Continuous assessment of work activities and posture in long-term care nurses

Abstract

The high prevalence of low back injuries in nursing has prompted the use of mechanical lift assists while overall assessment of activities and postures remains limited. The purpose of this study was to chronicle trunk posture and work tasks of long-term healthcare professionals. An inclinometer monitored trunk posture for 27 workers, 20 of whom were also observed continuously throughout their shift. Patient lifts and transfers accounted for less than 4% of the shift while patient care, unloaded standing and walking and miscellaneous tasks accounted for 85%. Manual lifts and transfers occurred twice as often as mechanically assisted lifts but took only half the time. The workers had a median trunk flexion angle of 9.2 degrees , spent 25% of their time flexed beyond 30 degrees and had peak flexion angles greater than 75 degrees in many tasks. Analysis of posture throughout the entire working shift indicates that, in addition to lifts and transfers, emphasis needs to be placed on patient care and miscellaneous activities when assessing injury risk for nurses. STATEMENT OF RELEVANCE: Patient handling has been the focus in the effort to reduce back pain and injury in nursing. In addition to the use of mechanical lifts, there is a need to examine other aspects of nursing, including patient care and other ancillary tasks, which comprise the majority of the work shift and, while often unloaded, exhibit extreme postures that may also lead to injury.

The Effect of Working Position on Trunk Posture and Exertion for Routine Nursing Tasks: An Experimental Study

“…In this context, many studies have examined manual patient transfers and identified them as a risk factor (Engkvist et al , 2000; Byrns et al , 2004). However, patient transfers take up <4% of a work shift (Hodder et al , 2010) and nurses have many other types of work to perform, such as washing patients, making beds, or changing dressings (Harber et al , 1987; Freitag et al , 2007). In a previous study, we found that nurses often bend forward (sagittal trunk inclination) when performing the pre-mentioned activities or work for extended periods in an inclined posture (static trunk inclination) (Freitag et al , 2007).…”

The Effectiveness of a Lumbopelvic Monitor and Feedback Device to Change Postural Behavior: A Feasibility Randomized Controlled Trial

“…39,51,57 Previous studies have used a variety of devices for postural monitoring. 4,13,18,48,58 A common problem found in postural-monitoring devices used during daily activities is the trade-off between portability and accuracy of measurements. Instruments such as the moment T T STUDY DESIGN: Feasibility randomized controlled trial.…”

Low back pain and coping strategies’ among nurses in Port Said City, Egypt

“…[8][9][10] Most physical risks contributing to LBP in nurses are focused on occupational factors such as extent of bending and lifting. [11] A range of personal physical factors, including reduced cardiovascular fitness, [12] poor back muscle endurance, [13] altered motor control patterns, [14] poor spinal posture, [15] and reduced sagittal range of motion [16,17] have been found in various LBP populations. Further, lifestyle factors such as physical inactivity [18] and high levels of vigorous physical activity [19] have been associated with LBP.…”