The Influence of Ergonomic Devices on Mechanical Load during Patient Handling Activities in Nursing Homes

Abstract

In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.

The Importance of Safe Patient Handling to Create a Culture of Safety: An Evidential Review

“…Resistance to change is one; ergonomic device use can be variable, with nurses sometimes choosing not to use a device when it is recommended, or to the extent that it was intended. Reasons given include: poor access, insufficient training, lack of space for use or storage, inadequate staffing, or increased time required compared with manual methods [5,7,41,46]. Knibbe et al found the behaviour change required in nurses was a major issue with implementation of device use-to adjust from two or more persons to only one required an adjustment in attitude for the nurse to realise that this was still safe practice [47].…”

“…The number of lost workdays due to injury was also generally reduced with introduction of ergonomic devices [7,43,45], as were costs associated with patient handling-related injury [45]. Use of ergonomic devices was also associated with reduced awkward back posture incidence and duration [46], safer patient transfers [47], and reduced risk of infrequent lower back pain [48]. Burdorf et al reported, however, that even the best scenario only showed a maximal reduction of 14% in lower back pain prevalence, while the projection from this analysis was that complete elimination of manual patient lifting would reduce lower back pain by 10.5% [43].…”

“…In general, however, a reduction in lost workdays due to injury was also found with ergonomic programme implementation [15,16,18,51], as were reductions in injury-related costs [16,51]. The quality of the study evidence overall is not high; some are small [13,14,41], not randomised [4,16,42,46,49,52], or lacking appropriate controls [4,12,16,17,45,49,50], or include other factors which may have an influence on the study result [44,48,51]. Table 1.…”

“…Koppelaar et al 2012 [46] Ergonomic device use assessed by 186 nurses on 735 patient handling activities in 17 nursing homes in the Netherlands, in real time, using a structured patient handling programme centred on the presence of a ward Ergo or Transfer Mobility coach (a specialist trained in ergonomic principles who is responsible for supporting this process).…”

“…A number of these studies are also underpowered -being either small [13,14,41,44,56], not randomised [4,16,46,42,49,52], or lacking appropriate controls [4,12,16,17,45,49,50]. Several studies are also based on self-reported data [6,14,42,44].…”