2012-03-01 12:00 - Messages

The Influence of Ergonomic Devices on Mechanical Load during Patient Handling Activities in Nursing Homes

Objectives: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities.
Methods: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distinct patient handling activities, defined by transferring a patient, providing personal care, repositioning patients in the bed, and putting on and taking off anti-embolism stockings. During real-time observations over ∼60 h among 186 nurses on 735 separate patient handling activities in 17 nursing homes, it was established whether ergonomic devices were actually used. Mechanical load was assessed through observations of frequency and duration of a flexed or rotated trunk >30° and frequency of pushing, pulling, lifting or carrying requiring forces <100 N, between 100 and 230 N, and >230 N from start to end of each separate patient handling activity. The number of patients and nurses per ward and the ratio of nurses per patient were used as ward characteristics with potential influence on mechanical load. A mixed-effect model for repeated measurements was used to determine the influence of ergonomic devices and ward characteristics on mechanical load.
Results: Use of ergonomic devices was required according to national guidelines in 520 of 735 (71%) separate patient handling activities, and actual use was observed in 357 of 520 (69%) patient handling activities. A favourable ratio of nurses per patient was associated with a decreased duration of time spent in awkward back postures during handling anti-embolism stocking (43%), patient transfers (33%), and personal care of patients (24%) and also frequency of manually lifting patients (33%). Use of lifting devices was associated with a lower frequency of forces exerted (64%), adjustable bed and shower chairs with a shorter duration of awkward back postures (38%), and an anti-embolism stockings slide with a lower frequency of forces exerted (95%).
Conclusions: In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.

Source : KOPPELAAR, Elin, Hanneke J.J, KNIBBE, Harald, S. MIEDEMA, et Alex BURDOFF. Annals of Occupational Hygiene, mars 2012 p. 1-11.
http://dx.doi.org/10.1093/annhyg/mes009

Guide - Ergonomie du bureau

L'aménagement ergonomique des postes informatisés est une condition essentielle, mais insuffisante pour la prévention des TMS. Nous savons maintenant qu'il est malsain de demeurer trop longtemps assis devant un ordinateur. L'organisation des tâches doit prévoir de bouger et de se lever régulièrement de son poste de travail si l'on veut prévenir les TMS.
Ce guide présente un résumé pratique de l'état des connaissances sur l'ergonomie du bureau. Les principes proposés peuvent s'appliquer à d'autres secteurs que celui du bureau. 

Éditeur : ASSTSAS ;  Auteur : Christine Lamarche, Rose-Ange Proteau, Jocelyn Villeneuve; Parution : Mars 2012 ; Nombre de pages : 124.

Source : http://www.asstsas.qc.ca/publications/publications-specialisees/guides-de-prevention/guide-ergonomie-du-bureau.html

Ache and melancholy

Co-occurence of musculoskeletal pain and depressive symptoms in Finland
It is important to recognise the connection between musculoskeletal pain and depression in regard to work ability, well-being at work and continuing to work. When present at the same time, they may strengthen each other's negative effect on the quality of life, functional capacity and work ability. The co-occurrence may increase visits to the doctor, sickness absences, work incapacity and early retirement.

Source : http://www.ttl.fi/en/news/Pages/Ache_och_melancholy.aspx

Musculoskeletal injuries among hospital patient care staff before and after implementation of patient lift and transfer equipment

Objective: Using an observational research design and robust surveillance data, we evaluated rates of musculoskeletal (MS) injuries, days away from work, and restricted work days among patient care staff at a medical center and community hospital in the United States over 13 years, during which time a “minimal manual lift” policy and mechanical lift equipment were implemented.
Methods: Workers’ compensation claims data were linked to human resources data to define outcomes of interest and person-time at risk to calculate rates. Poisson and negative binomial regression with lagging were used to compare outcome rates in different windows of time surrounding the intervention. Patterns of MS injuries associated with patient-handling were contrasted to patterns of other MS injuries that would not be affected by the use of mechanical lift equipment.
Results: At the medical center, no change in the patient-handling MS injury rate followed the intervention. A 44% decrease was observed at the community hospital. At both hospitals, the rate of days away declined immediately – before it was reasonable for the intervention to have been adopted.
Conclusions: Institutional-level changes at the time of the intervention likely influenced observed results with findings only partially consistent with an intervention effect. Observational studies can be useful in assessing effectiveness of safety interventions in complex work environments. Such studies should consider the process of intervention implementation, the time needed for intervention adoption, and the dynamic nature of work environments.

Source : Schoenfisch AL, Lipscomb HJ, Pompeii LA, Myers DJ, Dement JM. Musculoskeletal injuries among hospital patient care staff before and after implementation of patient lift and transfer equipment. Scand J Work Environ Health. 2012.
http://dx.doi.org/10.5271/sjweh.3288

Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

OBJECTIVES: Epidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In this study, we aimed to relate periods of high peak exposure during computer use with the occurrence of neck-shoulder (NS) and arm-wrist-hand (AWH) symptoms.
METHODS: A prospective cohort study among 1951 office workers was carried out for two years, with periodical questionnaires and continuous measurements of computer input use. To define peak exposure, a distinction was made between peak days and weeks. Peak days were defined as days with a long duration of computer (ie, ≥4 hours) or mouse use (ie, ≥2.5 hours) or days with high frequency of mouse (ie, ≥20 clicks per minute) or keyboard use (ie, ≥160 keystrokes per minute). Weeks containing ≥3 peak days were considered peak weeks. Independent variables were numbers of peak days and peak weeks during a 3-month measurement period; dependent variables were self-reported NS and AWH symptoms during the following 3-month measurement period.
RESULTS: Valid data were available for 2116 measurements of 774 office workers. No relation was found between any of the peak exposure parameters and AWH symptoms or with peak exposure in duration and NS symptoms. Most parameters referring to high frequency-related peak exposure were associated with less NS symptoms, but the effect estimates were very small and the confidence intervals close to the null.
CONCLUSION: In this study, we found no indication that high peaks in computer use were related to the occurrence of NS or AWH symptoms.

Source : Richter JM, van den Heuvel SG, Huysmans MA, van der Beek AJ, Blatter BM. Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms? Scand J Work Environ Health. 2012;38(2):155-162.
http://www.sjweh.fi/show_abstract.php?abstract_id=3196

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