The provision of patient lifts, and access to them when it counts, can significantly contribute to the reduction of injury and improvement of job control among nurses, according to new research from UCSF.
“Our study shows that making lifting equipment readily available and removing barriers against lift use are both key to injury prevention,” says lead author Soo-Jeong Lee, assistant professor in the Department of Community Health Systems at UCSF’s School of Nursing.
Mechanical lifts have been shown to reduce the risk of musculoskeletal injury from patient handling. They are used in hospitals and other medical settings to safely transfer patients with reduced mobility. Patient handling tasks account for up to sixty-six percent of all musculoskeletal injuries among health care workers, the authors point out.
For the study, researchers surveyed 361 nurses randomly selected from the American Association of Critical-Care Nurses. Respondents worked in a variety of settings including intensive care, trauma units, operating rooms, and emergency departments. The survey asked nurses to report any pain, aching, stiffness, numbness, and tingling in the last 12 months and its frequency, duration, and severity. Nurses were also asked if work caused their pain or made it worse.
Respondents reported on their access to lifting equipment, use of lifts, and details about their place of work.
Nurses with a high-level of lift availability were fifty percent less likely to have work-related low back pain and nurses with a medium-level of lift availability and use were about seventy percent less likely to have work-related shoulder pain.
“I expected the greatest effect of a lift intervention to be on low back pain,” notes Lee. “The strongest protective effect, in fact, was suggested for shoulder pain. The evidence was consistent across different measures.”
Nurses with higher access to lifts also reported greater job control and reduced job stress. “It’s well known that psychosocial factors such as job stress affect musculoskeletal symptoms,” Lee says. “And job control is one of the components that affect job stress. For example, when nurses need to move physically dependent patients and the lift is not available, they have little control over the lift task. This may increase job stress as well as put them at risk of injury.”
Only forty-seven percent of nurses were provided lifts by their employer in 2006, according study authors. In a recent survey of California nurses following the implementation of California’s Hospital Patient and Health Care Worker Injury Protection Act (AB 1136), which came into effect January 1, 2012, Lee found sixty-one percent of hospital nurses now have access to lifts.
“There has been an improvement,” says Lee, “but the new legislation requires acute care hospitals to provide a lifting device, so I expect this number to increase.”
David Rempel, professor of Medicine in the UCSF Division of Occupational and Environmental Medicine and director of the joint Berkeley and UCSF Ergonomics Program, is an advisor to Cal/OSHA on AB 1136. Currently, Cal/OSHA is working with the Occupational Safety and Health Standards Board to adopt and implement its Safe Patient Handling regulation. Public hearing of the regulation occurred on September 19, 2013.
Dr. Lee’s study appeared in the International Journal of Nursing Studies and was co-authored by Julia Faucett, professor emerita in the Department of Community Health Systems at UCSF’s School of Nursing, Marion Gillen, retired deputy director of COEH and clinical professor, UCSF, and Niklas Krause, director of the Southern California Education and Research Center at UCLA.
Funding came from the American Association of Occupational Health Nurses Foundation, The Sigma Theta Tau International Alpha Eta Chapter, the UCSF Graduate Division, and the UCSF School of Nursing Century Club. Lee’s follow-up investigation in 2013 received separate funding from the Southern California NIOSH Center.
Read the journal article.
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