Session number: 1071
Abstract title: Redesigning Patient Handling Tasks to Prevent Nursing Back Injuries
Author(s):
Audrey Nelson, Ph.D, RN - Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa
John D. Lloyd, Ph.D.(c) - Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa
Nancy Menzel, MS, RN - Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa
Objectives: Based on previous research, nine “high risk” patient handling tasks involving vertical lifting, lateral transfers, frequent bending, and/or sustained awkward positions were redesigned using new patient handling technologies and work practice controls. They key objective of this study was to evaluate the biomechanical benefit of the proposed redesigned tasks.
Methods: A laboratory trial was conducted to evaluate muscle activity, compressive force on the spine, joint moments, and perceived comfort. We compared 63 subjects who performed the redesigned tasks with 71 subjects who used standard procedures. Data were collected using the HumanTRAC three-dimensional motion tracking system, electromyography, and a modified Borg Scale to assess perceived comfort in performing the task.
Results: Findings from the objective data revealed significant improvement in five of the redesigned tasks. Nurses indicated a subjective preference for the redesigned tasks (1) transferring from bed to stretcher, (2) transferring from bed to wheelchair or Geri-chair, and (3) pulling a patient up in either a chair or bed. Findings from the objective data supported the nurse’s perception of improved comfort for the previous three redesigned tasks, but also indicated significant improvement in (1) bathing a patient in bed and (2) applying anti-embolism stockings. No significant improvements were noted in two tasks: making an occupied bed and dressing a patient in bed.
Conclusions: Nursing tasks can be redesigned to minimize risk of injury using new patient handling technologies and work practice controls. Patient handling equipment is not always intuitive in its use and human error can contribute to increased risk to both the caregiver and the patient. Ceiling-mounted patient lifts can reduce musculoskeletal injuries in nursing staff, and should be considered in units with high injury rates due to highly dependent patient populations. Further study is needed to redesign other high-risk tasks to promote safer work environments for nursing staff.
Impact statement: This study offers tremendous potential for reducing back injuries among caregivers during the performance of high-risk nursing tasks. A program is underway to transfer findings of this study throughout the VHA system for longitudinal evaluation.