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Evans KW, Myers D, Rockefeller K. Work-related injury or work-related pain? A qualitative investigation of work-related pain and injury management among rehabilitation professionals1. Work 2024; 78:99-109. [PMID: 38393874 DOI: 10.3233/wor-230453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Patient mobility tasks place rehabilitation professionals (Physical and Occupational Therapists) working in hospitals at high risk for work-related musculoskeletal disorders (WMSDs). However, when investigating engagement with a Safe Patient Handling and Mobility program (SPHM), administrative records at a level one trauma hospital showed that rehabilitation professionals reported zero work-related injuries over an eight-year period. OBJECTIVE As part of a qualitative study conducted to discover their unique work experiences, we explored some of the reasons that rehabilitation professionals might not report work-related injuries to their employers. METHODS Using a collective case study design, six focus groups were conducted with 25 members of the rehabilitation team within a level-one trauma hospital. Focus groups were recorded; transcripts were analyzed for emergent themes using first and second cycle coding procedures. RESULTS Participants in this study denied experiencing work-related injuries but frequently described working in pain, often attributed to patient mobility tasks. These experiences were not reported to employers. Self-management of their pain through co-worker treatment, over-the-counter medications, or informal alteration in job tasks were reported as common. CONCLUSION Administrative injury records may underrepresent injuries among rehabilitation professionals. This may be due to their perception of work-related pain as something different than work-related injuries, or that many of these rehabilitation professionals treat their own work-related pain and symptoms rather than report them. To get a more accurate assessment of injury frequency among rehabilitation professionals, researchers should gather information directly from the participants, and should inquire about work-related pain in addition to injury.
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Affiliation(s)
- Kimeran W Evans
- Division of Physical Therapy, West Virginia University, Morgantown, WV, USA
| | - Douglas Myers
- Department of Community and Environmental Health, Boise State University, Boise, ID, USA
| | - Kathleen Rockefeller
- College of Health Care Sciences, Nova Southeastern University, Clearwater, FL, USA
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Abdul Halim NSS, Mohd Ripin Z, Ridzwan MIZ. Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis. Workplace Health Saf 2023; 71:557-576. [PMID: 37539959 DOI: 10.1177/21650799231185335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population. METHODS Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results. RESULTS A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention. CONCLUSION The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.
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Affiliation(s)
- Nur Shuhaidatul Sarmiza Abdul Halim
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
| | - Zaidi Mohd Ripin
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
| | - Mohamad Ikhwan Zaini Ridzwan
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
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Lind CM, Abtahi F, Forsman M. Wearable Motion Capture Devices for the Prevention of Work-Related Musculoskeletal Disorders in Ergonomics-An Overview of Current Applications, Challenges, and Future Opportunities. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094259. [PMID: 37177463 PMCID: PMC10181376 DOI: 10.3390/s23094259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) are a major contributor to disability worldwide and substantial societal costs. The use of wearable motion capture instruments has a role in preventing WMSDs by contributing to improvements in exposure and risk assessment and potentially improved effectiveness in work technique training. Given the versatile potential for wearables, this article aims to provide an overview of their application related to the prevention of WMSDs of the trunk and upper limbs and discusses challenges for the technology to support prevention measures and future opportunities, including future research needs. The relevant literature was identified from a screening of recent systematic literature reviews and overviews, and more recent studies were identified by a literature search using the Web of Science platform. Wearable technology enables continuous measurements of multiple body segments of superior accuracy and precision compared to observational tools. The technology also enables real-time visualization of exposures, automatic analyses, and real-time feedback to the user. While miniaturization and improved usability and wearability can expand the use also to more occupational settings and increase use among occupational safety and health practitioners, several fundamental challenges remain to be resolved. The future opportunities of increased usage of wearable motion capture devices for the prevention of work-related musculoskeletal disorders may require more international collaborations for creating common standards for measurements, analyses, and exposure metrics, which can be related to epidemiologically based risk categories for work-related musculoskeletal disorders.
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Affiliation(s)
- Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
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van de Wijdeven B, Visser B, Daams J, Kuijer PP. A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: a scoping review. BMC Musculoskelet Disord 2023; 24:87. [PMID: 36726094 PMCID: PMC9890723 DOI: 10.1186/s12891-023-06155-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSDs) are a key topic in occupational health. In the primary prevention of these disorders, interventions to minimize exposure to work-related physical risk factors are widely advocated. Besides interventions aimed at the work organisation and the workplace, interventions are also aimed at the behaviour of workers, the so-called individual working practice (IWP). At the moment, no conceptual framework for interventions for IWP exists. This study is a first step towards such a framework. METHODS A scoping review was carried out starting with a systematic search in Ovid Medline, Ovid Embase, Ovid APA PsycInfo, and Web of Science. Intervention studies aimed at reducing exposure to physical ergonomic risk factors involving the worker were included. The content of these interventions for IWP was extracted and coded in order to arrive at distinguishing and overarching categories of these interventions for IWP. RESULTS More than 12.000 papers were found and 110 intervention studies were included, describing 810 topics for IWP. Eventually eight overarching categories of interventions for IWP were distinguished: (1) Workplace adjustment, (2) Variation, (3) Exercising, (4) Use of aids, (5) Professional skills, (6) Professional manners, (7) Task content & task organisation and (8) Motoric skills. CONCLUSION Eight categories of interventions for IWP are described in the literature. These categories are a starting point for developing and evaluating effective interventions performed by workers to prevent WMSDs. In order to reach consensus on these categories, an international expert consultation is a necessary next step.
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Affiliation(s)
- Bert van de Wijdeven
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
| | - Bart Visser
- grid.431204.00000 0001 0685 7679Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Joost Daams
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
| | - Paul P.F.M. Kuijer
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
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Lind CM, De Clercq B, Forsman M, Grootaers A, Verbrugghe M, Van Dyck L, Yang L. Effectiveness and usability of real-time vibrotactile feedback training to reduce postural exposure in real manual sorting work. ERGONOMICS 2023; 66:198-216. [PMID: 35466852 DOI: 10.1080/00140139.2022.2069869] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Vibrotactile feedback training may be used as a complementary strategy to reduce time in demanding postures in manual handling. This study evaluated the short- and medium-term effects of concurrent posture-correction vibrotactile feedback training on trunk inclination exposure in real manual sorting work. Fifteen warehouse workers completed the training and the follow-up sessions. Trunk inclination angles were recorded using the ambulatory Smart Workwear System. Questionnaires were used for assessing system usability, perceived physical exertion, and work ability. The results showed reduced time in trunk inclination >30°, >45°, and >60°, and reductions in the 90th, 95th, and 99th percentile trunk inclination angles, when receiving feedback and immediately after feedback withdrawal. No significant reduction was retained after one and three weeks. The wearer's comfort was scored high, and the feedback did not increase the perceived cognitive demands. No significant effects attributed to changed trunk inclination exposure were observed for perceived physical exertion or work ability. The training program has the potential of contributing to reduced trunk inclination exposure in the short term. Future studies are needed to evaluate if improvements in the feedback training can transfer the short-term results to retained median- and long-term effects.Practitioner summary: A two-day training program with concurrent posture-correction vibrotactile feedback can contribute to reduced exposure of trunk inclination in real manual sorting work in the short term. More research is needed on how to design the feedback training programs in order to be effective in the long term.
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Affiliation(s)
- Carl Mikael Lind
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Mikael Forsman
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | | | | | | | - Liyun Yang
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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The Effect of Interventions on Preventing Musculoskeletal Injuries Related to Nurses Work: Systematic Review. J Pers Med 2023; 13:jpm13020185. [PMID: 36836419 PMCID: PMC9958813 DOI: 10.3390/jpm13020185] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The 12-month prevalence of musculoskeletal disorders related to work (MDRW) in nurses rests between 71.8% to 84%, so it is urgent to develop preventive intervention programs with the purpose of avoiding negative physical, psychological, socioeconomic, and working aspects. There are several intervention programs aimed at preventing musculoskeletal disorders related to work for nurses, but few have successfully proven results. Despite the evidence pointing to the benefits of multidimensional intervention programs, it is essential to determine which interventions have positive effects on the prevention of this kind of disorder to create an effective intervention plan. AIM This review intends to identify the different interventions adopted in the prevention of musculoskeletal disorders related to work in nurses and to compare the effectiveness of these interventions, providing the appropriate and scientific basis for building an intervention to prevent musculoskeletal disorders in nurses. METHOD This Systematic Review was guided by the research question, "What are the effects of musculoskeletal disorders preventive interventions on nursing practice?" and carried out in different databases (MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials, SCOPUS, and Science Direct). Later, the results were submitted to the eligibility criteria, the appraisal quality of the papers, and the data synthesis was performed. RESULTS 13 articles were identified for analysis. The interventions implemented to control the risk were: training patient-handling devices; ergonomics education; involving the management chain; handling protocol/algorithms; acquiring ergonomics equipment; and no-manual lifting. CONCLUSIONS The studies associated two or more interventions, the majority of which (11 studies) were training-handling devices and ergonomics education, therefore emerging as the most effective instruments in the prevention of MDRW. The studies did not associate interventions that cover all risk factors (individual, associated with the nature of the work, organizational, and psychological aspects). This systematic review can help with making recommendations for other studies that should associate organizational measures and prevention policies with physical exercise and other measures aimed at individual and psychosocial risk factors.
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Richarz H, Tamayo A, Rahmig J, Siepmann T, Barlinn J. The impact of mechanical devices for lifting and transferring of patients on low back pain and musculoskeletal injuries in health care personnel-A systematic review and meta-analysis. J Occup Health 2023; 65:e12423. [PMID: 37712457 PMCID: PMC10502824 DOI: 10.1002/1348-9585.12423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Heavy lifting in nursing is highly associated with low back pain (LBP) and musculoskeletal injuries (MSI). We aimed to evaluate the impact of mechanical devices used for patient lifting and transferring on risk of LBP and MSI of health care personnel. METHODS We conducted a systematic review and meta-analysis. The literature search was performed during 1st and 12th September 2021 using 17 electronic databases and handsearching of bibliographies of included studies. Twenty studies were included in the qualitative synthesis and eight studies with in total 2087 participants in the meta-analysis. Dependent on the study design, risk of bias was assessed by Cochrane RoB 2.0, EPOC, and MINORS. We conducted random-effects meta-analyses assessing Hedges's g and 95% CI of MSI rate, perceived LBP, and peak compressive spinal load. We calculated prediction intervals and conducted a cost-benefit analysis (CBA). RESULTS All outcomes showed significant, adjusted pooled effect sizes (MSI rate: g = 1.11, 95% CI 0.914-1.299; perceived LBP: g = 1.54, 95% CI -0.016-3.088; peak compressive spinal load: g = 1.04, 95% CI -0.315 to 2.391). True effect sizes in 95% of all comparable populations fell in the following prediction intervals: MSI rate = -1.07-3.28, perceived LBP = -0.522-3.594, and peak compressive spinal load = -15.49 to 17.57. CBA revealed cost-benefit ratios of 1.2 and 3.29 between cumulative total savings and investment costs of intervention. CONCLUSIONS Prediction intervals confirmed strong true effect sizes for MSI rate and perceived LBP in 95% of all comparable populations but not for peak compressive spinal load. Mechanical lifting and transferring devices displayed a favorable cost-benefit ratio and should be considered for clinical implementation.
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Affiliation(s)
- Hans‐Udo Richarz
- Division of Health Care SciencesDresden International UniversityDresdenGermany
| | - Arturo Tamayo
- Winnipeg Regional Health Authority (WRHA), Department of Medicine, Section of NeurologyUniversity of ManitobaWinnipegManitobaCanada
- The Max Rady Faculty of Health Sciences, Brandon Regional Health CentreUniversity of ManitobaWinnipegManitobaCanada
| | - Jan Rahmig
- Department of NeurologyUniversity Hospital Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Timo Siepmann
- Division of Health Care SciencesDresden International UniversityDresdenGermany
- Department of NeurologyUniversity Hospital Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Jessica Barlinn
- Department of NeurologyUniversity Hospital Carl Gustav Carus, Technische Universität DresdenDresdenGermany
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BERARDI A, TOFANI M, COLALELLI F, VALENTE D, SELLITTO G, RUOTOLO I, GALEOTO G. The psychometric properties of the Italian version of the PEDro Scale. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.22.04593-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Albanesi B, Piredda M, Bravi M, Bressi F, Gualandi R, Marchetti A, Facchinetti G, Ianni A, Cordella F, Zollo L, De Marinis MG. Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature. JOURNAL OF SAFETY RESEARCH 2022; 82:124-143. [PMID: 36031239 DOI: 10.1016/j.jsr.2022.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/26/2021] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Beatrice Albanesi
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy; Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy.
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Rome, Italy
| | - Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Rome, Italy
| | - Raffaella Gualandi
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy
| | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy
| | | | - Andrea Ianni
- Research Unit in Hygiene, Statistics and Public Health, Campus Bio-Medico University, Rome, Italy
| | - Francesca Cordella
- CREO Lab - Advanced Robotics and Human Centred Technologies, Campus Bio-Medico University, Rome, Italy
| | - Loredana Zollo
- CREO Lab - Advanced Robotics and Human Centred Technologies, Campus Bio-Medico University, Rome, Italy
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Duffett-Leger L, Beck AJ, Siddons A, Bright KS, Alix Hayden K. What Do We Know About Interventions to Prevent Low Back Injury and Pain Among Nurses and Nursing Students? A Scoping Review. Can J Nurs Res 2021; 54:392-439. [PMID: 34860587 DOI: 10.1177/08445621211047055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY BACKGROUND Back injuries are common among nurses worldwide with lifetime prevalence of lower back pain ranging from 35% to 80%, making nursing a profession at great risk for back injuries. PURPOSE This systematic scoping review explored and mapped existing evidence regarding the prevention of low back injury and pain among nurses and nursing students. METHODS Using a scoping review methodology, six databases were searched initially in September 2017 and updated June 2020. Studies investigating interventions designed to reduce back injuries and pain among regulated nurses and student nurses, published in peer-review journals and written in English, were eligible for inclusion in this review. Quantitative, qualitative, and mixed methods studies of regulated nurses, nursing students, and nursing aides were included. Two independent reviewers screened, critically analysed studies using a quality appraisal tool, extracted data, and performed quality appraisals. RESULTS Two searches yielded 3,079 abstracts and after title, abstract and screening, our final synthesis was based on 48 research studies. CONCLUSIONS Forty years of research has demonstrated improvements in quality over time, the efficacy of interventions to prevent back injury and pain remains unclear, given the lack of high-quality studies. Further research, using multi-dimensional approaches and rigorous study designs, are needed.
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Affiliation(s)
| | - Amy J Beck
- Faculty of Nursing, 2129University of Calgary, Calgary, AB, Canada
| | - Anya Siddons
- Faculty of Nursing, 2129University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- Department of Community Health Sciences, 70401Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, 2129University of Calgary, , Calgary, AB, Canada
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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: 2] [Impact Index Per Article: 0.7] [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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Price JW. Osteopathic model of the development and prevention of occupational musculoskeletal disorders. J Osteopath Med 2021; 121:287-305. [PMID: 33635956 DOI: 10.1515/jom-2020-0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Context The direct and indirect costs of work-related musculoskeletal disorders are significant. Prevention is the most effective way to control these costs. To do that, we must understand how these disorders develop. Objectives To use the five models of osteopathic care to illustrate how cellular processes and neural reflexes interact to create work-related musculoskeletal pathology and to provide evidence-informed musculoskeletal injury and disability prevention recommendations. Methods A literature review of electronic databases (Google Scholar, PubMed, OVID, Cochrane Central Register of Controlled Trials, PEDro, and OSTMED.DR) from inception to October 16, 2019 and hand-search of publication references was performed for systematic reviews, cohort studies, case-control studies, and randomized controlled trials. The search terms reflected topics related to occupational injury and injury prevention, and included supplementary laboratory studies and narrative reviews related to the biological aspects of musculoskeletal injury. The eligible studies contained the following criteria: (1) the population of working age; (2) exposures to known risk factors, musculoskeletal disorders, and psychosocial factors; (3) written in English; (4) full text papers published in peer-reviewed journals; and (5) systematic review, cohort study, case-control study, and randomized controlled trial methodology. Studies were excluded if they included outcomes of productivity and costs only or outcomes that were assessed through qualitative methods only. Results The literature search resulted in 1,074 citations; 26 clinical studies and 14 systematic reviews were used in this review. A comprehensive workplace musculoskeletal disorder prevention program should match demands to capacity, correct dysfunctional movement patterns, and limit tissue vulnerability (biomechanical-structural model); restore alpha-gamma balance, tonic-phasic synergistic function, and autonomic balance (neurological model); maximize physiologic reserve (metabolic-energy model) component of a prevention program; optimize respiration and circulation (respiratory-circulatory model); and address cognitive distortions (behavioral-biopsychosocial model). Conclusions The presented osteopathic model of the development and prevention of work-related musculoskeletal disorders suggests that a combination of preventive interventions will be more effective than any single preventive intervention.
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Affiliation(s)
- James William Price
- Ascension St. Vincent Occupational Medicine Clinic, Evansville, IN, USA.,College of Osteopathic Medicine, Marion University, Indianapolis, IN, USA
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Brückner U, Laux S, Schneider-Lauteren S, Schneider J. Excessing Energy Expenditure in Female Healthcare Workers in a University Hospital. Ann Work Expo Health 2021; 66:89-101. [PMID: 34314496 DOI: 10.1093/annweh/wxab054] [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: 08/10/2020] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The assessment of energy expenditure (EE) at workplaces maintains a central topic in occupational health due to increasing work-related issues. Today 80% of employees in the healthcare system are women. Limited research concerning their physical activity at work is available. The purpose of the study was the investigation of body composition, maximum physical capacity and quantification of physical work activity for female healthcare workers under real-time conditions. METHODS Occupational physical activity (PA) of 33 female healthcare workers in a university hospital was quantified. Health associate professionals (HAP), health professionals (HP), and females working from cleaners and helpers (CH) department participated. All underwent cardio pulmonary exercise test. For every working task VO2, VCO2 and RER were measured and EE was calculated individually for each task. RESULTS Forty-two different working tasks were identified and grouped in seven categories to compare physical activity (PA): 'office and laboratory work', 'bedside patient care', 'instrument reprocessing, packing boxes', 'walking with patient, or alone', 'pushing carts or wheelchairs', 'strenuous cleaning in bent posture' and 'lifting heavy boxes, weights or items'. By comparing groups of healthcare workers, CH and HAP spent significant (p < 0.01) more EE (in kcal/min) 3.9 resp. 3.2 than HP 2.5. Light PA e.g. office and laboratory work (2.7 ± 0.6) and bedside patient care (2.9 ± 0.7) were accomplished by HP and HAP while HAP and CH performed moderate PA such as 'packing boxes' (3.6 ± 0.8), 'pushing carts' and 'strenuous cleaning' (4.7 ± 0.9). Work performed by CH and HAP, i.e. 'strenuous cleaning' and 'lifting heavy items' showed highest kcal per kg Fat Free Mass (FFM) per hour with 5.80 [4.05-7.81] and 6.94 [5.18-9.03] kcal/kgFFM/h. CONCLUSION Our findings lend preliminary support to the hypothesis that the majority of activities in female healthcare workers were of low and moderate PA and can be accomplished by middle aged and even older female workers. CH performed tasks with heavy physical activities (PA) like cleaning and lifting heavy weights. HAP performed light/moderate PA below their maximum physical capacity.
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Affiliation(s)
- Ulrike Brückner
- Institute and Outpatient Clinic for Occupational and Social Medicine University Hospital Gießen, Aulweg 129, 35392 Gießen, Germany
| | - Sandra Laux
- Institute and Outpatient Clinic for Occupational and Social Medicine University Hospital Gießen, Aulweg 129, 35392 Gießen, Germany
| | - Stephanie Schneider-Lauteren
- Institute and Outpatient Clinic for Occupational and Social Medicine University Hospital Gießen, Aulweg 129, 35392 Gießen, Germany
| | - Joachim Schneider
- Institute and Outpatient Clinic for Occupational and Social Medicine University Hospital Gießen, Aulweg 129, 35392 Gießen, Germany
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Lee SJ, Stock L, Michalchuk V, Adesoye K, Mullen K. Impact of California Safe Patient Handling Legislation: Health Care Workers' Perspectives. Workplace Health Saf 2021; 69:124-133. [PMID: 33522462 DOI: 10.1177/2165079920975388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Musculoskeletal injuries from patient handling are significant problems among health care workers. In California, legislation requiring hospitals to implement safe patient handling (SPH) programs was enacted in 2011. This qualitative study explored workers' experiences and perceptions about the law, their hospital's SPH policies and programs, patient handling practices, and work environment. METHODS Three focus groups were conducted with 21 participants (19 nurses and 2 patient handling specialists) recruited from 12 hospitals located in the San Francisco Bay Area and San Joaquin Valley. Qualitative content analysis was used for data analysis. RESULTS Multiple themes emerged from diverse experiences and perceptions. Positive perceptions included empowerment to advocate for safety, increased awareness of SPH policies and programs, increased provision of patient handling equipment and training, increased lift use, and improvement in safety culture. Perceived concerns included continuing barriers to safe practices and lift use such as difficulty securing assistance, limited availability of lift teams, understaffing, limited nursing employee input in the safety committee, blaming of individuals for injury, increased workload, and continuing injury concerns. Participants indicated the need for effective training, sufficient staffing, and management support for injured workers. CONCLUSIONS/APPLICATION TO PRACTICE This study identified improvements in hospitals' SPH programs and practices since the passage of California's SPH law, as well as continuing challenges and barriers to safe practices and injury prevention. The findings provide useful information to understanding the positive impacts of the SPH law but also notes the potential limitations of this legislation in the view of health care workers.
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Zakerian SA, Afzalinejhad M, Mahmodi M, Sheibani N. Determining the Efficiency of Ergonomic Belt During Patient Handling and its Effect on Reducing Musculoskeletal Disorders in Nurses. SAGE Open Nurs 2021; 7:23779608211057939. [PMID: 34888415 PMCID: PMC8649436 DOI: 10.1177/23779608211057939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Nursing personnel are always at risk for work-related musculoskeletal disorders, and patient transportation is one of the major risk factor for these disorders. OBJECTIVE The aim of this study was to evaluate the ergonomic belt to improve patient transferring conditions. METHODS The subjects included 60 health care workers (HCW) of a hospital with patient transfer experience. The ergonomic belt was examined to help move the patient from one bed to another. The prevalence of musculoskeletal disorders was assessed through the Nordic questionnaire, the degree of perceived exertion through the Borg criterion, and the patient's movement through the MAPO index before and after the intervention. RESULTS The results showed a significant decrease in Borg scale scores and MAPO index in two factors of education and auxiliary tools and overall scores of this index. We also saw a significant reduction in musculoskeletal disorders in the neck, shoulders and arms, waist, hands and wrists, thighs, knees and legs. There were no significant differences in the elbow and forearm before and after using the ergonomic belt. CONCLUSION In general, it can be concluded that the use of ergonomic belt had helped to reduce the risk of musculoskeletal disorders, as well as reducing the perceived exertion of nurses and other relevant personnel.
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Affiliation(s)
- Seyed Abolfazl Zakerian
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Afzalinejhad
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Mahmodi
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Sheibani
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
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Sundstrup E, Seeberg KGV, Bengtsen E, Andersen LL. A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:588-612. [PMID: 32219688 PMCID: PMC7716934 DOI: 10.1007/s10926-020-09879-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752 ).
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | | | - Elizabeth Bengtsen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
- Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
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Lind CM, Yang L, Abtahi F, Hanson L, Lindecrantz K, Lu K, Forsman M, Eklund J. Reducing postural load in order picking through a smart workwear system using real-time vibrotactile feedback. APPLIED ERGONOMICS 2020; 89:103188. [PMID: 32854822 DOI: 10.1016/j.apergo.2020.103188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 04/08/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users' experience of the system. The results showed reduced time in trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30° and ≥45° when the workers received feedback, and for trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30°, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program.
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Affiliation(s)
- Carl Mikael Lind
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden.
| | - Liyun Yang
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden
| | - Farhad Abtahi
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden
| | - Lars Hanson
- The Virtual Systems Research Centre, School of Engineering Science, University of Skövde, Skövde, Sweden; User Centred Product Design, Global Industrial Development, Scania CV, Södertälje, Sweden
| | - Kaj Lindecrantz
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden; Faculty of Textiles, University of Borås, SE-501 90, Borås, Sweden
| | - Ke Lu
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden
| | - Mikael Forsman
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden
| | - Jörgen Eklund
- Unit of Occupational Medicine, Karolinska Institutet, Solnavägen 4, SE-113 65, Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57, Huddinge, Sweden
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Vinstrup J, Jakobsen MD, Madeleine P, Andersen LL. Biomechanical load during patient transfer with assistive devices: Cross-sectional study. ERGONOMICS 2020; 63:1164-1174. [PMID: 32362200 DOI: 10.1080/00140139.2020.1764113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
This study utilised a cross-sectional design to perform measurements of muscle activity as well as forward - and lateral trunk inclination angle during a full workday among 52 female healthcare workers from 16 different departments at five Danish hospitals. Using linear mixed models, the 95th percentile ranks of the normalised root mean square (nRMS) values were analysed for the different types of assistive devices. Compared to no assistive device (mean nRMS 27.9%, 95% CI 24.8%-31.0%), the use of intelligent beds (23.9%, CI 20.2%-27.6%) and ceiling-lifts (24.0%, CI 20.3%-27.7%) led to lower erector spinae nRMS values across all types of patient transfers. Conversely, the use of bedsheets (30.6%, CI 27.1%-34.2%), sliding-sheets (30.3%, CI 26.8%-33.9%) and sliding-boards (33.5%, CI 29.5%-37.6%) were associated with higher levels of erector spinae muscle activity.Consistent use of ceiling-lifts and intelligent beds reduces the physical workload and may thereby decrease the risk of musculoskeletal disorders among healthcare workers. Practioner Summary: Frequent patient transfer is associated with an increased risk of back pain and injury among healthcare workers. This analysis compares the level of physical load during patient transfer with commonly used assistive devices. The results show that use of the ceiling-lift and intelligent bed is associated with relatively low physical load during patient transfer. Abbreviations: RMS: root mean square; nRMS: normalized root mean square; EMG: electromyography; MSD: musculoskeletal disorder; LBP: low-back pain; VAS: visual analogue scale; MVC: maximal voluntary contraction.
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Affiliation(s)
- Jonas Vinstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Markus D Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Pascal Madeleine
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Denmark
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de Campos TF, Maher CG, Fuller JT, Steffens D, Attwell S, Hancock MJ. Prevention strategies to reduce future impact of low back pain: a systematic review and meta-analysis. Br J Sports Med 2020; 55:468-476. [PMID: 32646887 DOI: 10.1136/bjsports-2019-101436] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the evidence from randomised controlled trials (RCTs) on the effectiveness of prevention strategies to reduce future impact of low back pain (LBP), where impact is measured by LBP intensity and associated disability. DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, Embase, CINAHL, PEDro and The Cochrane (CENTRAL) databases from inception to 22 October 2018. ELIGIBILITY CRITERIA RCTs evaluating any intervention aiming to prevent future impact of LBP, reporting an outcome measure of LBP intensity and/or disability measured at least 3 months post-randomisation, and the intervention group must be compared with a group that received no intervention/placebo or minimal intervention. Trials restricting recruitment to participants with current LBP were excluded. RESULTS 27 published reports of 25 different trials including a total of 8341 participants fulfilled the inclusion criteria. The pooled results, from three RCTs (612 participants), found moderate-quality evidence that an exercise programme can prevent future LBP intensity (mean difference (MD) -4.50; 95% CI -7.26 to -1.74), and from 4 RCTs (471 participants) that an exercise and education programme can prevent future disability due to LBP (MD -6.28; 95% CI -9.51 to -3.06). It is uncertain whether prevention programmes improve future quality of life (QoL) and workability due to the overall low-quality and very low-quality available evidence. CONCLUSIONS This review provides moderate-quality evidence that an exercise programme, and a programme combining exercise and education, are effective to reduce future LBP intensity and associated disability. It is uncertain whether prevention programmes can improve future QoL and workability. Further high-quality RCTs evaluating prevention programmes aiming to reduce future impact of LBP are needed.
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Affiliation(s)
- Tarcisio F de Campos
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Chris G Maher
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joel T Fuller
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Daniel Steffens
- Royal Prince Alfred Hospital, Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Attwell
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Mark J Hancock
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Lee SJ, Rempel D. Comparison of lift use, perceptions, and musculoskeletal symptoms between ceiling lifts and floor-based lifts in patient handling. APPLIED ERGONOMICS 2020; 82:102954. [PMID: 31546092 DOI: 10.1016/j.apergo.2019.102954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/26/2019] [Accepted: 09/14/2019] [Indexed: 06/10/2023]
Abstract
Lifting equipment can reduce the risk of injury from patient handling, but limited availability and adoption have been a persistent problem. Data from statewide surveys of California nurses (N = 389) in 2013 and 2016 were analyzed to evaluate lift use, perceptions about lifts and injury risk, and musculoskeletal symptoms by type of available lifts. Nurses with ceiling lifts (23%) were significantly more likely to use lifts and had more positive perceptions about lifts, regarding worker safety, patient safety and comfort, ease of use, access, and storing, than nurses with only floor lifts (77%). Nurses with ceiling lifts reported less low back pain and shoulder pain. Our study findings suggest that providing ceiling lifts can result in superior outcomes to floor-based lifts in multiple aspects, including better acceptance and use by nurses for patient handling, as well as being associated with reduced work-related musculoskeletal symptoms in the low back and shoulders.
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Affiliation(s)
- Soo-Jeong Lee
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA.
| | - David Rempel
- Department of Bioengineering, University of California, Berkeley, CA, USA
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21
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Association between Psychosocial Working Conditions and Perceived Physical Exertion among Eldercare Workers: A Cross-Sectional Multilevel Analysis of Nursing Homes, Wards and Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193610. [PMID: 31561538 PMCID: PMC6801705 DOI: 10.3390/ijerph16193610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022]
Abstract
This cross-sectional multilevel study aims at investigating the associations between psychosocial working conditions of different workplace levels and perceived physical exertion among eldercare workers. Data were obtained from the 'Danish Observational Study of Eldercare work and musculoskeletal disorderS' (DOSES) study, including 536 eldercare workers, nested in 126 wards and 20 nursing homes. Psychosocial working conditions were measured by the Copenhagen Psychosocial Questionnaire (COPSOQ). The physical workload was measured with a self-administered scale (0-10) rating perceived physical exertion. Multilevel linear mixed models were used to determine associations of psychosocial conditions between nursing homes, wards, and workers with physical exertion. Most of the variance in the perceived physical exertion was explained by differences between workers (83%), but some variance was explained by wards (11%) and nursing homes (6%). Workers employed in nursing homes with low influence (p = 0.01) and poor leadership (p = 0.02), and in wards with high quantitative demands (p = 0.03), high work pace (p < 0.001), and low justice (p = 0.01) were at increased risk of reporting higher physical exertion. The strongest associations were found for low influence, low quality of leadership, and high work pace at nursing homes and ward levels. In conclusion, improving specific psychosocial working conditions at nursing home and ward levels may be of particular importance to reduce excessive physical workload in eldercare workers.
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Tang K, Diaz J, Lui O, Proulx L, Galle E, Packham T. Do active assist transfer devices improve transfer safety for patients and caregivers in hospital and community settings? A scoping review. Disabil Rehabil Assist Technol 2019; 15:614-624. [PMID: 31248300 DOI: 10.1080/17483107.2019.1604822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Safe patient handling practices reduce injury risk for healthcare workers (HCW) and patients, but may conflict with goals of rehabilitation and person-centred care by minimizing (a) active participation in transfers and (b) autonomy and dignity while using mechanical lifts. Active assist transfer devices (AATDs) have potential to address both safety and support needs for appropriate clients.Purpose: What is the scope and nature of the evidence to support the use of AATD for improving transfer safety for patients and caregivers in both hospital and community settings?Methods: Scoping review of peer-reviewed and Gray literature, using systematic search strategies and multiple reviewers for identifying papers and extracting data.Findings: Twenty-nine peer-reviewed publications, and 12 other documents (policy, technical) were included in the review. Half focused on HCW safety in the hospital setting, with only seven addressing patient safety in the community. Generally, literature was of low quality, with no controlled trials to support the benefit of this equipment, and often represented a nursing care perspective. However, positive outcomes reported included safety, satisfaction, and equipment utilization.Implications: There is a need for rigorous research on use of AATDs in the community comparing rehabilitation outcomes across other forms of transfer equipment. Other important targets include injury risk for family caregivers, and potential to support early discharge. At present, utilization of AATDs within the rehabilitation field will continue to rely on best judgement of the care team. Implementation of AATDs should be considered a compelling target for practice-based research and quality improvements.Implications for rehabilitationThe use of active assist transfer devices is associated with their availability in the in-patient hospital setting.The use of active assist transfer devices is associated with positive patient experience, such as increased patient satisfaction and dignity. Improved patient adherence and cooperation with healthcare workers during mobilization and rehabilitation may follow.Most current evidence is focused on caregiver safety outcomes and is in support of decreased injury rates with increased active assist transfer device use. There is a limited amount of evidence focusing on the rehabilitation outcomes with active assist transfer device use.With current evidence, the use of AATDs should be used at the discretion of the care team.
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Affiliation(s)
- K Tang
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - J Diaz
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - O Lui
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - L Proulx
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - E Galle
- West Lincoln Memorial Hospital Hamilton Health Sciences, Grimsby, Canada
| | - T Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
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Iwakiri K, Takahashi M, Sotoyama M, Liu X, Koda S. Priority approaches of occupational safety and health activities for preventing low back pain among caregivers. J Occup Health 2019; 61:339-348. [PMID: 31004382 PMCID: PMC6718835 DOI: 10.1002/1348-9585.12055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/22/2019] [Accepted: 03/30/2019] [Indexed: 11/11/2022] Open
Abstract
Objectives The incidence of occupational low back pain (LBP) is high among caregivers. The use of care equipment and training about care methods could prevent LBP among caregivers. However, in care facilities in Japan, these measures are not adequately employed. Moreover, the care facilities have faced issues regarding poor staffing in recent years. The present study investigated the relationship between LBP and occupational safety and health activities (OSHAs) for preventing LBP among caregivers and aimed to validate the priority approaches of OSHA. Methods This cross‐sectional study was conducted in care facilities for the elderly in Japan. Questionnaires for administrators and caregivers were distributed to 1,000 facilities and 5,000 caregivers, respectively. Questionnaires completed by 612 facilities and 2,712 caregivers were analyzed. Results No direct association was observed between severe LBP and OSHA, but indirect association was done. A significant relationship was noted between severe LBP and the care methods. Direct factors causing severe LBP were lifting a resident using human power and taking an unsuitable posture. These care methods were associated with the following OSHAs: promoting the use of care equipment, training about care methods, and consultation regarding the use of care equipment and employing an appropriate care method with the person in charge. Conclusions These OSHAs decreased lifting a resident using human power and taking an unsuitable posture, which are the primary risk factors of LBP. Therefore, these OSHAs should be implemented as priority approaches to prevent LBP among caregivers in care facilities for the elderly.
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Affiliation(s)
- Kazuyuki Iwakiri
- National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Masaya Takahashi
- National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Midori Sotoyama
- National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Xinxin Liu
- National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Shigeki Koda
- National Institute of Occupational Safety and Health, Kawasaki, Japan
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Hoe VCW, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev 2018; 10:CD008570. [PMID: 30350850 PMCID: PMC6517177 DOI: 10.1002/14651858.cd008570.pub3] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders worldwide. Studies have shown that the percentage of office workers that suffer from MSDs ranges from 20 to 60 per cent. The direct and indirect costs of work-related upper limb MSDs have been reported to be high in Europe, Australia, and the United States. Although ergonomic interventions are likely to reduce the risk of office workers developing work-related upper limb and neck MSDs, the evidence is unclear. This is an update of a Cochrane Review which was last published in 2012. OBJECTIVES To assess the effects of physical, cognitive and organisational ergonomic interventions, or combinations of those interventions for the prevention of work-related upper limb and neck MSDs among office workers. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, Web of Science (Science Citation Index), SPORTDiscus, Embase, the US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and the World Health Organization's International Clinical Trials Registry Platform, to 10 October 2018. SELECTION CRITERIA We included randomised controlled trials (RCTs) of ergonomic interventions for preventing work-related upper limb or neck MSDs (or both) among office workers. We only included studies where the baseline prevalence of MSDs of the upper limb or neck, or both, was less than 25%. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the interventions and outcomes in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS We included 15 RCTs (2165 workers). We judged one study to have a low risk of bias and the remaining 14 studies to have a high risk of bias due to small numbers of participants and the potential for selection bias.Physical ergonomic interventionsThere is inconsistent evidence for arm supports and alternative computer mouse designs. There is moderate-quality evidence that an arm support with an alternative computer mouse (two studies) reduced the incidence of neck or shoulder MSDs (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99), but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck or shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There is moderate-quality evidence that the incidence of neck or shoulder and right upper limb disorders were not considerably reduced when comparing an alternative computer mouse and a conventional mouse (two studies; neck or shoulder: RR 0.62; 95% CI 0.19 to 2.00; right upper limb: RR 0.91; 95% CI 0.48 to 1.72), and also when comparing an arm support with a conventional mouse and a conventional mouse alone (two studies) (neck or shoulder: RR 0.91; 95% CI 0.12 to 6.98; right upper limb: RR 1.07; 95% CI 0.58 to 1.96).Workstation adjustment (one study) and sit-stand desks (one study) did not have an effect on upper limb pain or discomfort, compared to no intervention.Organisational ergonomic interventionsThere is very low-quality evidence that supplementary breaks (two studies) reduce discomfort of the neck (MD -0.25; 95% CI -0.40 to -0.11), right shoulder or upper arm (MD -0.33; 95% CI -0.46 to -0.19), and right forearm or wrist or hand (MD -0.18; 95% CI -0.29 to -0.08) among data entry workers.Training in ergonomic interventionsThere is low to very low-quality evidence in five studies that participatory and active training interventions may or may not prevent work-related MSDs of the upper limb or neck or both.Multifaceted ergonomic interventionsFor multifaceted interventions there is one study (very low-quality evidence) that showed no effect on any of the six upper limb pain outcomes measured in that study. AUTHORS' CONCLUSIONS We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs. For other physical ergonomic interventions there is no evidence of an effect. For organisational interventions, in the form of supplementary breaks, there is very low-quality evidence of an effect on upper limb discomfort. For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort. Further high-quality studies are needed to determine the effectiveness of these interventions among office workers.
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Affiliation(s)
- Victor CW Hoe
- University of MalayaCentre for Occupational and Environmental HealthPantai ValleyKuala LumpurMalaysia50603
| | - Donna M Urquhart
- Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineAlfred Hospital, Commercial RdMelbourneVictoriaAustralia
| | - Helen L Kelsall
- Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineAlfred Hospital, Commercial RdMelbourneVictoriaAustralia
| | - Eva N Zamri
- University of MalayaDepartment of Social and Preventive MedicineKuala LumpurMalaysia50603
| | - Malcolm R Sim
- Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineAlfred Hospital, Commercial RdMelbourneVictoriaAustralia
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Changing the Perceptions of a Culture of Safety for the Patient and the Caregiver: Integrating Improvement Initiatives to Create Sustainable Change. Crit Care Nurs Q 2018; 41:226-239. [PMID: 29851672 DOI: 10.1097/cnq.0000000000000203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Evidence indicates that chances for a successful patient mobility program, prevention of pressure injury and falls, and safe patient handling are enhanced when an organization possesses an appropriate culture for safety. Frequently, these improvement initiatives are managed within silos often creating a solution for one and a problem for the others. A model of prevention integrating early patient mobility, preventing pressure injuries and falls while ensuring caregiver safety, is introduced. The journey begins by understanding why early mobility and safe patient handling are critical to improving overall patient outcomes. Measuring current culture and understanding the gaps in practice as well as strategies for overcoming some of the major challenges for success in each of these areas will result in sustainable change.
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Teeple E, Collins JE, Shrestha S, Dennerlein JT, Losina E, Katz JN. Outcomes of safe patient handling and mobilization programs: A meta-analysis. Work 2018; 58:173-184. [PMID: 29036857 DOI: 10.3233/wor-172608] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Variability in patient care settings and the range of patient handling tasks present challenges in developing and evaluating safe patient handling and mobilization (SPHM) programs. OBJECTIVE We performed a systematic meta-analysis of SPHM program evaluations. METHODS Systematic literature review identified published SPHM program evaluations. Injury Rate Ratios (IRR), pre- to post-intervention, were used to estimate intervention effects and to examine the influence of patient care level, program components, and follow-up time using meta-regression. RESULTS 27 articles reported evaluations from 44 sites. Combined effect estimate for all SPHM programs was 0.44 (95% CI 0.36, 0.54), reflecting substantial injury reductions after program implementation. While specific program components were not associated with greater effectiveness, longer follow-up duration was associated with greater injury rate reduction (p = 0.01) and intervention effects varied by level of care (p = 0.01), with the greatest effect in intensive care unit interventions (IRR 0.14; 95% CI 0.07, 0.30). CONCLUSIONS SPHM programs appear to be highly effective in reducing injuries. More research is needed to identify the most effective interventions for different patient care levels.
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Affiliation(s)
- Erin Teeple
- Department of Work Environment, University of Massachusetts, Lowell, MA, USA.,Liberty Mutual Research Institute for Safety, MA, USA
| | - Jamie E Collins
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Swastina Shrestha
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Jack T Dennerlein
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Richardson A, McNoe B, Derrett S, Harcombe H. Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: A systematic review. Int J Nurs Stud 2018; 82:58-67. [DOI: 10.1016/j.ijnurstu.2018.03.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 11/27/2022]
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Hegewald J, Berge W, Heinrich P, Staudte R, Freiberg A, Scharfe J, Girbig M, Nienhaus A, Seidler A. Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?-A Systematic Review of Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E476. [PMID: 29522440 PMCID: PMC5877021 DOI: 10.3390/ijerph15030476] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 01/25/2023]
Abstract
The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear. A systematic review of controlled intervention studies was conducted to examine if the risk of musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE®/PubMed®, EMBASE®, Allied and Complementary Medicine Database (AMED), and Cumulative Index of Nursing and Allied Health Literature (CINAHL®) were searched using terms for nursing, caregiving, technical aids, musculoskeletal injuries, and complaints. Randomized controlled trials and controlled before-after studies of interventions including technical patient handling equipment were included. The titles and abstracts of 9554 publications and 97 full-texts were screened by two reviewers. The qualitative synthesis included one randomized controlled trial (RCT) and ten controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio for musculoskeletal injury claims (post-intervention) of 0.78 (95% confidence interval 0.68-0.90). Overall, the methodological quality of the studies was poor and the results often based on administrative injury claim data, introducing potential selection bias. Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the certainty of the evidence according to GRADE approach ranged from low to very low.
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Affiliation(s)
- Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Wera Berge
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Philipp Heinrich
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Ronny Staudte
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Julia Scharfe
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Maria Girbig
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Albert Nienhaus
- Institute for Health Service Research in Dermatology and Nursing, University Clinics Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Service, Pappelallee 33-37, 22089 Hamburg, Germany.
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
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Járomi M, Kukla A, Szilágyi B, Simon-Ugron Á, Bobály VK, Makai A, Linek P, Ács P, Leidecker E. Back School programme for nurses has reduced low back pain levels: A randomised controlled trial. J Clin Nurs 2018; 27:e895-e902. [PMID: 28771864 DOI: 10.1111/jocn.13981] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES (i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques. BACKGROUND Millions of nurses around the world suffer from occupational-related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques. METHODS A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n = 67, control group n = 70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3 months. The programme consisted of didactic education, spine-strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses' patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0-100 visual analogue scale. RESULTS The pre-intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%-97.01% (control group: 8.57% pre-intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre-intervention increased from 10.44%-100% correct execution in the experimental group (control group: pre-intervention test 10.00% and postintervention test 11.42%). CONCLUSION The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses. RELEVANCE TO CLINICAL PRACTICE We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes.
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Affiliation(s)
- Melinda Járomi
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pecs, Hungary
| | - Aniko Kukla
- Veterans Administration Louis Stokes Medical Center, Cleveland, OH, USA
| | - Brigitta Szilágyi
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pecs, Hungary
| | - Ágnes Simon-Ugron
- Faculty of Physical Education and Sport, Institute of Physiotherapy and Theoretical Subjects, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Viktória Kovácsné Bobály
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pecs, Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pecs, Hungary
| | - Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Pongrác Ács
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pecs, Hungary
| | - Eleonóra Leidecker
- Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pecs, Hungary
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30
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The efficacy of interventions for low back pain in nurses: A systematic review. Int J Nurs Stud 2018; 77:222-231. [DOI: 10.1016/j.ijnurstu.2017.10.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022]
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Villarroya A, Arezes P, Díaz de Freijo S, Fraga F. Validity and reliability of the HEMPA method for patient handling assessment. APPLIED ERGONOMICS 2017; 65:209-222. [PMID: 28802441 DOI: 10.1016/j.apergo.2017.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 05/03/2017] [Accepted: 06/24/2017] [Indexed: 05/23/2023]
Abstract
Specific methods currently exist to assess occupational hazards resulting from patient handling in the healthcare sector, according to ISO/TR 12296. They are all similar in nature, but with a different analysis perspective; for that reason a comparison of the most relevant methods was performed in a previous research. As a result, a basis of a new tool that integrates the complementary aspects of those methods was proposed. To verify the validity and reliability of that method, a study within a hospital setting was carried out in five medical and surgical units of a public health institution. Based on the obtained results, the analysed method (called HEMPA) proved to be valid and reliable. Also, this method reflects a positive correlation between risk and damage and correctly quantifies risks regarding patient's dependence.
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Affiliation(s)
- A Villarroya
- Lucus Augusti Hospital, Servizo Galego de Saúde, Rúa Dr. Ulises Romero, nº 1, 27004 Lugo, Spain.
| | - P Arezes
- Research Centers for Industrial and Technology Management & Algoritmi, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal.
| | - S Díaz de Freijo
- Department of Applied Physics, Faculty of Science, University of Santiago de Compostela, Lugo, Spain.
| | - F Fraga
- Department of Applied Physics, Faculty of Science, University of Santiago de Compostela, Lugo, Spain.
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33
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Gold JE, Punnett L, Gore RJ. Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme. Occup Environ Med 2017; 74:389-395. [PMID: 27919063 PMCID: PMC5860804 DOI: 10.1136/oemed-2016-103930] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. METHODS Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5-6 years (F5) post-SRHP implementation among workers also in at least one prior survey. RESULTS LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and 'intense' aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work-family imbalance (RR=1.82 (1.12 to 2.98)). CONCLUSIONS In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.
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Affiliation(s)
- Judith E Gold
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Laura Punnett
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Rebecca J Gore
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - ProCare Research Team
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Risør BW, Casper SD, Andersen LL, Sørensen J. A multi-component patient-handling intervention improves attitudes and behaviors for safe patient handling and reduces aggression experienced by nursing staff: A controlled before-after study. APPLIED ERGONOMICS 2017; 60:74-82. [PMID: 28166902 DOI: 10.1016/j.apergo.2016.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 08/30/2016] [Accepted: 10/16/2016] [Indexed: 05/23/2023]
Abstract
This study evaluated an intervention for patient-handling equipment aimed to improve nursing staffs' use of patient handling equipment and improve their general health, reduce musculoskeletal problems, aggressive episodes, days of absence and work-related accidents. As a controlled before-after study, questionnaire data were collected at baseline and 12-month follow-up among nursing staff at intervention and control wards at two hospitals. At 12-month follow-up, the intervention group had more positive attitudes towards patient-handling equipment and increased use of specific patient-handling equipment. In addition, a lower proportion of nursing staff in the intervention group had experienced physically aggressive episodes. No significant change was observed in general health status, musculoskeletal problems, days of absence or work-related accidents. The intervention resulted in more positive attitudes and behaviours for safe patient-handling and less physically aggressive episodes. However, this did not translate into improved health of the staff during the 12-month study period.
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Affiliation(s)
- Bettina Wulff Risør
- Centre for Health Economics Research (COHERE), Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9B, 5000 Odense C, Denmark
| | | | - Lars Louis Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Jan Sørensen
- Centre for Health Economics Research (COHERE), Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9B, 5000 Odense C, Denmark.
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Jakobsen MD, Aust B, Dyreborg J, Kines P, Illum MB, Andersen LL. Participatory organizational intervention for improved use of assistive devices for patient transfer: study protocol for a single-blinded cluster randomized controlled trial. BMC Musculoskelet Disord 2016; 17:501. [PMID: 27998265 PMCID: PMC5175320 DOI: 10.1186/s12891-016-1339-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022] Open
Abstract
Background Epidemiological studies have shown that patient transfer is a risk factor for back pain, back injuries and long term sickness absence, whereas consistent use of assistive devices during patient transfer seems to be protective. While classical ergonomic interventions based on education and training in lifting and transferring techniques have not proven to be effective in preventing back pain, participatory ergonomics, that is meant to engage and motivate the involved parties while at the same time making the intervention maximally relevant, may represent a better solution. However, these findings are largely based on uncontrolled studies and thus lack to be confirmed by studies with better study designs. In this article, we present the design of a study which aims to evaluate the effect and process of a participatory organizational intervention for improved use of assistive devices. Methods The study was performed as a cluster randomized controlled trial. We recruited 27 departments (clusters) from five hospitals in Denmark to participate in the study. Prior to randomization, interviews, observations and questionnaire answers (baseline questionnaire) were collected to gain knowledge of barriers and potential solutions for better use of assistive devices. In April 2016, the 27 departments were randomly allocated using a random numbers table to a participatory intervention (14 clusters, 324 healthcare workers) or a control group (13 clusters, 318 healthcare workers). The participatory intervention will consist of workshops with leaders and selected healthcare workers of each department. Workshop participants will be asked to discuss the identified barriers, develop solutions for increasing the use of assistive devices and implement them in their department. Use of assistive devices (using digital counters -, primary outcome, and accelerometers and questionnaire - secondary outcome), perceived physical exertion during patient transfer, pain intensity in the lower back, occurrence of work-related back injuries during patient transfer, organizational readiness to change, knowledge on how to perform proper patient transfer, social capital and work ability (secondary outcomes) were assessed at baseline and will also be assessed at 1 year follow-up. Process evaluation will be based on qualitative and quantitative data to assess the implementation, the change process, and the impact of context aspects. Discussion The study will evaluate the effect and process of a participatory intervention on improving the use of assistive devices for patient transfer among hospital healthcare workers. By using cluster-randomization, as well as process- and effect evaluation based on objective measures we will contribute to the evidence base of a promising intervention approach. Trial registration ClinicalTrials.gov (NCT02708550). March, 2016.
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Affiliation(s)
- Markus D Jakobsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark
| | - Johnny Dyreborg
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark
| | - Pete Kines
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark
| | - Maja B Illum
- Region Midtjylland, Koncern HR Fysisk Arbejdsmiljø, DK-8800, Viborg, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, DK-9220, Aalborg, Denmark
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Implementing an Integrated Health Protection/Health Promotion Intervention in the Hospital Setting: Lessons Learned From the Be Well, Work Well Study. J Occup Environ Med 2016; 58:185-94. [PMID: 26849263 DOI: 10.1097/jom.0000000000000592] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study reports findings from a proof-of-concept trial designed to examine the feasibility and estimates the efficacy of the "Be Well, Work Well" workplace intervention. METHODS The intervention included consultation for nurse managers to implement changes on patient-care units and educational programming for patient-care staff to facilitate improvements in safety and health behaviors. We used a mixed-methods approach to evaluate feasibility and efficacy. RESULTS Using findings from process tracking and qualitative research, we observed challenges to implementing the intervention due to the physical demands, time constraints, and psychological strains of patient care. Using survey data, we found no significant intervention effects. CONCLUSIONS Beyond educating individual workers, systemwide initiatives that respond to conditions of work might be needed to transform the workplace culture and broader milieu in support of worker health and safety.
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Ronald LA, Yassi A, Spiegel J, Tate RB, Tait D, Mozel MR. Effectiveness of Installing Overhead Ceiling Lifts. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/216507990205000306] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The effectiveness of replacing floor lifts with mechanical ceiling lifts was evaluated in the extended care unit of a British Columbia hospital. Sixty-five ceiling lifts were installed between April and August 1998. Injury data were abstracted from injury reports for all staff musculoskeletal injuries (MSI) occurring in the unit during a 3 year period prior to installation and a 1.5 year follow up period. Descriptive statistics were calculated for injuries pre- versus post-installation. Rates were calculated as number of injuries per 100,000 worked hours. Rates for three pre- and three post-installation intervals were compared using Poisson regression. The rate of MSI caused by lifting/transferring patients was significantly reduced (58% reduction, p = .011) after installation, but rates of all MSI and MSI caused by repositioning did not statistically decline ( p > .05). Further follow up is necessary to determine whether or not ceiling lifts also can be effective for decreasing injuries related to repositioning patients on this unit.
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Waehrer G, Leigh JP, Miller TR. Costs of Occupational Injury and Illness within the Health Services Sector. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 35:343-59. [PMID: 15934169 DOI: 10.2190/rnq3-0c13-u09m-tenp] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Knowledge of costs is essential to allocate medical resources efficiently. The authors' goal was to estimate and compare costs across occupations, industries, gender, race, and types of nonfatal injuries and illnesses. This is an incidence study of nationwide data, 1993. Nonfatal incidence data were drawn from the Bureau of Labor Statistics Annual Survey. Medical costs were from the Detailed Claims Information data set. Productivity (wage) costs were calculated using the Current Population Survey. Pain and suffering costs were estimated from data on jury verdicts. Injuries and illnesses to nursing aides and orderlies cost $2,200 million; costs were $900 million for registered nurses and $40 million for licensed practical nurses. The ranking of health services industries in terms of costs was: hospitals (52 percent of all costs), nursing care facilities (38 percent), home care services (6 percent), physicians' offices (4 percent), and laboratories (<1 percent). Types of injuries (sprains, strains, fractures) were similar across occupations and industries, but types of illness (carpal tunnel syndrome, respiratory diseases) varied. The most costly injured body parts were: back, shoulder, knee, wrist, and neck. Injuries and illnesses comprised roughly 90 percent and 10 percent, respectively, of total costs. The hospital industry was the third most expensive of 313 U.S. industries. Costs of occupational injury and illness in the health services industry were high and varied across occupation, industry, disease, race, and gender.
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Affiliation(s)
- Clare Clarke
- Senior Staff Nurse, and a Manual Handling Work-Based Assessor/Instructor within the Critical Care teaching team, Papworth Hospital, Cambridgeshire
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Van Eerd D, Munhall C, Irvin E, Rempel D, Brewer S, van der Beek AJ, Dennerlein JT, Tullar J, Skivington K, Pinion C, Amick B. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med 2015; 73:62-70. [PMID: 26552695 PMCID: PMC4717459 DOI: 10.1136/oemed-2015-102992] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/27/2015] [Indexed: 11/29/2022]
Abstract
The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories. There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories.
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Affiliation(s)
- D Van Eerd
- Institute for Work & Health, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - C Munhall
- Institute for Work & Health, Toronto, Ontario, Canada
| | - E Irvin
- Institute for Work & Health, Toronto, Ontario, Canada
| | - D Rempel
- Division of Occupational and Environmental Medicine, School of Medicine, University of California, San Francisco, Richmond, California, USA
| | - S Brewer
- CB&I, Inc, The Woodlands, Texas, USA
| | - A J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J T Dennerlein
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Department of Physical Therapy, Movement & Rehabilitation Science, Northeastern University, Boston, Massachusetts, USA
| | - J Tullar
- School of Public Health, Institute for Health Policy, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - K Skivington
- Institute for Work & Health, Toronto, Ontario, Canada MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - C Pinion
- CB&I, Inc, The Woodlands, Texas, USA
| | - B Amick
- Institute for Work & Health, Toronto, Ontario, Canada Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida, USA
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Does the use of small aids during patient handling activities lead to a decreased occurrence of musculoskeletal complaints and diseases? A systematic review. Int Arch Occup Environ Health 2015; 89:547-59. [DOI: 10.1007/s00420-015-1094-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 09/28/2015] [Indexed: 01/09/2023]
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Requejo PS, Furumasu J, Mulroy SJ. Evidence-Based Strategies for Preserving Mobility for Elderly and Aging Manual Wheelchair Users. TOPICS IN GERIATRIC REHABILITATION 2015; 31:26-41. [PMID: 26366040 PMCID: PMC4562294 DOI: 10.1097/tgr.0000000000000042] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Elderly and aging manual wheelchair (MWC) users have increased risk for accelerated loss of function and mobility that greatly limits independence and affects quality of life. This review paper addresses important issues for preserving function and mobility for elderly and aging individuals who use a MWC by presenting the current available evidence and recommendations. These include recommendations for maximizing function, by decreasing pain, improving the ability to self-propel, and prolonging mobility and endurance through ergonomics, individualized wheelchair selection and configuration, and adaptations for increasing the capacity to handle the daily mobility demands through training, strengthening, and exercise. Each recommendation is supported by current research in each relevant area.
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Affiliation(s)
- Philip S. Requejo
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Rehabilitation Engineering Program, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
| | - Jan Furumasu
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
| | - Sara J. Mulroy
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
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Abstract
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.
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Shepley MM, Song Y. Design Research and the Globalization of Healthcare Environments. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2014; 8:158-98. [DOI: 10.1177/193758671400800112] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, “how pervasive is healthcare design research outside of the United States?” METHOD: The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies. RESULTS: While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited. CONCLUSION: Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered.
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Ravishankar N, Mujja A, Lewis MG, Sreekumaran Nair N. A tool to measure complexity in public health interventions. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2014. [DOI: 10.1016/j.cegh.2014.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
BACKGROUND Acute care physical therapists are at risk for developing work-related musculoskeletal disorders (WMSDs) due to manual patient handling. Safe patient handling (SPH) reduces WMSDs caused by manual handling. OBJECTIVE The purpose of this study was to describe the patient handling practices of acute care physical therapists and their perceptions regarding SPH. Additionally, this study determined whether an SPH program influences the patient handling practices and perceptions regarding SPH of acute care physical therapists. METHODS Subscribers to the electronic discussion board of American Physical Therapy Association's Acute Care Section were invited to complete a survey questionnaire. RESULTS The majority of respondents used SPH equipment and practices (91.1%), were confident using SPH equipment and practices (93.8%), agreed that evidence supports the use of SPH equipment and practices (87.0%), and reported the use of SPH equipment and practices is feasible (92.2%). Respondents at a facility with an SPH program were more likely to use SPH equipment and practices, have received training in the use of SPH equipment and practices, agree that the use of SPH equipment and practices is feasible, and feel confident using SPH equipment and practices. LIMITATIONS The study might not reflect the perceptions and practices of the population of acute care physical therapists. CONCLUSION Acute care physical therapists are trained to use SPH equipment and practices, use SPH equipment and practices, and have positive perceptions regarding SPH. Acute care physical therapists in a facility with an SPH program are more likely to use SPH equipment and practices, receive training in SPH equipment and practices, and have positive perceptions regarding SPH. Quasi-regulatory organizations should incorporate SPH programs into their evaluative standards.
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Jäger M, Jordan C, Theilmeier A, Wortmann N, Kuhn S, Nienhaus A, Luttmann A. Analyse der Lumbalbelastung beim manuellen Bewegen von Patienten zur Prävention biomechanischer Überlastungen von Beschäftigten im Gesundheitswesen. ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2014. [DOI: 10.1007/s40664-013-0010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hogan DAM, Greiner BA, O'Sullivan L. The effect of manual handling training on achieving training transfer, employee's behaviour change and subsequent reduction of work-related musculoskeletal disorders: a systematic review. ERGONOMICS 2014; 57:93-107. [PMID: 24387742 DOI: 10.1080/00140139.2013.862307] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This systematic review investigated the effectiveness of manual handling training on achieving training transfer, leading to a positive change in employee's manual handling behaviour and a reduction of work-related musculoskeletal disorders (WRMSDs) following training. Six electronic databases were searched for randomised controlled trials, non-randomised controlled trials or cohort studies with a control and/or comparison group that investigated the effectiveness of manual handling training. Thirteen articles met the inclusion and exclusion criteria. Following quality assessment, nine of the included articles were found to be of high quality. This systematic review suggests that there has been very little research focusing on the effectiveness of manual handling training on training transfer to employees and the associated behavioural change. This review indicates that whilst employees report understanding and awareness following training, this does not always lead to the expected behavioural change. This review also suggests it cannot be demonstrated that training transfer will lead to a reduction of WRMSDs.
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Affiliation(s)
- Dervla A M Hogan
- a Department of Epidemiology and Public Health , University College Cork , Cork , Ireland
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Alperovitch-Najenson D, Treger I, Kalichman L. Physical therapists versus nurses in a rehabilitation hospital: comparing prevalence of work-related musculoskeletal complaints and working conditions. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 69:33-39. [PMID: 23930794 DOI: 10.1080/19338244.2012.719555] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The objective of this study was to investigate the prevalence and work avoidance of work-related musculoskeletal complaints and to compare patient handling tasks and psychosocial factors of physical therapists (PTs) and nurses in a rehabilitation hospital. Cross-sectional observational study was carried out using questionnaires relating to basic demographics, prevalence of musculoskeletal morbidity, workload, and job satisfaction. Comparing 26 PTs and 54 nurses, all females, lower back pain was significantly more prevalent in PTs, even after adjusting for the confounding demographic factors; PTs performed full and partial manual patient transfer, as well as trunk bending and walking assistance more frequently than the nurses and were significantly more satisfied. Unique physical load could be the main factor for the high prevalence of lower back pain in PTs. They should urgently initiate a "no-lift policy" in treatment.
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Affiliation(s)
- D Alperovitch-Najenson
- Department of Environmental and Occupational Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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A formação de profissionais de saúde para a prevenção de lesões musculoesqueléticas ligadas ao trabalho a nível da coluna lombar: uma revisão sistemática. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.rpsp.2014.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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