of both patients and staff in long-term care settings.

Occupational injury severity among healthcare workers: a retrospective study

BACKGROUND

Healthcare workers (HCWs) are exposed to a multitude of hazards in the hospital environment, increasing their risks of sustaining injuries at a higher rate compared to workers in other sectors and resulting in substantial level of modified work and absenteeism. This study aims to examine the burden and determinants of occupational injury severity of HCWs at a tertiary care hospital in Lebanon.

METHODS

This retrospective cross-sectional study examined incident reports completed by HCWs over a period of 5 years (January 2018 to December 2022). Injury severity was assessed by HCWs' need for an Emergency Department (ED) visit after sustaining an injury at work. The association with age, sex, occupation, and type of injury was examined. Results were reported as adjusted OR, with their corresponding 95% confidence intervals and p-values, using logistic regression.

RESULTS

1,772 injury reports were recorded, of which 790 were included for analysis since the sample was limited to the outpatient clinic opening hours to ensure a more accurate assessment of injury severity. Of these, 27% required an ED visit. Male sex (OR = 1.601, p-value = 0.005) was associated with more severe injuries. Transportation injuries (OR = 5.927, p-value = 0.001) were more severe compared to other injury mechanism, while needle-pricks (OR = 0.008, p-value = 0.000), exposure to blood products (OR = 0.025, p-value = 0.000), and exposure to harmful substances (OR = 0.209, p-value = 0.003) were less severe. Age and occupation only showed significance at the bivariate level.

CONCLUSION

This study highlighted significant determinants of injury severity among HCWs, emphasizing the critical need for targeted interventions for individuals at risk. Implementing comprehensive safety and wellness programs can enhance the overall health and safety of HCWs in high-stress environments.

Manual handling and back pain among health care professionals in neurological inpatient and outpatient settings: a mixed methods study

BACKGROUND

The number of patients with neurological disorders and severe disability is increasing globally. These patients often need help with positioning and the amount of support varies with their level of impairment. High rates of work-related musculoskeletal disorders are observed among healthcare professionals (HCP) with patient contact due to injuries during manual handling. There is insufficient research on manual handling by nurses and other HCP.

OBJECTIVES

The primary aim of this study was to explore manual handling strategies by HCP in neurological inpatient and outpatient settings. A secondary aim was to explore pain during and post manual handling activities.

DESIGN

A convergent parallel mixed methods design.

METHODS

A quantitative survey was combined with qualitative semi-structured telephone interviews of HCP. The inclusion criteria were licensed allied HCP with at least seven years of experience with neurological patients in inpatient and/or outpatient settings and expertise in manual handling. Exclusion criteria included insufficient proficiency in German and pre-existing illness prior to start of professional education. The survey data were analysed using descriptive statistics and interviews were evaluated through inductive-reflexive thematic analysis.

RESULTS

Ten nurses, 10 occupational, 12 physiotherapists participated. Survey findings showed moderate time pressure, body strain, and low back and neck pain during patient transfers. HCPs spent an average of 7.3 (± 5.5) hours per week on personal endurance and strength training. They considered transfer aids moderately important and accessible, predominantly using the transfer board. Interdisciplinary collaboration in patient transfers was reported as crucial and usually available. We identified three themes from interviews: (1) individualised manual handling; (2) facilitating active patient participation during transfers; (3) maintaining personal physical fitness.

CONCLUSIONS

Neurological symptoms, patient fears, and goal setting necessitated personalised transfer strategies. Patient characteristics, lack of space and time complicated transfers, prompting HCPs to use perception-oriented techniques, leverage, gravity, and momentum.

Career aspiration and influencing factors study of intern nursing students: A latent profile analysis

BACKGROUND

The intensifying global aging population exacerbates the serious shortage of nurses, placing immense pressure on the healthcare system worldwide. Overwhelming workloads, limited career development opportunities, and high turnover rates among nurses compound these challenges. Career aspiration is closely related to individual active work behavior and career orientation, and is significant for stabilizing the nursing team. Identifying different subgroups of career aspiration among intern nursing students and analyzing the influencing factors can provide tailored support and interventions for their career development, contributing to addressing the global nursing shortage and shaping the future of the nursing profession.

AIMS

To identify different subgroups of career aspiration among intern nursing students and to analyze the related factors of the different subgroups.

METHODS

This secondary analysis relied upon a cross-sectional study conducted in China among 521 nursing students during clinical practice. Latent profile analysis was used to identify subgroups of career aspiration among intern nursing students, and multivariate logistic regression was used to analyze factors influencing their career aspiration. The Career Aspiration Scale, General Demographic Information Questionnaire, and the Nursing Students Clinical Practice Poor Adaptation Scale were utilized as measures.

RESULTS

There were four different subgroups of career aspiration, namely the "Moderate career aspiration type (33.7%)", "High leadership expectations-low effort type (11.6%)", "High professional development-low educational aspiration type (28.9%)", "High aspiration multidimensional leader-scholar type (25.8%)". School classification and clinical practice poor adaptation were significantly related factors for the four subgroups (all p < 0.05). Female significantly influenced the "high professional development-low educational aspiration type" (p < 0.001). Students' origin, grade point average, and student leadership experience significantly influenced the "high aspiration multidimensional leader-scholar type" (all p < 0.05).

CONCLUSIONS

This study has identified four distinct subgroups of career aspiration among Chinese intern nursing students and their influencing factors. These findings demonstrate the heterogeneity within the intern nursing student population, provide an effective supplement with a more in-depth analysis to the previous research and underscore the need for tailored educational approaches in clinical practice. By nurturing nursing students' career aspiration, a stable and competent nursing workforce will be cultivated to meet future healthcare demands and propel the advancement of the nursing profession.

A mixed methods approach to describe the efficacy of lift assist device use to reduce low back musculoskeletal disorder risk factors during three common patient extrication scenarios

This mixed-method study evaluated the efficacy of lift assist device use (Binder®, Eagle®, Maxi Air®) relative to manual lifting/care-as-usual in reducing low back muscle activity and perceived exertion during simulated patient extrication tasks. User feedback was recorded to identify factors that might influence use. Twenty paramedics performed a floor to stretcher lift, lateral transfer, and confined space extrication care-as-usual and with lift assist devices. Use of a lift assist reduced low back muscle activity during floor to stretcher and confined space tasks by 34-47%. Paramedics perceived exertion decreased from 'somewhat hard' to 'light' or 'very light' when using an assistive device. Paramedics noted that ease of use, patient comfort, task time, patient acuity, among other considerations would influence use decisions. Lift assist devices were efficacious at reducing low back muscle activity and perceived exertion during floor to stretcher and patient extrication tasks.

Exploring Musculoskeletal Injuries Among Informal and Formal Carers of People With Dementia

BACKGROUND

Carers of people with dementia manually handle the care recipients (eg, repetitive lifting, transferring, and pulling) as part of the care service, increasing the musculoskeletal injury risk to themselves.

OBJECTIVE

We aimed to determine the prevalence of musculoskeletal injuries among informal and formal carers of people with dementia and the perceived associated risk factors.

METHODS

Primary carers of people with dementia (26 males and 141 females) from Dementia Care Centers and Home Care programs completed a questionnaire providing information about (a) the carers' and their care recipients' characteristics, (b) musculoskeletal symptoms (via the Nordic Musculoskeletal Questionnaire) and related aspects, and (c) the caregiving activities exposing the carers to risk of musculoskeletal injury.

RESULTS

Our results showed that 69.7% of informal and 86.7% of formal carers reported having more than 1 musculoskeletal injury, while 63.1% and 61.5%, respectively, reported having a musculoskeletal injury in the last year. Lower back had the highest injury prevalence (>10% for both groups). The 2 carer groups were not different in any of the variables.

CONCLUSIONS

Our results reinforce calls for education and support of carers, regardless of their formal status, to enable injury-free and prolonged service provision.

Patient handling training interventions and musculoskeletal injuries in healthcare workers: Systematic review and meta-analysis

Workplace injuries are a serious issue for the health and social care industry, with the sector accounting for 20 % of all serious claims reported. The aim of this systematic review was to determine whether patient handling training interventions that included instruction on patient transfer techniques are effective in preventing musculoskeletal injuries in healthcare workers. Methods: Electronic databases MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Health and Safety Science Abstracts (ProQuest) were searched for controlled trials from January 1996-August 2022. Risk of bias was evaluated using the PEDro scale and overall certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluation for each meta-analysis. Results: A total of nine studies (3903 participants) were included. There is moderate certainty evidence that could not conclude whether patient handling training affects the 12-month incidence of lower back pain (OR = 0.83, 95 % CI [0.59, 1.16]). There is low certainty evidence that patient handing training does not prevent lower back pain in health professionals without pre-existing pain (MD = -0.06, 95 % CI [-0.63, 0.52]) but may reduce lower back pain in those with pre-existing pain (MD = -2.92, 95 % CI [-5.44, -0.41]). The results also suggest that there may be a positive effect of training incorporating risk assessment on musculoskeletal injury rates; however the evidence is of very low certainty. There is low certainty evidence from a single study that training may have a short-term effect on sickness absences.) Conclusions: There is a lack of evidence to support patient handling training when delivered to all healthcare staff. Training in its current form may be an ineffective strategy for reducing musculoskeletal injuries and pain. High quality disinvestment studies or trials incorporating risk assessment strategies are warranted. Practical Applications: This review suggests health service managers question the effectiveness of current patient handling training practices and consider evaluating current practices before allocating resources to meet employee risk reduction obligations.

Manual patient handling in the healthcare setting: a scoping review

BACKGROUND

Manual patient handling is the most frequently reported risk factor for work related musculoskeletal disorders in healthcare. Patient handling tasks are routinely performed manually without assistive devices and can create awkward postures and high loads for nurses and allied health professionals (AHPs). However, AHPs, notably physiotherapists, also utilize therapeutic handling to facilitate patient movement during rehabilitation.

OBJECTIVES

To comprehensively map the literature surrounding manual patient handling (without assistive devices) by healthcare practitioners.

METHODS

AMED, CINAHL, MEDLINE, SPORTDiscus, and EMBASE databases were searched. Grey literature was sourced from Google Scholar, EThOS, Open Grey, Health and Safety Executive, National Institute for Occupational Safety and Health and Work Safe Australia. Literature published in English between 2002 and 2021 was included.

RESULTS

Forty-nine records were included: 36 primary research studies, 1 systematic review and 12 'other' including narrative and government reports. Primary research was predominantly observational cross-sectional (n = 21). The most common settings included laboratories (n = 13) and hospitals (n = 13). Seven research questions were identified, with patient handling practices (n = 13) the most common. Nurses formed the largest practitioner population (n = 13) and patients were often simulated (n = 12). Common outcomes included tasks performed (n = 13) and physical demands during patient handling (n = 13).

CONCLUSION AND IMPLICATIONS OF KEY FINDINGS

This comprehensive scoping review identified that most research was observational, investigating nurses in hospitals or laboratories. More research on manual patient handling by AHPs and investigation of the biomechanics involved in therapeutic handling is needed. Further qualitative research would allow for greater understanding of manual patient handling practices within healthcare. CONTRIBUTION OF THE PAPER.