Effects of Training in Modifying Work Methods and Behaviors During Common Patient Handling Activities

Abstract

In a 1994 survey, on incidence rates of musculoskeletal injuries among private industries within the U.S, nurses ranked first nationally. Patient handling tasks are considered to be a precipitating factor in the development of many musculoskeletal injuries. For many decades personnel training has been an intervention widely used for the nursing back problem. Inconsistency regarding the effectiveness of many personnel training programs, lack of controlled research among existing studies, and a primary focus only on long term reduction of injury rates makes the interpretation of the success of personnel training programs a difficult one. This study is based on the assumption that, if a training program is to be effective as a means of reducing musculoskeletal injuries, it must first modify worker behaviors and biomechanical stresses to a measurable degree.

This research investigated the effects of training (Video and Lecture/Practice) on modifying working behaviors and biomechanical stress. Two tasks were examined (wheelchair to bed and lift up in bed) with two types of assistance (one-person or two-person) and two levels of patient's dependence (semi-dependent or dependent). Changes in behaviors were examined immediately following training (1-2 days delay) and after a short period of time (4-6 weeks) and evaluated using the criteria of subjective ratings of exertion, and postural and biomechanical measures. Results indicated that training led to several significant changes in the knee, hip, elbow and torso angles, whole body, shoulders and low back RPE, shear forces and shoulder moments. No differences were observed in these measures after a short period of time, suggesting retention of the information presented during the training programs. Results as a whole suggest that training can positively affect the working postures and biomechanical stress during common patient handling tasks. All the postural changes and biomechanical measures were advantageous in terms of reducing musculoskeletal stress. It was also found that after a short period of time (4-6 weeks) still retained the information presented during the training programs. Training using a combination of lecture and practice in some cases achieved better results than Video-based training.