2016-12-01 12:00 - Messages

Initial Results of an Evidence-Based Safe Patient Handling and Mobility Program to Decrease Hospital Worker Injuries

The rate for musculoskeletal injuries among health care workers is one of the highest for all industrial sectors in the United States; these injuries often occur during manual handling (i.e., lifting, moving, transferring, and repositioning) of patients. The following article describes the process used to complete a comprehensive assessment, as well as the planning, implementation, and initial evaluation of a quality improvement program to reduce work-related musculoskeletal disorders (WMSD) among health care workers employed by a rural Midwest hospital. Key elements for WMSD injury reduction were identified and compared across literature sources, national standards, and current state and federal legislative requirements for hospitals. The program used a multi-factor design that included evidence-based interventions (i.e., those supported by emerging evidence) to create a comprehensive Safe Patient Handling and Mobility (SPHM) program intended to address the unique needs of the organization. Initial program results are reviewed as well as significant considerations and challenges for SPHM programs.

Source: Przybysz, L., & Levin, P. F. (2016). Workplace health & safety.

An observational method for Postural Ergonomic Risk Assessment (PERA)

Monotonous, repetitive work characterizes production lines. Repetitive movements and awkward postures are the most prominent physical risk factors in the workplace. Various legislations have been enacted along with technical standards for ergonomic risk evaluation to ensure the safety of the operators.
There are numerous methods to assess the ergonomic risk at work. However, most methods are not meant to be used for assessing cyclic work. This paper proposes a method, Postural Ergonomic Risk Assessment (PERA), which is suitable to evaluate the postural ergonomic risk of short cyclic assembly work. Its key features are simplicity and compliance with standards. The added value of the method is that it provides an analysis of every work task in the work cycle, which facilitates the identification of sources of high risk to the operator.
The method has been verified on nine work cycles, constituted by 88 work tasks, and it demonstrates accordance with the European Assembly Worksheet (EAWS), which has been developed to comply with the relevant standards and is one of the most comprehensive tools for ergonomic risk assessment.

Source: Chander, D. S., & Cavatorta, M. P. (2017). International Journal of Industrial Ergonomics, 57, 32-41.

Difference between male and female workers lifting the same relative load when palletizing boxes

A few biomechanical studies have contrasted the work techniques of female and male workers during manual material handling (MMH). A recent study showed that female workers differed from males mostly in the strategy they used to lift 15-kg boxes from the ground, especially regarding task duration, knee and back postures and interjoint coordination. However, the lifting technique difference observed in females compared to males was perhaps due to a strength differences. The objective of this study was to test whether female workers would repeat the same lifting technique with a load adjusted to their overall strength (females: 10 kg; males: 15 kg), which can be considered a “relative load” since the overall back strength of females is 2/3 that of males. The task for the participants consisted in transferring boxes from one pallet to another. A dynamic 3D linked segment model was used to estimate the net moments at L5/S1, and different kinematic variables were considered. The results showed that the biomechanics of the lifting techniques used by males and females were similar in terms of task duration and cumulative loading, but different in terms of interjoint coordination pattern. The sequential interjoint coordination pattern previously seen in females with an absolute load (15 kg) was still present with the relative load, suggesting the influence of factors more intrinsically linked to sex. Considering that the female coordination pattern likely stretched posterior passive tissues when lifting boxes from the ground, potentially leading to higher risk of injury, the reason for this sex effect must be identified so that preventive interventions can be proposed.

Source: Plamondon, A., Larivière, C., Denis, D., Mecheri, H., Nastasia, I., & IRSST MMH research group. (2017). Applied Ergonomics, 60, 93-102.

Work-Related Psychosocial Factors and Mental Health Problems Associated with Musculoskeletal Pain in Nurses

A Cross-Sectional Study
Background. Musculoskeletal pain is the most common cause of incapacity among nurses. This study aimed to report the prevalence of musculoskeletal pain among hospital nurses and to explore the associations of work-related psychosocial factors and mental health problems with musculoskeletal pain. Methods. A cross-sectional survey was carried out among registered nurses at Tartu University Hospital during April and May 2011. Binary logistic regression was used to assess the associations between dependent and independent variables. Results. Analysis was based on 404 nurses (45% of the hospital's nursing population). The overall prevalence of MSP was 70% in the past year and 64% in the past month. Lower back (57%) and neck (56%) were the body areas most commonly painful in the past year. Higher quantitative and emotional demands, work pace, low justice and respect in the workplace, influence on work organisation, and role conflicts were significantly associated with musculoskeletal pain among nurses. All mental health problems and most strongly somatic stress symptoms were associated with musculoskeletal pain. Conclusions. Work-related psychosocial risk factors and mental health problems, especially somatic stress symptoms, have an important impact on the occurrence of musculoskeletal pain among university hospital nurses.

Source: Freimann, T., Pääsuke, M., & Merisalu, E. (2016). Pain Research and Management.

Pushing and pulling: An assessment tool for OHS practitioners

A tool has been developed for supporting practitioners when assessing manual pushing and pulling operations based on an initiative by two global companies in the manufacturing industry. The aim of the tool is to support occupational health and safety practitioners in risk assessment and risk management of pushing and pulling operations in the manufacturing and logistics industries. It is based on a nine-multiplier equation that includes a wide range of factors affecting an operator's health risk and capacity in pushing and pulling. These multipliers are based on psychophysical, physiological, and biomechanical studies in combination with judgments from an expert group consisting of senior researchers and ergonomists. In order to consider usability, more than fifty occupational health and safety practitioners (e.g. ergonomists, managers, safety representatives, and production personnel) participated in the development of the tool. An evaluation by 22 ergonomists supports that the push/pull tool is user friendly in general.

Source: Lind, C. M. (2016). International Journal of Occupational Safety and Ergonomics, 1-40.

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
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.

Source: Risør, B. W., Casper, S. D., Andersen, L. L., & Sørensen, J. (2017). Applied Ergonomics, 60, 74-82.

Allied Health Professionals and Work-Related Musculoskeletal Disorders

A Systematic Review
Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.

Source: Anderson, S. P., & Oakman, J. (2016). Safety and Health at Work.

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