Patient Handling Methods and Musculoskeletal Disorders among Nurses
Date Issued
2012
Date
2012
Author(s)
Cheng, Yu-Sheng
Abstract
Nurses have one of the highest prevalence of musculoskeletal disorders （MSDs） among all the occupations and healthcare practitioners, resulting in nursing shortage and decreasing the quality of healthcare. The main cause of musculoskeletal injuries in nurses is showed to be patient handling. Patient handling can be carried out in different methods and may have varied risks for musculoskeletal system. However, previous research to compare the risks of MSDs by different patient handling methods was mostly done in laboratory context. Until now few studies examined nurses'' patient handling methods in working situation and its impact on MSDs. Thus, the purposes of this study include: 1) To survey MSDs (prevalence, affected body parts, pain intensity, and functional impact on work) among nurses in Taiwan. 2) To examined patient handling tasks (frequency, perceived exertion, and patient handling methods such as types of assistive technology and number of executors) executed by hospital nurses in Taiwan. 3) To identify potential risk factors including demographic and workplace characteristics and variables of patient handling tasks for number of prevalent body parts among hospital nurses in Taiwan. The results may provide the strategies for preventing MSDs among nurses in Taiwan.
In this cross-sectional study, a questionnaire survey was carried out among nurses in one medical center, four metropolitan hospitals and belonging nursing homes in northern Taiwan. A self-reported questionnaire was used to investigate 1) demographic and workplace characteristics. 2) MSDs of neck, shoulder, upper back, lower back, elbow, wrist/hand, hip, knee, ankle/foot. 3) Nurses'' performance of 10 patient handling tasks. Questionnaires were distributed by nursing stations, and 470 valid questionnaires were collected.
The 6-month prevalence of MSDs at any body parts was 88.3%, and half of the participants reported at least MSDs of four body parts. Lower back (77.2%）, neck (64.2%）and shoulder (58.7%） were the most prevalent body parts. Nurses with wrist/hand complaints had the highest proportion (21.6%) of severe functional impact on work and absence from work due to MSDs, followed by nurses with lower back complaint s (20%). There''s a significant difference of MSDs prevalence of shoulder, upper back, wrist/hand, and ankle/foot among different wards. In general, surgical, intensive care, and long-term care units had higher prevalence of MSDs, contrary to internal medical and emergency units. The prevalence of lower back MSDs is high among all units, and up to 92~95.7% in neurosurgical and neurology units, implicating the common issue of lower back pain.
All surveyed patient handling tasks were executed by at least 60% of nurses in Taiwan. Four patient handling tasks in bed (moving in the bed, turning or rolling over in bed, from lying to sitting in bed, from bed to bed）were performed by at least 90% of surveyed nurses, and these four tasks were with the highest frequency and patient handling burden (defined as frequency multiply by scores of perceived exertion）. In addition, "from bed to chair/wheelchair with patients unable to sit up " and "up from floor" were two tasks that had the highest perceived exertion and highest perceived extent to cause MSDs. These six tasks mentioned above had high priority to pay attention for. In average, nurses in Taiwan preferred to use transfer equipment in four out of ten patient handling tasks, and the other tasks were mostly carried out manually. Four tasks in bed had the highest proportion to use transfer equipment, ranging from 55.4% to 93.8%. The equipment most often used was bed sheets, slide boards/ slippery sheets, and electric beds.
Ordinal regression analysis showed that older age, married, graduate school, certain wards (long-term care, surgical, intensive care), higher patient handling burden, and higher loads due to manual patient handling were the risk factors for more body parts with MSDs.
In conclusion, the burden and methods of patient handling were both risk factors for MSDs among nurses in Taiwan. Appropriate transfer equipment and education on how to properly handle patients is needed to decrease the burden of patient handling and its unhealthy impact on MSDs among nurses.
Subjects
nurses
musculoskeletal disorders
patient handling methods
Type
thesis
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