| Study 1 – Lim, H.J., Black,T.R., Shah,S.M., Sarker, S. & Metcalfe,J. (2011). Evaluating repeated patient handling injuries following the implementation of a multi-factor ergonomic intervention program among health care workers. Journal of Safety Research, 42, 185-191. |
| Kind of study |
Control case experimental study |
| Population |
Nursing professionals789 for the intervention group and 691 for the control group.90% were women and the mean age was 40 years.Data were collected at 6 hospitals in Saskatchewan, Canada, with different "large, medium and small" sizes, from September 1, 2001 to December 1, 2006 |
| Objectives |
To evaluate the repeated musculoskeletal injuries in nursing professionals in a hospital context, after the implementation of a multifactorial ergonomic intervention program. |
| Intervention |
The control group did not receive any form of injury prevention program.The following measures were implemented to the intervention group:- furnished mechanical equipment: two mechanical lifts / unit;- formation on anatomy, injuries, body mechanics, personal health, lifting and patient handling procedures- 8-hour single training session and one one-hour refresher session per year. Course book and training materials were provided. Participation in these sessions was mandatory.Both groups were followed up for two years. |
| Results (outcomes) |
The intervention group had significantly fewer repeated lesions than the control group (p = 0.001 and p = 0.0001, respectively).Multivariate analysis showed that the intervention group had 38.1% fewer chances of having repeated lesions compared to the nurses in the control group.The 2-year pre-intervention and 2-year post-intervention results showed that the mean length of time lost due to injury in intervention hospitals decreased significantly by 55% (and from 36 days to 16.2 days).There was no statistically significant interaction between hospital size and group size. |
| Conclusions |
The study concluded that work-related musculoskeletal injuries in nurses after the intervention program were reduced.Implementing a multifactor program with the right equipment and training can reduce the risk of injury among health professionals. |
| Critical quality review |
85% |
| Study 2 – Fujishiro, K., Weaver,J.L., Heaney,C.A., Hamrick,C.A., & Marras,W.S. (2005). The Effect of Ergonomic Interventions in Healthcare Facilities on Musculoskeletal Disorders. American Journal of Industrial Medicine, 48, 338-347. |
| Kind of study |
Prospective experimental study |
| Population |
Nursing professionals working at 86 facilities, totaling 100 health units in Ohio. |
| Objectives |
To evaluate the effect of an ergonomic intervention program on rates of work-related musculoskeletal injuries in nurses. It occurred in two moments of evaluation: a 1-year pre-intervention and up to 2 years post-intervention. |
| Intervention |
The following measures were implemented:- financial support from the Bureau of Workers' Compensation (BWC) for the purchase of ergonomic devices;- Ergonomic evaluation performed by ergonomists of the program, for consultation, guidance and technical assistance after installation of the devices;- use by the ergonomist of a checklist of conformities relating to the actual use and maintenance of the equipment.- held a single session of training given by the ergonomics of 4 hours.Comparisons were made between different types of interventions: reduction of flexion, elimination of elevation, reduction of the Survey, and a combination of the three. |
| Results (outcomes) |
The mean rate of LMLT decreased from 12.32 to 6.64 per 200,000 hours worked. 77 units of work decreased LMELT rates.23 units of labor increased LMELT rates. |
| Conclusions |
The implementation of programs to improve ergonomic conditions and financial support for ergonomic equipment is an effective intervention to reduce rates of work-related musculoskeletal injuries in nurses. |
| Critical quality review |
83% |
| Study 3 – Lee J.E, Kim S.L, Jung H.S, Koo J.W., WooK.H. & Kim,M.T. (2009). Participatory Action Oriented Training for Hospital Nurses (PAOTHN) Program to Prevent Musculoskeletal Disorders. J Occup Health, 51: 370–376 |
| Kind of study |
Experimental study without control group |
| Population |
Nursing professionals from a hospital in the suburbs of Seoul, South Korea, with 689 beds.16 Units participated in the study- 7 general wards, 4 intensive care units, 1 operating room, 1 emergency room, 1 hemodialysis room, 1 delivery room and 1 outpatient clinic. 16 head nurses working as managers. |
| Objectives |
To construct and test a participatory action-oriented training program for Hospital Nurses (PAOTHN) to prevent work-related musculoskeletal injuries in nurses. |
| Intervention |
Research team (two nursing professors, three nursing doctorates, three occupational health physicians, one ergonomist, two hygienists, six head nurses and one nurse) developed a checklist with five types of nursing tasks with 43 Items that were related to musculoskeletal injuries:- patient care and treatment (8 items);- safe handling of drugs, medical devices and equipment (7 items);- workstation design (11 items);- physical environment (6 items);- facilities and administration (11 items).The following measures were implemented:- several participatory workshops: research team handed out a checklist to the participants, they visited the units and filled in, then discussed in the room the positives and what needed improvement.- continuous technical assistance by the research team;- discussion and implementation of participant improvements;- periodic forums to share "Best Practices" among participants- Conquest competitions.The program had two phases: development phase, followed by implementation and evaluation phase.Each participant presented a short study (within 3 months) and a long-term (within 6 months-1 year) action plan for musculoskeletal injuries in their own unit. |
| Results (outcomes) |
Improvement plans were presented (23 short-term and 23 long-term plans). Of the 46 plans, 18 of the suggested plans were completed, for an overall completion rate of 39.1%: 15 (65.2%) of the short-term plans and 3 (13.0%) long-term plans.In terms of the various types of tasks implemented, 9 (52.9%) involved the safe handling of drugs, devices and equipment; 4 (50.0%) involved patient care and treatment; 4 (40.0%) involved welfare institutions and administration; 1 (33.3%) involved Environments. |
| Conclusions |
The PAOTHN program was considered feasible and potentially useful in reducing risk factors and providing a practical model for efforts to prevent work-related musculoskeletal injuries in nurses in a hospital environment. |
| Critical quality review |
88% |
| Study 4- Nelson A., Matz M., Chen F., Siddharthan K., Lloyd J & Fragala G. (2006) Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. Int J Nurs Stud. Aug;43(6):717-33. |
| Kind of study |
Experimental study without control group |
| Population |
825 Nursing professionals from 23 health units |
| Objectives |
Design and implement a multifaceted safety improvement program and evaluate the impact of the program on the rate of injuries, lost work days, job satisfaction, program effectiveness, costs and investment. |
| Intervention |
The following measures were implemented:- ergonomic assessment of working conditions;- evaluation and decision of the technique of mobilization to be used with the implementation of the professional expert in security;-assignment of mechanical equipment for patient mobilization after ergonomic evaluation;- learning with error / incidents (after action reviews) and "do not perform manual lifting" policy. |
| Results (outcomes) |
In the short term there was a reduction associated with injury rates from 24/100 to 16.9 / 100, service days lost from 14.2 to 10.5, increased job satisfaction, self-reported safety in patient handling tasks reduced With statistical significance (p = 0.027).For cost-effectiveness over a 10-year period, $ 204,599 per year is saved. The capital invested in materials and training of human resources is recovered at the end of 3.75 years. |
| Conclusions |
More research is needed to assess the long-term impact of the program.The program was successful in the short term. |
| Critical quality review |
96% |
| Study 5- Warming, S., Ebbehoj, N.E., Wiese, N., Larsen, L.H., Duckert, J. & Tonnesen, H. (2008) Little effect of transfer technique instruction and physical fitness training in reducing low back pain among nurses: a cluster randomised intervention study. Ergonomics. Oct;51(10):1530-48. |
| Kind of study |
Experimental Case-control |
| Population |
156 Nursing professionals from 11 wards.6 wards for the intervention group with 105 nursing professionals (55 for TT and 50 for PTSD) and 5 wards for the control group with 76 nursing professionals |
| Objectives |
To evaluate the effect of a technical transfer education (TT) program in combination with physical fitness training (TTPT) compared to a control group. |
| Intervention |
No measures were implemented to the control group.The following measures were implemented to the intervention group:- a technical education program on transfer and mobilization of patients for 4 days, given by an experienced trainer to the nurses in the services (training taught according to the model of the knowledge of transfer and movement assistance: the ergonomic principles are used and the patient capacity is taken into account when performing the mobilization techniques.)- physical program, 1 hour, 2 times a week, lasting 8 weeks.(Training plan: warm-up exercises, aerobic workout [running at the treadmill, rowing or bicycle)] and strength training [aimed at the trunk and glutes]).Place: performed at the Hospital, during working hours.Follow-up of 12 months. |
| Results (outcomes) |
The intervention group significantly improved LBP disability (p = 0.001). |
| Conclusions |
The implementation of the training program on patient mobilization techniques in combination (or not) with the exercise program did not decrease the number of self-reported LMELT complaints at the end of 1 year. However, improving physical capacity has been shown to alleviate some of the consequences of LMELT, in particular disability. |
| Critical quality review |
88% |
| Estudo 6 - Zadvinskis IM & Salsbury SL. (2010).Effects of a multifaceted minimal-lift environment for nursing staff: pilot results. West J Nurs Res. Feb;32(1):47-63. |
| Kind of study |
Near-experimental with control group |
| Population |
77 Nursing professionals - 46 Nursing professionals (intervention group) and 29 Nursing professionals (control group). 95% women, with a mean age of 33.7%. Average hours worked per week was 35.5% |
| Objectives |
To examine the effectiveness of a multifactorial program of minimum elevation on the use of mechanical equipment, rates of musculoskeletal injuries and the costs of compensation for occupational accidents. |
| Intervention |
Both intervention and control groups received engineering control (various equipment with recommendations for the different types of equipment), and they maintained the lifting equipment that they had previously had to study. All these equipment remained for a year.The following measures were implemented to the intervention group:- engineering controls (equipment)- administrative (nursing policy reflected the best evidence and algorithms of the VISN Patient Safety Center).- behavioral (training program): eight coaches to cover the 24 hours, had training training, two sessions of 4 hours each. |
| Results (outcomes) |
Nursing staff in the intervention group presented greater use of lifting equipment (p = .002).The incidence rate of injury in the intervention group was 3.26 / 100 to 3.43 / 100 in the control group.The costs related to work accidents decreased from US $ 6,566 compared to US $ 11,145 |
| Conclusions |
The multifaceted program with mechanical equipment presented a decrease in the rate of injuries, with reduction of workers' compensation costs. |
| Critical quality review |
90% |
