Effectiveness of an evidence-based curriculum module in nursing schools targeting safe patient handling and movement.

TLDR: It is found that nurse educator and student knowledge improved significantly at intervention schools, as did intention to use mechanical lifting devices in the near future, and the curriculum module is ready for wide dissemination across nursing schools to reduce the risk of MSDs among nurses.

Abstract: Nursing schools in the United States have not been teaching evidence-based practices for safe patient handling, putting their graduates at risk for musculoskeletal disorders (MSDs). The specific aim of this study was to translate research related to safe patient handling into the curricula of nursing schools and evaluate the impact on nurse educators and students' intentions to use safe patient handling techniques. Nurse educators at 26 nursing schools received curricular materials and training; nursing students received the evidence-based curriculum module. There were three control sites. Questionnaires were used to collect data on knowledge, attitudes, and beliefs about safe patient handling for both nurse educators and students, pre- and post-training. In this study, we found that nurse educator and student knowledge improved significantly at intervention schools, as did intention to use mechanical lifting devices in the near future. We concluded that the curriculum module is ready for wide dissemination across nursing schools to reduce the risk of MSDs among nurses.

Figures

Table 1. Test Statistics for Student Knowledge, Beliefs, Attitudes, Behavioral Control, Social Norm, and Intentions (pre and post comparisons) (n=1201)

Table 3. Item Analysis of Nurse Educators Content and Process of Curriculum Covered as Part of Fundamental Nursing Curriculum (n=57).

Table 2. Test Statistics for Student Knowledge, Attitude, Belief and Social Norm Scales (Control versus Intervention)

Full text

Nursing Faculty Publications School of Nursing
12-2007
Effectiveness of an evidence-based curriculum module in nursing Effectiveness of an evidence-based curriculum module in nursing
schools: Targeting safe patient handling and movement schools: Targeting safe patient handling and movement
Nancy Menzel
University of Nevada, Las Vegas
, nancy.menzel@unlv.edu
Audrey L. Nelson
Patient Safety Center of Inquiry
Thomas R. Waters
National Institute for Occupational Safety and Health
Nancy Hughes
American Nurses Association
Pamela C. Hagan
American Nurses Association
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Repository Citation Repository Citation
Menzel, N., Nelson, A. L., Waters, T. R., Hughes, N., Hagan, P. C., Powell-Cope, G., Thompson, V. (2007).
Effectiveness of an evidence-based curriculum module in nursing schools: Targeting safe patient
handling and movement.
International Journal of Nursing Education Scholarship, 4
(1), 1-19.
http://dx.doi.org/10.2202/1548-923X.1486
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Authors Authors
Nancy Menzel, Audrey L. Nelson, Thomas R. Waters, Nancy Hughes, Pamela C. Hagan, Gail Powell-Cope,
and Viviam Thompson
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International Journal of Nursing
Education Scholarship
Volume 4, Issue 1 2007 Article 26
Effectiveness of an Evidence-Based
Curriculum Module in Nursing Schools
Targeting Safe Patient Handling and
Movement
Audrey L. Nelson
∗
Thomas R. Waters
†
Nancy N. Menzel
‡
Nancy Hughes
∗∗
Pamela C. Hagan
††
Gail Powell-Cope
‡‡
Carol Sedlak
§
Vivian Thompson
¶
∗
Patient Safety Center of Inquiry, Audrey.Nelson@va.gov
†
National Institute for Occupational Safety and Health, trw1@cdc.gov
‡
University of Nevada Las Vegas School of Nursing, nancy.menzel@unlv.edu
∗∗
American Nurses Association, Nancy.hughes@ana.org
††
American Nurses Association, phagan@ana.org
‡‡
James A. Haley VAMC, gail.powell-cope@va.gov
§
Kent State University College of Nursing, csedlak@kent.edu
¶
Patient Safety Center of Inquiry, vivian.thompson2@va.gov
Copyright
c
2007 Berkeley Electronic Press. All rights reserved.

Effectiveness of an Evidence-Based
Curriculum Module in Nursing Schools
Targeting Safe Patient Handling and
Movement
∗
Audrey L. Nelson, Thomas R. Waters, Nancy N. Menzel, Nancy Hughes, Pamela
C. Hagan, Gail Powell-Cope, Carol Sedlak, and Vivian Thompson
Abstract
Nursing schools in the United States have not been teaching evidence-based practices for
safe patient handling, putting their graduates at risk for musculoskeletal disorders (MSDs). The
specific aim of this study was to translate research related to safe patient handling into the curricula
of nursing schools and evaluate the impact on nurse educators and students’ intentions to use safe
patient handling techniques. Nurse educators at 26 nursing schools received curricular materials
and training; nursing students received the evidence-based curriculum module. There were three
control sites. Questionnaires were used to collect data on knowledge, attitudes, and beliefs about
safe patient handling for both nurse educators and students, pre- and post-training. In this study, we
found that nurse educator and student knowledge improved significantly at intervention schools, as
did intention to use mechanical lifting devices in the near future. We concluded that the curriculum
module is ready for wide dissemination across nursing schools to reduce the risk of MSDs among
nurses.
KEYWORDS: nurse educator, safe patient handling, student nurse education, school of nursing
∗
The study was supported by the National Institute for Occupational Safety and Health (NIOSH),
American Nurses Association (ANA), and the Department of Veterans Affairs, Veterans Health
Administration, Patient Safety Center of Inquiry (Tampa, Fl). The views expressed in this article
are those of the authors and do not necessarily represent the views of the Department of Veterans
Affairs or the National Institute of Occupational Safety and Health.

Problem Statement
Traditionally, nursing school curricula have focused on manual patient
lifting techniques and use of “proper” body mechanics, despite the fact that over
30 years of evidence documents that these approaches are not safe (Hignett et al.,
2003; Nelson, Fragala & Menzel, 2003). Persistence of these unsafe practices
perpetuates the considerable number of work-related musculoskeletal disorders
that continue plague the nursing workforce (Edlich, Winters, Hudson, Britt, &
Long, 2004; Nelson et al., 2006; Panel on Musculoskeletal Disorders et al., 2001;
Smedley, Egger, Cooper, & Coggon, 1995).
Purpose of Study
The purpose of this study was to translate research related to safe patient
handling into the curricula taught in nursing schools in the United States (US) and
evaluate its effectiveness for use as a component of fundamental nursing
education.
Evidence-Based Approaches to Safe Patient Handling
In the past decade research has led to advancements in safe patient
handling (Nelson & Baptiste, 2004), including: (1) patient handling
equipment/devices, (2) unit-based patient care ergonomic assessment protocols,
(3) no lift policies, and (4) training on proper use of patient handling
equipment/devices. Advancements in technology have resulted in a wide array of
patient handling equipment that did not exist a decade ago. Promising new
interventions, which are still being tested, include use of unit-based peer leaders
and clinical tools, such as decision algorithms and patient assessment protocols
for selecting the right techniques given patients’ needs.
Incorporation of this research and patient handling technologies into
nursing schools is critical for educating a new generation of nurses better prepared
to promote safe patient handling.
Development of a New Nursing Curriculum Module
Based on a review of nursing textbooks and manual handling content on
the U.S. national registered nurse licensing exam, it was evident that safe patient
handling techniques had been based on tradition rather than scientific evidence;
undergraduate nursing students are taught unsafe manual patient handling
techniques and are rarely exposed to the newest patient handling devices. Possible
reasons for this gap include lack of knowledge about safe patient handling and
lack of available evidence-based teaching materials for nurse educators.
1
Nelson et al.: Evidence-Based Nursing School Curriculum in Safe Patient Handling
Published by Berkeley Electronic Press, 2007

Frequently asked questions

Q1. What are the contributions in "Effectiveness of an evidence-based curriculum module in nursing schools: targeting safe patient handling and movement" ?

The specific aim of this study was to translate research related to safe patient handling into the curricula of nursing schools and evaluate the impact on nurse educators and students ’ intentions to use safe patient handling techniques. In this study, the authors found that nurse educator and student knowledge improved significantly at intervention schools, as did intention to use mechanical lifting devices in the near future. 

Q2. What future works have the authors mentioned in the paper "Effectiveness of an evidence-based curriculum module in nursing schools: targeting safe patient handling and movement" ?

Comparing students pre- to post-test and the intervention to the control group, the program resulted in statistically significant improvements in a number of immediate outcomes, including attitudes toward mechanical and manual lifting ; albeit small absolute differences from pre- to post-intervention attitudes, knowledge and beliefs about safe patient handling ; beliefs in their abilities to exert behavioral control in using mechanical lifting devices ; and finally, in intentions to use mechanical lifting devices in the near future. Curriculum changes, programs to increase safe patient handling in practice settings, and legislative efforts to mandate safe patient handling synergistically have the potential to change nursing 16 International Journal of Nursing Education Scholarship, Vol. 4 [ 2007 ], Iss. 1, Art. 26 http: //www. 

Q3. Why did the student knowledge scale be deflected?

Due to restriction of range (low scores on baseline test), which tends to deflect reliability, reliability estimates for the student knowledge scale were calculated on post test data. 

Q4. What was the effect of the curriculum on students?

The effectiveness of the curriculum on students was evaluated by using paired sample t-tests to test for pre/post test differences, and an alpha level of 0.05 was used for all statistical tests. 

Q5. What was used to guide evaluation of the safe patient handling curriculum module?

The Theory of Planned Behavior (TPB) (Ajzen & Fishbein, 1980) was used to guide evaluation of the safe patient handling curriculum module. 

Q6. What is the way to prevent injuries after entering the professional nursing workforce?

6. Teaching safe patient handling to nursing students will help to prevent injuries after entering the professional nursing workforce. 

Q7. How many nurses are needed to help a patient?

6. When manually transferring a patient from bed to chair, having two ormore nurses to help will typically protect them from injury. 

Q8. Why did the participating schools choose to use the new curriculum?

Due to their interest in adopting the most current evidencebased curriculum and teaching models, the participating schools may have biased the results toward successful outcomes. 

Q9. What are the difficult to conduct studies examining the efficacy of interventions?

Studies examining the efficacy of interventions are difficult to conduct, requiring optimum evaluation conditions in order to control for potential bias and confounding factors. 

Q10. How many nurses agreed to continue using the new curriculum?

Eighty percent of nurse educators (n=47) agreed that14International Journal of Nursing Education Scholarship, Vol. 4 [2007], Iss. 1, Art. 26http://www.bepress.com/ijnes/vol4/iss1/art26 

Q11. How many nurses are doing the lifting?

4. It is OK to lift a patient up off the floor without using equipment solong as at least two or more nurses are doing the lifting. 

Q12. What were the questions asked to measure fidelity of the curriculum module?

To measure program fidelity, nurse educators implementing thecurriculum module were asked yes/no questions on “what topics in safe patient handling are covered as part of the nursing curriculum module.” 

Q13. What is the reason for the lack of knowledge about safe patient handling?

Based on a review of nursing textbooks and manual handling content on the U.S. national registered nurse licensing exam, it was evident that safe patient handling techniques had been based on tradition rather than scientific evidence; undergraduate nursing students are taught unsafe manual patient handling techniques and are rarely exposed to the newest patient handling devices. 

Q14. What is the way to teach safe patient handling to nursing students?

5. For nursing schools, replacing body mechanics classes and manual techniques for patient handling with safe patient handling equipment is necessary. 

Q15. What are the barriers to long term gains?

The barriers to long term gains are many, including clinical sites where nursing staff rely on manual lifting techniques and where patient handling equipment is not available.