Manual Handling Workload and Musculoskeletal Discomfort in Nursing Personnel
01 Jan 2001-
TL;DR: This paper presents a meta-analysis of the literature on screening for Musculoskeletal Disorders and results show that screening for WMSDs in nurses’ high-risk patient care units results is positive.
Abstract: iv Chapter 1: Introduction 1 Scope and Cost of Back Pain 2 Relationship of Musculoskeletal Pain to Workers’ Compensation Claims 3 Association with Strenuous Tasks 3 Chapter 2: Review of the Literature 6 Causes of Musculoskeletal Disorders 6 Body Parts Affected by WMSDs in Nursing 6 WMSD Risk Factors 6 Patient Handling and Movement Risk Factor Assessment 10 Patient Weight As Risk Factor 12 Assessing Risk 12 Exposure Assessment 16 Nursing Workload Measurement Systems 17 Risk Reduction Factors 19 Characteristics of James A. Haley VAMC High-Risk Patient Care Units 19 Screening for Musculoskeletal Disorders 20 Null Hypotheses 22 Definition of Terms 22 Chapter 3: Methods 27 Study Design 27 Sample and Sampling Procedures 27 Data Collection Procedures 28 Chapter 4: Results 30 Sample Size/Power Analysis 30 Data Analysis 30 Sample 30 Data Coding 32 Independent Variables 32
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TL;DR: Measuring the change in current back pain prevalence yields more timely information about the effectiveness of an ergonomic intervention than assessing injury incidence rates, because of the high percent of nursing staff members who work in pain but delay filing workers' compensation claims.
Abstract: 1. The problem of work related musculoskeletal disorders of the low back in nursing personnel has been well documented in the literature by cross sectional studies showing high prevalence rates in licensed nurses and nursing aides. However, it is difficult to compare findings among these studies because of the use of nonstandardized symptom surveys, variations in case definitions, and other methodological inconsistencies. 2. Measuring the change in current back pain prevalence yields more timely information about the effectiveness of an ergonomic intervention than assessing injury incidence rates, because of the high percent of nursing staff members who work in pain but delay filing workers' compensation claims. 3. As employers attempt to reduce manual handling injuries, occupational health nurses may be called upon to survey workers for musculoskeletal symptom prevalence and document the effectiveness of ergonomic interventions. Before using or developing any musculoskeletal disorder symptom survey for workplace surveillance or research, occupational health nurses should determine whether the survey has adequate reliability, validity, responsiveness, and practicality.
76 citations
Cites background from "Manual Handling Workload and Muscul..."
...Forty six studies, including the author's doctoral research (Menzel, 2001), were chosen for further review....
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22 citations
TL;DR: The prevalence of work related musculoskeletal disorders among nurses was high in the study area and working in mal-positions, working in the same positions for long period of time, working with disoriented patients and bending or twisting back during work were identified associated factors.
Abstract: Background: Musculoskeletal disorders represent a significant occupational problem among nurses; however, there is paucity of information on work related musculoskeletal disorder among nurses in Ethiopia. Objective: To assess work related musculoskeletal disorders and associated factors among nurses working in Jimma Zone Public hospitals, South west Ethiopia. Methods: Institutional based cross-sectional study was conducted in Jimma Zone public hospitals from March 12-27, 2015. Systematic random sampling technique was used to select 333 participants. Data were analyzed by using binary logistic regression and Odds ratios with 95% confidence intervals used to examine associations between dependent and independent variables. Results: The prevalence of work related musculoskeletal disorders at any body site was 60.8% and the highest report 124 (67.8%) was seen in the lower back which was followed by the neck 44 (24%) and knees 43 (23.6%). Lifting and transferring dependent patients [AOR 2.1 (1.1-4.3)], giving wound care [AOR 4.2 (1.9-8.9)], working in medical ward [AOR 9.6 (2.4-38.3)] and Intensive care unit [AOR 3.4 (1.2-9.7)], working in mal-positions [AOR 9.7 (2.2-42.6)], working in the same positions for long period of time [AOR, 6.1 (1.3-28.7)], working with disoriented patients [AOR 2.6 ( 1.1-5.7) and bending or twisting back during work [AOR 5.1 (1.1-23.7)] were identified associated factors. Conclusion: The prevalence of work related musculoskeletal disorders among nurses was high in the study area. Lifting and transferring dependent patients, giving wound care, working in medical ward and Intensive care unit, working in mal-positions, working in the same positions for long period of time, working with disoriented patients and bending or twisting back during work were identified associated factors.
6 citations
Journal Article•
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Journal Article•
TL;DR: Age and experience were significantly associated with musculoskeletal symptoms in the different body regions and the results indicated out of every 10 workers, in the last work week, seven reported complaints in the lower legs.
Abstract: Although Musculoskeletal Disorders (MSDs) represents a common occupational problem, few epidemiological studies have investigated MSDs among industrial workers. MSDs are a common industrial health problem throughout the world and a serious cause of disability among the industrial workers.The goal of the study was to investigate the prevalence of musculoskeletal symptoms (ache, pain, or discomfort) among rubber workers in Iran, using the standard Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). The study population consisted of 100 males with mean age 31.73. Out of every 10 workers, in the last work week, seven reported complaints in the lower legs. The results are also indicated age and experience were significantly associated with musculoskeletal symptoms in the different body regions.
4 citations
Cites background from "Manual Handling Workload and Muscul..."
...[21]; Nursing personnel [19]; Information Technology professionals [22]; Production assembly workers [23]; Dental students [24]; notebook computer users [25]....
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References
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TL;DR: This summary draws together the findings form over 80 studies published over three decades, finding that nursing is among the high risk occupations with respect to low back problems, and one of the popular notions is generally proven, that more frequent patient handling appears to correlate with increased incidence of low back pain.
Abstract: This summary draws together the findings form over 80 studies published over three decades. The studies reviewed are categorized into three groups: (a) epidemiological; (b) 'testing out'; and (c) exploratory. There has been agreement on a number of points, in particular that nursing is among the high risk occupations with respect to low back problems, with a point prevalence of approximately 17%, an annual (period) prevalence of 40-50% and a lifetime prevalence of 35-80%. When considering the contributory factors there is some divergence, but one of the popular notions is generally proven, that more frequent patient handling appears to correlate with increased incidence of low back pain. However, the traditional approach of training in lifting and handling techniques alone has been shown to be of little, or no, long-term benefit and the value of ergonomics remains to be seen. Much work has also been done by taking aspects of nursing work into the laboratory, using experimental studies which have mostly focused on specific sub-tasks (of the generic task of patient handling), looking at specific transfers and procedures (e.g. bed to chair) or transfer techniques ('stoop versus squat'). Although a level of quantification can be made about the different techniques, it is questionable whether this is of any practical use, especially when considering the wide variation of loads encountered during manual handling of patients. The limitations of using quantitative methodologies is revealed in the very small number of exploratory studies. All of the studies cited in this review used methodologies based in the positivist paradigm. There does not appear to be any published work using participative or interview methods to obtain qualitative data which might identify contributory factors in the onset of occupational low back pain in nursing staff.
273 citations
"Manual Handling Workload and Muscul..." refers background in this paper
...…back pain are the most frequent outcome variables in cohort or cross-sectional studies of nursing personnel (Fuortes, Shi, Zhang, Zwerling, & Schootman, 1994; Harber et al., 1987; Hignett, 1996; Kumar, 1990; Leighton & Reilly, 1995; Smedley et al., 1995; Stobbe et al., 1988; Stubbs et al., 1983)....
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...Injuries to the back or back pain are the most frequent outcome variables in cohort or cross-sectional studies of nursing personnel (Fuortes, Shi, Zhang, Zwerling, & Schootman, 1994; Harber et al., 1987; Hignett, 1996; Kumar, 1990; Leighton & Reilly, 1995; Smedley et al., 1995; Stobbe et al., 1988; Stubbs et al., 1983)....
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TL;DR: An appropriate ergonomic intervention programme offers great promise in reducing physical stress and risk of low-back pain to nursing personnel, but large-scale studies in different nursing homes are needed to confirm the above findings.
Abstract: A prospective epidemiologic study was conducted in two units (140 beds and 57 nursing assistants) of a nursing home to demonstrate the efficacy of an ergonomic intervention strategy to reduce back stress to nursing personnel. The total programme involved the following: determining patient handling tasks perceived to be most stressful by the nursing assistants (NAs); performing an ergonomic evaluation of these tasks; and conducting a laboratory study to select patient transferring devices perceived to produce less physical stress than existing manual patient-handling methods. The intervention phase included training NAs in the use of these devices, modifying toilets and shower rooms, and applying techniques to patient care. Immediately after completing the intervention programme, a post-intervention analysis (which lasted eight months in unit 1 and four months in unit 2) was performed. A biomechanical evaluation of the physical demands required to perform stressful patient-handling tasks showed that the me...
271 citations
TL;DR: A large-scale, randomized, controlled trial of an educational program to prevent work-associated low back injury found no long-term benefits associated with training.
Abstract: Background Low back injuries are common and costly, accounting for 15 to 25 percent of injuries covered by workers' compensation and 30 to 40 percent of the payments made under that program. The high costs of injury, the lack of effective treatment, and the evidence that there are behavioral risk factors have led to widespread use of employee education programs that teach safe lifting and handling. The effectiveness of those programs, however, has received little rigorous evaluation. Methods We evaluated an educational program designed to prevent low back injury in a randomized, controlled trial involving about 4000 postal workers. The program, similar to that in wide use in so-called back schools, was taught by experienced physical therapists. Work units of workers and supervisors were trained in a two-session back school (three hours of training), followed by three to four reinforcement sessions over the succeeding few years. Injured subjects (from both the intervention and the control groups) were rand...
260 citations
"Manual Handling Workload and Muscul..." refers background in this paper
...Scope and Cost of Back Pain Due to its widespread prevalence, back pain is costly to industry, accounting for 20% to 40% of the workers’ compensation payments in general industry (Daltroy et al., 1997; Jensen, 1987; Snook, 1982; Webster & Snook, 1994)....
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...Due to its widespread prevalence, back pain is costly to industry, accounting for 20% to 40% of the workers’ compensation payments in general industry (Daltroy et al., 1997; Jensen, 1987; Snook, 1982; Webster & Snook, 1994)....
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TL;DR: It may be concluded that future research of health risks of nursing work should have a wider focus than the relation between physical workload and low back pain.
Abstract: OBJECTIVES: To determine the prevalence of musculoskeletal complaints of the back, arms or neck, and legs among nurses, and to investigate the relation between these complaints and various work related and personal variables. METHODS: A questionnaire survey was carried out in four nursing homes in The Netherlands. RESULTS: The response was 95% and resulted in 846 completed questionnaires. It was found that a large proportion of the subjects regularly had back complaints (36%) but also had arm or neck (30%) and leg complaints (16%). Almost all respondents (89%) considered nursing work as physically strenuous. Most of them complained of working under time pressure (69%), increased work pressure (70%), and having no opportunity to take a break from the work (70%). The physical variables which seem to trouble the subjects most were lifting (65%), working in awkward postures (47%), and stooping (34%). Moreover, 53% of the subjects responded that the ergonomic lay out of the ward was disagreeable. Most of the work related variables under study seemed to be associated with musculoskeletal complaints. For all types of complaints the strongest associations were found with having to lift heavy loads. Apart from physical stress various aspects of work pressure showed strong associations with the occurrence of musculoskeletal complaints. The variables on the ergonomy of the ward showed less clear associations with musculoskeletal complaints than were found for physical stress and work pressure. CONCLUSIONS: From these results it may be concluded that future research of health risks of nursing work should have a wider focus than the relation between physical workload and low back pain.
259 citations
"Manual Handling Workload and Muscul..." refers background in this paper
...Some researchers have broadened the focus from the back to musculoskeletal discomfort in other body parts as well, particularly the arm, neck, shoulders or leg (Ahlberg-Hulten, Theorell, & Sigala, 1995; Engels et al., 1996; Estryn-Behar et al., 1988)....
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TL;DR: A potential pathway between psychosocial stress and spine loading has been identified that may explain how psychosocially stressful environments solicited more of a coactivity response in people with certain personality traits, making them more susceptible to spine loading increases and suspected low back disorder risk.
Abstract: Study design The effects of psychosocial stress on muscle activity and spinal loading were evaluated in a laboratory setting. Objective To evaluate the influence of psychosocial stress, gender, and personality traits on the functioning of the biomechanical system and subsequent spine loading. Summary of background data Physical, psychosocial, and individual factors all have been identified as potential causal factors of low back disorders. How these factors interact to alter the loading of the spine has not been investigated. Methods Twenty-five subjects performed sagittally symmetric lifts under stressful and nonstressful conditions. Trunk muscle activity, kinematics, and kinetics were used to evaluate three-dimensional spine loading using an electromyographic-assisted biomechanical model. A personality inventory characterized the subject's personality traits. Anxiety inventories and blood pressure confirmed reactions to stress. Results Psychosocial stress increased spine compression and lateral shear, but not in all subjects. Differences in muscle coactivation accounted for these stress reactions. Gender also influenced spine loading; Women's anterior-posterior shear forces increased in response to stress, whereas men's decreased. Certain personality traits were associated with increased spine loading compared with those with an opposing personality trait and explained loading differences between subjects. Conclusions A potential pathway between psychosocial stress and spine loading has been identified that may explain how psychosocial stress increases risk of low back disorders. Psychosocially stressful environments solicited more of a coactivity response in people with certain personality traits, making them more susceptible to spine loading increases and suspected low back disorder risk.
253 citations