Evidence-based patient handling: systematic review

Hignett, Sue; Crumpton, Emma; Ruszala, Sue; Alexander, Pat; Fray, Michael; Fletcher, Brian

doi:10.7748/ns2003.04.17.33.33.c3383

Cited by 51 publications

(20 citation statements)

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“…For example in Canada, the one-person low pivot manual transfer and two person side-by-side transfer is banned while in England hazardous manual lifts such as the drag lift, cradle lift, shoulder lift, and others have been banned. (Hignett et al, 2003;Musculoskeletal Injury, 2003;Retsas & Pinikahana, 2000) The Royal College of Nursing was credited for first proposing the concept of a "lift free hospital." Despite over a decade head start in addressing this problem, the challenge of providing proper equipment in every facility is still a challenge, as is getting nurses to change manual patient handling practices they learned in school.…”

Section: Administrative Controlsmentioning

confidence: 99%

Evidence-Based Practices for Safe Patient Handling and Movement

Nelson

Baptiste

2006

BMM

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Efforts to reduce injuries associated with patient handling are often based on tradition and personal experience rather than scientific evidence. The purpose of this article is to summarize current evidence for interventions designed to reduce caregiver injuries, a significant problem for decades. Despite strong evidence, published over three decades, the most commonly used strategies have strong evidence that demonstrate they are ineffective. There is a growing body of evidence to support newer interventions that are effective or show promise in reducing musculoskeletal pain and injuries in care providers. The authors have organized potential solutions into three established ergonomic solution types: engineering based, administrative, and behavioral. For each intervention, the level of evidence to support its use is provided.Key words: work-related musculoskeletal injuries, patient handling, no lift policy, ergonomics, lifting techniques, nurse safety Strategies to prevent or minimize work-related musculoskeletal injuries associated with patient handling are often based on tradition and personal experience rather than scientific evidence. The most common patient handling approaches in the United States include manual patient lifting, classes in body mechanics, training in safe lifting techniques, and back belts. Surprisingly there is strong evidence that each of these commonly used approaches is not effective in reducing caregiver injuries. A major paradigm shift is needed away from these ineffective approaches towards the following evidence-based practices: (a) patient handling equipment/devices, (b) patient care ergonomic assessment protocols, (c) no lift policies, (d) training on proper use of patient handling equipment/devices, and (e) patient lift teams. Promising new interventions, which are still being tested, include use of unit-based peer leaders and clinical tools, such as algorithms and patient assessment protocols. Given the complexity of this high-risk, high volume, highcost problem, multifaceted programs are more likely to be effective than any single intervention. This new call for action includes systematic change in health care facilities across the continuum of care as well as a new curriculum for schools of nursing. Statement of the ProblemNursing personnel are consistently listed as one of the top ten occupations for work-related musculoskeletal disorders, with incidence rates of 8.8 per 100 in hospital settings and 13.5 per 100 in nursing home settings (Bureau of Labor Statistics, 2002). These are considered to be low estimates, since underreporting of injuries in nursing is common (U.S. Department of Health & Human Services, 1999). Aggregated data on prevalence of back injury, compiled from over 80 studies, revealed an international worldwide point prevalence of approximately 17%, an annual prevalence of 40-50% and a lifetime prevalence of 35-80% (Hignett, 1996). While there has been a steady decline in the rates of most occupational injuries starting in 1992, work-related musculos...

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Section: Administrative Controlsmentioning

confidence: 99%

Evidence-Based Practices for Safe Patient Handling and Movement

Nelson

Baptiste

2006

BMM

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“…Ergonomic solutions remain necessary [1][2][3][4]. According to scientific studies, the primary causes of back injuries are patient handling tasks, such as lifting, transferring and repositioning patients [5], and static postural stress [6][7].…”

Section: Introductionmentioning

confidence: 99%

“…In order to reduce these injuries, healthcare facilities worldwide are paying greater attention to ergonomics. Actions include the use of lifting aids to reduce dynamic loads during lifting and repositioning patients, lifting specialists 1 and training. Research continues to prove that an ergonomic approach focusing on a combination of interventions can be beneficial [8,21].…”

Section: Introductionmentioning

confidence: 99%

“…Actions include the use of lifting aids to reduce dynamic loads during lifting and repositioning patients, lifting specialists 1 and training. Research continues to prove that an ergonomic approach focusing on a combination of interventions can be beneficial [8,21]. Evidence exists that multi-element ergonomic interventions, -particularly those that include risk assessments, observation of workers in their working environment, tailoring of training to suit individual needs, and the redesign of equipment and handling taskscan be effective in reducing the risk of manual handling injuries [9].…”

Section: Introductionmentioning

confidence: 99%

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How Smart is the Carevo®? Results of a Study on a New Shower Trolley Generation

Knibbe¹,

Knibbe²,

Waaijer³

2013

TOERGJ

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Abstract:The purpose of this study was to compare the traditional height-adjustable shower trolley with the Carevo, a shower trolley with a new design. Compared to the traditional height-adjustable shower trolley, the Carevo has higher side supports, indented curves on the long sides, handles, arrow-shaped ends, and a mattress with a flexible mid-section. In this study four nurses carried out five shower cycles using the traditional height-adjustable shower trolley and five shower cycles using the Carevo. These activities were filmed and analysed by multi-moment sampling at a fixed 3-second interval. Each observation consists of a back score, arm score, leg score and neck score. Results show that working with the Carevo leads to less postural stress on the musculoskeletal system of the caregiver, compared to the traditional heightadjustable shower trolley. There is a 10.2% improvement in time spent in a neutral back position and a 9.4% improvement in the time spent in a neutral neck position. However, the improvements depend on the cut off point: if the cut off point is a flexed back posture of 20°, a 3.0% improvement is found. Although quality of care and comfort was not the subject of this research, we would like to state there is room for improvement, as the patient spends only a small part of the total time on the trolley being showered, which can easily lead to an uncomfortable experience. This quality of care issue seems to be addressed more effectively by new features of the Carevo compared to the traditional height-adjustable shower trolley.

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“…First, proper body mechanics when transferring, lifting, repositioning, or otherwise moving patients do not prevent WMSDs (Hignett et al, 2003;Marras, Davis, Kirking, & Bertsche, 1999). Second, ergonomic approaches, such as policies that limit the weight that staff can lift, use of SPH equipment (e.g., ceiling lifts, floor-based lifts, sit-to-stand devices, lateral transfer aids, and adjustable hospital beds), patient assessment, and use of algorithms to guide equipment selection do reduce WMSDs among health care workers (Collins et al, 2004;Evanoff et al, 2003;Nelson, Motacki, & Menzel, 2009).…”

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confidence: 99%

Safe-Patient-Handling Equipment in Therapy Practice: Implications for Rehabilitation

Darragh

Campo

Frost

et al. 2013

The American Journal of Occupational Therapy

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OBJECTIVE. To determine how safe-patient-handling (SPH) equipment is used in rehabilitation and how it affects therapists, patients, and therapy practice. METHOD. We used a qualitative, instrumental case study design. Thirty-five occupational and physical therapist practitioners from three facilities participated in the study. RESULTS. Therapists reported a broad range of applications for equipment (e.g., functional mobility and neuromusculoskeletal function). They reported that SPH equipment increased treatment options for therapists and increased participation options for patients, although equipment limitations exist. Three themes emerged from the analysis: choice, potential, and safety. CONCLUSION. SPH equipment has therapeutic applications in rehabilitation, especially for medically complex or bariatric patients. Therapists in this study engaged in a highly individualized, complex process of decision making when selecting and using SPH devices in rehabilitation. More research to refine and test therapeutic uses is necessary.

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Evidence-based patient handling: systematic review

Abstract: It is recommended that healthcare providers should review their current equipment provision and approach to managing risks and injuries associated with patient handling activities in the context of this research evidence.

Cited by 51 publications

References 0 publications

Evidence-Based Practices for Safe Patient Handling and Movement

Evidence-Based Practices for Safe Patient Handling and Movement

How Smart is the Carevo®? Results of a Study on a New Shower Trolley Generation

Safe-Patient-Handling Equipment in Therapy Practice: Implications for Rehabilitation

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