Effectiveness of a multidimensional intervention program in improving occupational musculoskeletal disorders among intensive care unit nurses: a cluster-controlled trial with follow-up at 3 and 6 months
Abstract:Background
Intensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses.
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“…The studies included in this SR allow us to answer the research question. As can be seen in Table 6 , the researchers associated two or more interventions [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ], the most frequent being the training-handling devices, with the aim of training nurses to use the equipment for mobilization and/or patient transfer [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 ], thus controlling the major risk factor for injuries.…”
Section: Resultsmentioning
confidence: 99%
“…Eleven studies associate training-handling devices with ergonomics education [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 36 ] and information on risk factors, use of mechanical devices, and use of the principles of body mechanics during the use of mechanical means, but also in carrying out other activities.…”
Section: Resultsmentioning
confidence: 99%
“…The studies included reinforce the importance of programs aimed at learning the correct handling of patients and/or using the principles of biomechanics in carrying out this activity [ 19 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 36 ], the use of mechanical means that reduce overload, and the associated risk [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 ], including the policy of no manual lifting [ 27 ]. These data are consistent with the recommendations of the Occupational Safety and Health Administration (OSHA) which recommends the increased availability of assistive devices and the use of even the most basic assistive devices as an integral part of safe patient handling [ 40 ].…”
Section: Discussionmentioning
confidence: 99%
“…The design of a preventive intervention program for MDRW must be based on multidimensionality and the diagnosis of the specific needs of the target population, such as work characteristics, the type of ergonomic equipment existing, the environment, and the organizational culture implemented [ 19 ]. These types of preventive programs can be more successful due to their direct relationship with the praxis and should include the assessment of risk perception, educational programs with ergonomic posture training of preventive clinical skills, physical activity at the workplace, cognitive-behavioral therapy for the treatment of physical, psychological, occupational, ergonomic risk factors, and the promotion of a safe environment [ 19 ].…”
Background: The 12-month prevalence of musculoskeletal disorders related to work (MDRW) in nurses rests between 71.8% to 84%, so it is urgent to develop preventive intervention programs with the purpose of avoiding negative physical, psychological, socioeconomic, and working aspects. There are several intervention programs aimed at preventing musculoskeletal disorders related to work for nurses, but few have successfully proven results. Despite the evidence pointing to the benefits of multidimensional intervention programs, it is essential to determine which interventions have positive effects on the prevention of this kind of disorder to create an effective intervention plan. Aim: This review intends to identify the different interventions adopted in the prevention of musculoskeletal disorders related to work in nurses and to compare the effectiveness of these interventions, providing the appropriate and scientific basis for building an intervention to prevent musculoskeletal disorders in nurses. Method: This Systematic Review was guided by the research question, “What are the effects of musculoskeletal disorders preventive interventions on nursing practice?” and carried out in different databases (MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials, SCOPUS, and Science Direct). Later, the results were submitted to the eligibility criteria, the appraisal quality of the papers, and the data synthesis was performed. Results: 13 articles were identified for analysis. The interventions implemented to control the risk were: training patient-handling devices; ergonomics education; involving the management chain; handling protocol/algorithms; acquiring ergonomics equipment; and no-manual lifting. Conclusions: The studies associated two or more interventions, the majority of which (11 studies) were training-handling devices and ergonomics education, therefore emerging as the most effective instruments in the prevention of MDRW. The studies did not associate interventions that cover all risk factors (individual, associated with the nature of the work, organizational, and psychological aspects). This systematic review can help with making recommendations for other studies that should associate organizational measures and prevention policies with physical exercise and other measures aimed at individual and psychosocial risk factors.
“…The studies included in this SR allow us to answer the research question. As can be seen in Table 6 , the researchers associated two or more interventions [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ], the most frequent being the training-handling devices, with the aim of training nurses to use the equipment for mobilization and/or patient transfer [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 ], thus controlling the major risk factor for injuries.…”
Section: Resultsmentioning
confidence: 99%
“…Eleven studies associate training-handling devices with ergonomics education [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 36 ] and information on risk factors, use of mechanical devices, and use of the principles of body mechanics during the use of mechanical means, but also in carrying out other activities.…”
Section: Resultsmentioning
confidence: 99%
“…The studies included reinforce the importance of programs aimed at learning the correct handling of patients and/or using the principles of biomechanics in carrying out this activity [ 19 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 36 ], the use of mechanical means that reduce overload, and the associated risk [ 19 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 ], including the policy of no manual lifting [ 27 ]. These data are consistent with the recommendations of the Occupational Safety and Health Administration (OSHA) which recommends the increased availability of assistive devices and the use of even the most basic assistive devices as an integral part of safe patient handling [ 40 ].…”
Section: Discussionmentioning
confidence: 99%
“…The design of a preventive intervention program for MDRW must be based on multidimensionality and the diagnosis of the specific needs of the target population, such as work characteristics, the type of ergonomic equipment existing, the environment, and the organizational culture implemented [ 19 ]. These types of preventive programs can be more successful due to their direct relationship with the praxis and should include the assessment of risk perception, educational programs with ergonomic posture training of preventive clinical skills, physical activity at the workplace, cognitive-behavioral therapy for the treatment of physical, psychological, occupational, ergonomic risk factors, and the promotion of a safe environment [ 19 ].…”
Background: The 12-month prevalence of musculoskeletal disorders related to work (MDRW) in nurses rests between 71.8% to 84%, so it is urgent to develop preventive intervention programs with the purpose of avoiding negative physical, psychological, socioeconomic, and working aspects. There are several intervention programs aimed at preventing musculoskeletal disorders related to work for nurses, but few have successfully proven results. Despite the evidence pointing to the benefits of multidimensional intervention programs, it is essential to determine which interventions have positive effects on the prevention of this kind of disorder to create an effective intervention plan. Aim: This review intends to identify the different interventions adopted in the prevention of musculoskeletal disorders related to work in nurses and to compare the effectiveness of these interventions, providing the appropriate and scientific basis for building an intervention to prevent musculoskeletal disorders in nurses. Method: This Systematic Review was guided by the research question, “What are the effects of musculoskeletal disorders preventive interventions on nursing practice?” and carried out in different databases (MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials, SCOPUS, and Science Direct). Later, the results were submitted to the eligibility criteria, the appraisal quality of the papers, and the data synthesis was performed. Results: 13 articles were identified for analysis. The interventions implemented to control the risk were: training patient-handling devices; ergonomics education; involving the management chain; handling protocol/algorithms; acquiring ergonomics equipment; and no-manual lifting. Conclusions: The studies associated two or more interventions, the majority of which (11 studies) were training-handling devices and ergonomics education, therefore emerging as the most effective instruments in the prevention of MDRW. The studies did not associate interventions that cover all risk factors (individual, associated with the nature of the work, organizational, and psychological aspects). This systematic review can help with making recommendations for other studies that should associate organizational measures and prevention policies with physical exercise and other measures aimed at individual and psychosocial risk factors.
“…34-70 Some articles appeared to be relevant upon initial review, but were excluded because the independent effects of the nine healthy buildings determinants could not be concluded. 71-78 Figure 1.PRISMA flow diagram of search results.…”
Objective Back pain and neck pain are very common, costly, and disabling. Healthy building determinants within the built environment have not been adequately assessed as contributors to these conditions. The objective of this study was to systematically review the literature on the relationship of healthy building determinants with back and neck pain. Data Source PubMed, CINAHL, EMBASE, Google Scholar, and PEDRo. Study Inclusion and Exclusion Criteria: Studies were included if they met the following criteria: Adults, comparison of healthy building determinants (air quality, ventilation, dust and pests, lighting and views, moisture, noise, safety/security, thermal health, water quality) with back and neck pain, original research, English. Studies were excluded if full text articles were unavailable and if the focus was patient and materials handling or ergonomics. Data Extraction Data extraction and other review procedures were elaborated according to PRISMA guidelines. Data Synthesis: Data were synthesized with an approach adapted from Oxford Centre for Evidence-Based Medicine and American Physical Therapy Association. Results 37 articles enrolling 46,223 participants were eligible. Most articles were cross-sectional (31/37) and fair quality (28/37). None were interventional. Evidence was found to generally support a relationship indicating that as healthy building determinants worsen, the risk of back and neck pain increases. Conclusion Although the available evidence precludes interpretations about causality, the study's findings are starting points to guide future research, knowledge creation, and health promotion initiatives about the relationships of the built environment with back and neck pain.
Background
Improving the work ability of nurses is highly important for ensuring a functioning healthcare system, which can be achieved via exercising and enhancing ergonomic work behaviors of the nurses. The objective of this systematic review was to synthesize work ability-enhancing exercise and ergonomic workplace health promotion interventions in different nursing settings and their effects on work ability.
Methods
Intervention studies incorporating at least one component of physical exercise or ergonomic work behavior for nurses were eligible for inclusion. Three electronic databases (Medline, PsycInfo, CINAHL) were searched for studies published until October 2022. The methodological quality of interventions was assessed. Due to intervention and outcome heterogeneity, narrative synthesis was conducted.
Results
The search identified a total of 37 studies. Sample size ranged from 14 to 316 (N = 3487). Overall quality was moderate (M = 0.76). Programs comprised aerobic exercising, “back school,” ergonomics, increasing physical activity, multicomponent programs, physiotherapy, and yoga. Positive effects on work ability (e.g., reduced back pain or stress levels) were reported in 34 studies. However, if follow-up analyses were included, the effects typically diminished. Common training principles and training control mechanisms were applied in studies.
Discussion
The review indicates the efficacy of exercise-based health promotion for increasing nurses’ work ability. However, results are limited by the lack of long-term improvements and scarcity of application of training principles. Therefore, setting-specific interventions, respecting work demands and training principles, are recommended.
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