when it comes to safe patient handling, what does it take to perform this task ergonomically?
Int J Environ Res Public Health. 2020 Jul; 17(fourteen): 4971.
Healthcare Workers and Manual Patient Handling: A Pilot Study for Interdisciplinary Preparation
Maria Grazia Lourdes Monaco
iiiOccupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
Daniela Feola
4Occupational Doctor in Healthcare Setting, 40138 Bologna, Italy; moc.liamg@daloef
Dino Della Ventura
5Section of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; moc.em@arutnevalledonid
Received 2020 May 31; Accepted 2020 Jul vii.
Abstract
Transmission patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to advise an MPH training model involving interdisciplinary aspects. A scheduled grooming plan was performed with 60 healthcare workers (HCWs) from a infirmary in Naples, Italia, providing training divided into iii sections (occupational wellness—section 1; physical therapy—section 2; psychosocial section—department three) and lasting vi hours. L-ii HCWs performed the training session. In section i, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural belch of the anatomical areas most involved in MPH. The last department provided teamwork consolidation through a office-playing do. The training plan could too exist useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct whatever incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH take chances exposure and also underlines the demand for standardization of this formative model, which could represent a useful tool for studying the existent effectiveness of training in workplaces.
Keywords: healthcare workers, manual patient treatment, occupational gamble preparation
one. Introduction
Manual patient handling (MPH) is ane of the major occupational risks for healthcare workers (HCWs). According to the sixth European Working Condition Survey (EWCS), several working tasks are performed in lifting or moving people. Ane caption could be the contempo expansion of the intendance sector in Europe, where a number of occupations require these types of tasks. According to the European survey, an increase in the per centum of workers involved in MPH (up to 10%) could exist observed, and this is the but posture-related risk among those included in the EWCS that is shown to be on the increase. In detail, the percentage of female workers involved in MPH tasks for ane-4th to three-fourths of their working time is 9%, double that of men [1].
These exposure data account for the high percentage of musculoskeletal disorders (MSDs) in some categories of workers. The work-related musculoskeletal disorders (WRMSDs) in nursing workers are well reported in the scientific literature; the hateful almanac prevalence rates are 55% for low back hurting (LBP), 44% for shoulder pain, 42% for neck pain, 26% for upper extremity pain, and 36% for lower extremity pain [ii]. The year prevalence of low back pain in nurses has a mean of lxx%, and the lifetime prevalence ranges from 35 to 80%. Recurrence rates of low back pain in nurses exceed seventy% [3]. This prevalence charge per unit has been found in countries all over the world; moreover, LBP might outcome in activity limitation for over 50% of HCWs [4,5]. HCWs are committed to several workplace activities (i.e., patient hygiene, the pronation/supination of patients in intensive care units (ICUs), moving patients from beds to stretchers or wheelchairs, etc.) that expose them to a variety of factors and moving geometries associated to LBP development.
This intendance setting variability and the related range of involved handling tasks are challenges in assessing the safety of MPH conditions and in developing improvement programs, including specific training to all personnel [half dozen].
MPH and the required not-ergonomic postures involve cumulative spinal loads, ofttimes associated with lumbar disc structural degeneration and other disorders [seven].
According to the WHO biopsychosocial model, health status is granted by the integration of medical and social aspects. As plant in the International Nomenclature of Functioning, overall wellness can be illustrated by the following diagram (Figure ane) [8].
International Nomenclature of Performance—Paradigm of Overall Wellness.
The absenteeism or reduction of physical hazards in the workplace, e.g., when moving patients, is a goal of job quality. All HCWs (i.eastward., nurses, sanitary aides, helpers and technicians) develop personal characteristics through their experiences, values, attitudes, and biases that have significant effects on their communication with patients. Some HCWs' beliefs and attitudes are related to a complex relationship betwixt feelings and emotional responses in patient intendance, work organization, and risk exposure. These aspects need to be deepened in the gamble assessment because they could inspire interest in challenging clinical situations and physician self-intendance, which can ameliorate specific training.
The American Physical Therapy Clan (APTA) introduced in 2014 the standards recommendation for the development of safety patient handling (SPH) training programs and issued a position statement on the role of a physical therapist in these programs. Olkowski et al. [ix] stated that physical therapists determine the well-nigh appropriate handling method for both patients and HCWs and they train HCWs in the use of SPH equipment and practices, participate in SPH programs, and could be involved in SPH policy. Moreover, several studies have investigated the effectiveness of physical training in improving the capabilities for transmission handling, often highlighting benign effects resulting from customized exercises, in terms of improved physical capacity for manual handling tasks [10,eleven].
According to Clemes et al., high priority should be given to developing and evaluating multidimensional interventions, incorporating do training, conducted in a multidisciplinary way, to promote forcefulness and flexibility, involving a physical therapist during the course and exploring practical exercises that could be performed at home or while working [12].
The culture of safety in the workplace undoubtedly influences the shared perceptions of workers within a specific healthcare setting. Consequently, hospitals must increase their focus on ecology and organizational aspects by incorporating a specific training program, which needs to be administered continuously, and taking care of aspects aimed at creating a safe civilisation that involves condom patient handling and mobility tasks [xiii].
Healthcare settings predispose HCWs to psychological effort and stress, making nursing a high-gamble occupation. This often results in a deterioration of the relational and teamwork skills that underlie the cooperation and sharing of some risk exposures, such as MPH. Very often, in fact, numerous bedside operations (i.east., therapeutic maneuvers or patient bedside hygiene) require the involvement of multiple operators, simultaneously. Coordination in these operations is necessary for the reduction of adventure exposure. An impaired human relationship capacity may occur in the risk perception, deteriorating the perception itself. Useful teamwork is therefore the ground for sharing the risk amidst the operators. Communication and cooperation within an exposed grouping to MPH, especially for tasks involving the simultaneous activity of two operators, is activated by the relationships that are established betwixt the workers; information technology is not just simple information sharing, but it is a complex social phenomenon influenced by the emotional, cultural, and social background of the participants and by the context in which it occurs. Moreover, Lee et al. showed that the safety climate in workplaces was the most influential factor associated with safe patient treatment behaviors among disquisitional intendance nurses [14]; a positive organizational safety climate, a people-oriented civilisation, and ergonomic practices were significant factors for condom patient handling behaviors among hospital nurses [xv].
The number of patient-treatment activities per day was a hard measure in adventure assessment; this chance exposure could be assessed by single questions directly addressed to operators. Various assessment methods accept been developed over the years. These methods present several limitations; for instance, some aspects of HCWs' physical piece of work demands, such as non-ergonomic trunk postures that may generate a relatively high mechanical load on the dorsum, were underestimated within some evaluation assessments. HCWs often perform physical tasks that are considered complex, unplanned, and unpredictable.
Many authors recommend that specific MPH training plays a key role in prevention programs related to transmission handling [16,17]; these programs might prove transfer techniques practice for all staff and provide feedback on the skills of trained staff [18]. In many countries, such as the United states of america, there is no standardized method for training in MPH, despite the loftier incidence of injury. In Italy, the MPH preparation programs are often non-specific and accept more care of the legislative and theoretical aspects than the practical ones. In addition, the practical skills are always aimed at training in the use of technical aids, with less impact on the postural gesture linked to the correct motion of the patient. Targeted exercises and physiotherapeutic techniques of postural reprogramming are undoubtedly recommended for LBP treatment, management, and chronicity prevention, more specifically in HCWs exposed to MPH. HCWs who had less education, strength grooming, and fitness levels had a lower adherence to do programs designed based on prevention risk. Motivational strategies should be targeted at these persons, even scheduling specific work training related to MPH exposure risk [19].
However, elaborating this program is complex, as information technology requires in-depth knowledge about the workplace and the work organization, the shifts carried out, the clinical and psychological conditions of the personnel involved, the gamble assessment, and the hazard perception that these workers have most their condition. On-the-job grooming would have a greater affect than, for example, a not-contextualized education. The nature of training, i.e., theoretical, applied, or both, must also be considered to optimize cognition application and favorize the opportunity of applying cognition in real settings. Resnick et al. likewise identified workplace constraints that can hinder the implementation of preventive practices. For case, participants mentioned that the difficulty of accessing equipment, likewise as overcrowded workspaces, specially for in-abode care, complicates the awarding of the preventive practices they take learned [20]. Other scientific data confirm that the work surroundings can influence the application of preventive measures [17].
Thus, each specific training plan carried out in the workplace should be thoroughly planned and not exist exclusively due to legal obligation. Training and education programs are widely adopted as key injury prevention strategies. Training aimed at refuting incorrect attitudes and reconditioning daily operational gestures could be a chief objective of training programs for HCWs exposed to MPH risk, such equally the model proposed in this paper.
The aim of this pilot study was to assess the feasibility of an interdisciplinary MPH training model, in society to define a standardized model that can be generally proposed to workplaces.
2. Methods
ii.ane. Setting and Study Pattern
The pilot study was carried out in a Southern Italian infirmary (Naples, Italy) in November 2018 and enrolled 60 HCWs. Within the telescopic of the mandatory training for HCWs exposed to MPH, an innovative interdisciplinary program was created. This training model was proposed and approved by the Hospital Wellness Management. The program was divided into three sections with a full duration of 6 h, according to specific Italian regulations. Each module lasted ii h and consisted of theoretical and practical parts, focusing on 3 aspects: (a) acquiring theoretical knowledge and updates on patient-centered treatment according to the WHO BioPsychosocial Health Model; (b) learning manual, technical, and practical skills for the dynamic patient–environment–worker interaction and physical effort evaluation, through techniques of global postural reprogramming according to the Mézières method; (c) improving the relational and chatty skills within the working grouping.
A scheme of the training plan is summarized in Figure 2.
An occupational physician coordinated section i. This section was developed in ii parts. The first role, lasting 60 min, was dedicated to a frontal lesson in which, later a brief mention of the biomechanical overload problems in the workplace and the primary related risks, the cess of the current MPH and the inanimate loads risk in the hospital were illustrated. In the side by side 60 min, the HCWs filled out a grade on the risk perception near MPH. It was a self-administered questionnaire that consisted of a free grid, in which the workers had to represent three of the worst handling conditions they had ever perceived; each free particular was then accompanied by a score according to the Borg c10 scale, appropriately illustrated [21]. For each section, the country of the art concerning biomechanical risk assessment was described. The authors used this preparation moment to illustrate to all participants the results of the biomechanical risk assessment, carried out through validated methods, such every bit the "Elevator Alphabetize" by National Found for Occupational Safety and Health (NIOSH) for load handling and the "Movement and Aid of Infirmary Patients" (MAPO) index for MPH take chances assessment; subsequently, after collection of the Borg calibration results, a comparison was made between the assessed risk using NIOSH/MAPO and the perceived take chances evaluated on-site using the Borg calibration. This comparison was and then commented on via an interactive arroyo between the teacher and learners. Later the terminate of the training program, all these data were discussed with the hospital'due south Wellness and Rubber Department and included in the gamble cess document as a participatory arroyo to take chances assessment in this issue.
A physiotherapist coordinated department ii of the training program. At commencement, the principal techniques of patient handling were illustrated; afterwards, the HCWs were trained on the aforementioned correct handling maneuvers [22] as well every bit the postural/overload unloading training through some of Mézières' basic global postural reeducation techniques.
The terminal module (section three) was conducted past a psychotherapist, who focused on the theoretical part of the problems inherent in adventure perception and on the practical part related to assertive advice and office playing for teamwork improvement [23].
Data were reported according to the STROBE statement guidelines for reporting observational studies [24].
2.two. Training Model Evaluation
To evaluate the proposed model, several aspects were simultaneously taken into account. Outset, a final satisfaction questionnaire, developed past the authors, was administered to all participants at the cease of the form. This survey consisted of 6 questions, each with five closed answers (with five items—strongly agree, concord, neutral, disagree, strongly disagree) and three open-ended questions. Another variable was the adherence to the interdisciplinary preparation program vs. standard (HCWs participation percentage).
Last but not to the lowest degree, the management elaborated a cost-effectiveness analysis of the training program proposed.
2.3. Ethics
This pilot study was conducted within the mandatory training workers' program co-ordinate to Italian constabulary [25]. The research was performed following the upstanding standards laid down in the 1964 Declaration of Helsinki and its subsequently amendments.
2.4. Statistical Analysis
Information were analysed using SPSS ver. 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY, USA: IBM Corp.). Descriptive analysis and continuous variables were given every bit the mean ± standard deviation (SD), and categorical variables were given as the absolute value and relative frequency.
3. Results
The full sample enrolled for training was made upwardly of threescore HCWs. 8 workers did not consummate the course (iii were ill at the scheduled date, and five of them were not available for personal reasons and preferred to be rescheduled for the next grooming course, performed in the regular style). Twenty-five men and 27 women (mean age 49.4 (SD ± 7.2) and 45.9 (SD ± 8.8), respectively) were finally engaged. The cohort group had a hateful job seniority of about 24.6 years (SD ± viii,ane) and a median age of 26.five years (range: 7–38). Enrolled workers came from several infirmary departments involved in MPH, such as surgery (orthopedics, bariatric surgery, etc.), maternal-fetal medicine, medicine and health services, and physiotherapy, where bedridden patients are hospitalized.
3.ane. Grooming Plan—Occupational Medicine Section
Figure iii shows the questionnaire results. Letters from A to F evidence the Borg's scale scores attributed to the job categories by the subjects enrolled in the written report. The virtually represented tasks include patient lifting (n.thirty answers; Borg CR-10: hateful: 7.66 (±i.80); median: 7; range: four–ten), bed/stretcher transferring (n.22 answers; Borg CR-10: mean: 7.27 (±2.25); median: 7; range: 3–10), and patient bed hygiene (due north.11 answers; Borg CR-x: mean: 8.36 (±1.50); median: 8; range: 5–ten), which are tasks perceived equally heavier.
Answers provided by healthcare workers (HCWs) to the questionnaire. A–H each box refers to a task identified by the HCWs as overloading. The abscissa axis shows the reference number of the HCW. The ordinate axis shows the value of the Borg scale (Borg CR-10) attributed by each worker to the task.
Overall, activities such equally the handling of medical/emergency trolleys and materials supply, which are involved in inanimate load moving, are considered to pose less risk within the sample examined (n.xiii answers; Borg CR-10: mean iii.76 (±1.58); median: 3; range: ii–7). Lastly, for the staff of the maternal-foetal ward (Figure 3-H) there is a lower perception of the MPH take chances, given the minor weight of the patients, compared to the movement of inanimate loads (as incubators).
3.2. Grooming Plan—Physiotherapy Section
This program was carried out by a physiotherapist and lasted a total of ii hours. Participants were divided into four groups of 13 people. The first office (ane h) was characterized by frontal grooming on the general principles regarding the correct bedside posture gesture and the correct illustrated movements of the patients following specific manuals [22]. Afterwards, for the practical part, the postural discharge exercises were illustrated and conducted according to the postural reprogramming theories in the Mézières method. These exercises tin be resumed cyclically inside specific routine training that will be carried out autonomously in the hospital or at home. Effigy 4 and Figure 5 show 2 examples of taught activities for postural belch, respectively, for the lumbar spine, which is well-nigh affected past biomechanical overload [26], and for the shoulder-humeral girdle.
An example of an practise performed past the physiotherapist during department two of the training. Lumbar stretching according to the Méziéres method.
An example of an exercise performed by the physiotherapist during section two. Codman's (pendulum) exercises.
3.iii. Preparation Program—Psychological Section
The final section focused on the need to correctly perceive the take chances and to establish useful teamwork in lodge to reduce any incorrect practices in terms of patient handling. First, a theoretical session was carried out (1 h); the importance of risk perception and the differences betwixt the perceived risk and the real working environment were illustrated. The theory of assertiveness [27] was also introduced in society to explain the next session. The practical session involved the participants divided randomly into four teams, who had been assigned a single specific objective related to the office-playing action. According to the proposed scenario, each worker had to imagine themselves as part of the crew of a spacecraft having landing problems, i of the solutions for which was to remove part of the load of the spacecraft, consisting of necessary appurtenances such as h2o, oxygen, freeze-dried food, wear, and drugs. Each group was asked to achieve a unanimously shared conclusion well-nigh the elimination of the objects described above, each supposedly indispensable. Finally, the three groups had to come to a unanimous understanding, showing a adept level of teamwork. One group showed critical bug by not reaching a shared decision. A debriefing session to finally talk over the results of each group was carried out.
3.4. End of Course Evaluation
Equally shown in Figure vi, the feedback was overwhelmingly positive. Several suggestions coming from the open up-ended questions concerned the course duration, in particular regarding department ii, as emerged from open up questions (vi HCWs straight requested longer training by the physiotherapist).
Satisfaction questionnaire results.
Equally for the training participation, only three of the 55 workers available (amidst 60 HCWs involved, v were non bachelor for personal reasons) expressly preferred to enrol in the standard training program, with an adherence rate of 94.5%.
Finally, the hospital direction carried out a cost-effectiveness assay. Although the final direct costs were higher than the standard course previously conducted, due to the need for a multidisciplinary teaching team and the division of workers into small groups, the management reported that the innovative methodological approach was sustainable as well as the standard one.
four. Discussion
Healthcare organizations worldwide are increasingly focusing on strategies to create a safe patient handling culture in workplaces. All the same, the WRMSD rate amidst HCWs continues to increase despite efforts concentrating on valid MPH preparation and education. European regulations legislate the necessity of specific grooming programs to inform all workers about the risks to which they are exposed, the working procedures and standards that must be observed, and personal protective equipment and their specific use. Thus, specific training is, in fact, an important attribute of occupational health and safety and represents a critical cistron in prevention processes within organized structures, including healthcare settings. Ziam et al. showed some disquisitional issues: the basic MPH education taken at college and university, as well as on-the-job grooming, appears inadequate due to lack in context and duration of training performed; WRMSD prevention training is not a 'business organisation' and is rather rare in the real job context [28].
It is therefore articulate that MPH grooming could play an of import role in workplace prevention. Training programs could as well exist useful for adventure assessment itself, equally they could examine the perceptions of the specific risk of the diverse workers and wrong attitudes and therefore correct whatsoever uncorrected procedures, reducing the exposure to specific risks in the field. Even so, the training programs are non standardized worldwide, both in terms of content and preparation approach.
This pilot written report allowed united states to experiment with a multidisciplinary approach focused on several preventive steps, such as the cess of risk, its perception, and some "concrete therapy strategies" for reducing WRMSDs.
iv.ane. Training Program—Occupational Medicine Section
In our opinion, the results from this training department should be useful to produce a better contribution to chance assessment; on the basis of the information provided by the questionnaire, it was concluded that the nigh perceived chance was the transmission handling of the non-collaborating patient, according to cess results; the operators involved in this blazon of movement (general medicine, post-surgical department, and ICUs) agreed to assign a score of x to the Borg c10 scale. Moreover, the transposition of the crippled patient (for example, from the bed to the stretcher) and the patients' bed hygiene are perceived as heavy. The MPH tasks have a variable motion geometry, often attributable to one of 3 groups, i.eastward., lifting, repositioning, or turning, with unlike levels of elevation net torque and compression at the lumbar, particularly at the L4/L5 joint. Patient lifting produces spinal compressive force and anterior/posterior and lateral shear forces at the L4/L5 and L5/S1 disks, as shown by biomechanical evaluations [29].
Past highlighting the risk perception related to a single MPH task, information technology might be possible to atomic number 82 a hazard cess review and to modify some incorrect attitudes held by employees in a existent job context. User condolement and perceived concrete exertion are necessary for a full risk assessment. Visual analogue scale (VAS) and Borg's concrete effort rating scale are useful for a quick assessment of the furnishings of handling and working posture [30]. These scales must be included equally an integral part of MPH risk assessment for their feedback role in work settings. The rating of perceived exertion in the depression back that includes the kinematics of the lumbopelvic–hip complex during patient transfer needs to be measured using Borg's CR-10 scale [31]. Our results are consistent with literature data [32]. It should be noted that, with regard to the percentage of workers who had non indicated patient lifting every bit critical, near of them came from departments in which these tasks were assessed as low risk (east.thou., maternal-fetal and health services departments).
In this occupational context of the "doubtfulness" of evaluation methods, the office of training seems to be a master attribute of prevention interventions. Smedley et al. reported that improving the manual-treatment training program and extending the apply of patient-handling equipment in the wards "may non have the desired furnishings on piece of work methods or on the rates of back symptoms, at to the lowest degree in the brusk term" [33]. However, in our opinion, these training programs demand to be customized in club to exist effective, according to the operational needs of the various hospital departments, the handling aids made available to the staff, the characteristics of the patients to exist treated, and, last but not least, the awareness of HCWs to risks related to the handling tasks. MPH must accept an interdisciplinary approach, as it must exist safe for both the operators and the patients themselves. In a new interpretation of patient handling, the transition from operator-centered to person-centered handling eliminates factors that hinder the autonomy of the patient in the therapeutic, organizational, and relational environment, and the use of autonomy aids effectively eliminates or reduces the need for MPH.
4.2. Training Programme—Physiotherapy Section
Preparation programs are often focused on education about trunk mechanics and patient handling techniques and remain the preferred prevention arroyo to reduce LBP in HCWs [34]. In some literature reviews [35,36], specific grooming in handling techniques is included as worker-directed preventive measures, such every bit training in the proper use of patient handling equipment and the presence of peer leaders.
As shown in the concluding satisfaction survey, the practical session conducted by the physiotherapist represents one of the well-nigh valuable training moments in the overall preparation program.
The model of training programs and their content are ofttimes centered around teaching patient handling techniques only. The approaches may vary: preparation may besides be theoretical regarding legislative orientation, biomechanical and ergonomic principles, or equipment use, with but a curt applied session apropos moving techniques. The literature shows that this method, when used in isolation, not focusing on applied sessions, has consistently failed to reduce MSDs in nursing staff [37]. Other training programs directly and actively involve all participants focusing on physical exercises such as muscle preparation, stretching, and endurance. These exercises tin be done at dwelling or in the workplace [38]. To date, these training programs can vary significantly from ane healthcare setting to another in terms of frequency and duration.
iv.iii. Training Plan—Psychological Section
The scientific literature suggests that private workers' safety practices are affected by organizational and psychosocial job factors. One of the most prominent bug regarding MPH in healthcare workplaces is the lack of support from colleagues, and this represents a pregnant bulwark to the implementation of MSD prevention practices. Teamwork oft depends on the working atmospheric condition in each setting.
The emergency situations could represent a stressful job setting that often does not modify behavioral attitudes, which often leads to unsuitable postural gestures. In this context, wrong chance perceptions are as well associated, leading to the persistence of incorrect patient moving. Garg et al. [34] have reported that nurses experience high stress on the shoulder and lower back during manual patient lifting and transfer. Performance and motivations are aspects that should be included in specific training related to risk exposure. In particular, the workers' shared perceptions nearly their safety in the workplace have been associated with higher incidences of safe work practices in various healthcare settings [39,forty].
The qualitative aspects of the communication exchange oft escape awareness, compromising the effectiveness of the interaction. Assertive advice is a full and complete manifestation of oneself, functional with respect to the legitimate affirmation/expression of 1's rights, interests, feelings, and behavior, avoiding the violation or denial those of others, without feet or guilt. 2 meanings coexist here: (1) to affirm and to make explicit ane's opinions and attitudes and (two) to remain committed to positively resolving problematic situations.
Training on a specific risk cistron, such every bit MPH, should also examine the aspects of relational competence within a circuitous relational setting in the workplace. The illustration of the assertiveness theory was the ground for proposing the practical session of role-playing, according to the methods described in the results. Indeed, function-playing allows for ascertainment of the ability to trouble-solve and demonstrate skillful cooperation during interactions.
Roleplay ofttimes indicates how difficult it tin exist to assess a shared decision regarding moving a patient in a routine scenario, or in an emergency. In improver, office-playing in supervised groups is a helpful tool to promote reflection and insight non simply for the HCWs' roles, but likewise for peers observing critical problems at the terminate of group sessions [41]. In our experiment, a debriefing session conducted with the grade later on the role-playing scenario provided positive feedback. This clinical role play facilitates teamwork, which increases involvement, self-efficacy, and empathic abilities in healthcare settings and in shared risk exposures.
There is a lack of empirical evidence regarding role-playing and its effectiveness in teamwork improvement. However, the agreement within the groups was considered as an alphabetize of the achievement of the planned goal.
Still, there are critical issues regarding specific MPH preparation. A 2010 systematic review plant that manual handling training is largely ineffective in reducing LBP, with considerable evidence supporting the fact that the principles learnt during preparation are non applied in the piece of work environment [42]. In our opinion, this statement could be related to the type of work training. In this work, we showed that in that location is no standard programme for MPH grooming. This pilot report proposes a model that can be standardized and highlights how the three grooming moments, i.e., occupational medicine, the physiotherapist, and the session defended to improving risk perception and teamwork activities, must be considered as a unique formative moment that improves overall MPH, as it explores all the dynamics (legislative, concrete, and psychological) connected to this take a chance exposure.
Moreover, some studies take demonstrated that grooming is more than cost-effective than engineering controls simply that the overall effectiveness of training remains low [43]. In our opinion, this is attributable to a lack of standardization among training courses, which are nevertheless not sufficiently setting-oriented. This drawback, furthermore, does non allow in-depth studies on the real outcomes of specific training, considering MPH grooming is overly heterogeneous, even inside the same nation.
The scheduling of specific HCWs training should exist customized for groups of workers and not generically provided by occupational physicians or wellness departments inside hospitals. They should also directly involve the training of all staff. Information technology is of import to devote adequate fourth dimension to pedagogy, prioritizing HCWs' occupational health and ensuring that the workforce is adequately trained and good for you [44].
4.4. Strenght and Weaknesses
This pilot written report supports the feasibility of an interdisciplinary didactic approach, counterbalanced in three phases that explore all aspects of adventure exposure and that can be easily reproduced in a healthcare setting. Our training program proposal shows that the standardization of MPH model preparation could be useful to better study several outcomes, such every bit toll-effectiveness, the WRMSD prevention rate, and workers' overall on-the-task comfort. Although the final direct costs were higher but sustainable, as already reported, information technology should be considered that, in this experience, all the teachers were external consultants to the hospital, due to a lack of appropriate staff within the hospital. However, in medium and large healthcare companies, internal professionals could be recruited, thus significantly reducing the costs incurred.
In improver, the participants' satisfaction and the possibility of modifying wrong individual work attitudes induced the health management department to approve the continuation of this preparation program in the same fashion for subsequent courses. Having the aforementioned training model for a long ascertainment menstruation volition allow the enterprise to straight monitor all the outcomes of interest, including, above all, the WRMSD prevention charge per unit.
The main limit of the study lies in the objectification of the end results, in particular regarding sections ii and iii of the training programs. It is necessary to employ this proposed arroyo to conduct prospective longitudinal studies in guild to reinforce these concluding results.
5. Conclusions
Interdisciplinary MPH training was plant to play a primal role in the awarding of MSD prevention and needs to be adapted according to the private, the organization, and the context. Indeed, it is fundamental that WRMSD prevention measures are contextualized to each workplace, offering training adapted to different risk perceptions, clinical conditions, and teamwork levels. This pilot written report offers an innovative preparation model underlining the need to standardize this specific aspect of occupational health so equally to improve study the outcomes in terms of effectiveness and feasibility. In our opinion, for this achievement, the proposed training program might be shared past international scientific community.
Abbreviations
| HCW | health care workers |
| LBP | low dorsum pain |
| MPH | manual patient handling |
| WRMSDs | piece of work-related musculoskeletal diseases |
| SPH | safe patient treatment |
| WHO | World Health System |
Author Contributions
Conceptualization: Eastward.Yard.M. and One thousand.Thousand.L.M.; methodology: E.Thou.G. and M.Thousand.50.G.; formal analysis: East.M.G., D.F., and Thousand.G.L.Thousand.; investigation: E.M.G., D.D.V., and F.D.; data curation: Due east.M.One thousand., D.F. and Grand.Chiliad.L.M.; writing—original draft preparation: E.M.Thousand. and G.G.L.M.; writing–review and editing: E.Grand.G., M.G.L.Thousand., K.Fifty., A.R.C., and N.1000.; supervision: E.M.G., M.G.L.One thousand., and M.50. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Conflicts of Interest
The authors declare that at that place are no conflicts of interest.
References
1. Eurofound . Sixth European Working Weather condition Survey—Overview Report. Publications Part of the Eu; Brussels, Belgium: Luxembourg: 2017. [Google Scholar]
two. Davis Chiliad.G., Kotowski Due south.E. Prevalence of musculoskeletal disorders for nurses in hospitals, long-term care facilities, and abode wellness care: A comprehensive review. Hum. Factors. 2015;57:754–792. doi: 10.1177/0018720815581933. [PubMed] [CrossRef] [Google Scholar]
3. Van Hoof W., O'Sullivan Thou., O'Keeffe Thousand., Verschueren Southward., O'Sullivan P., Dankaerts W. The Efficacy of Interventions for Depression Back Pain in Nurses: A Systematic Review. Int. J. Nurs. Stud. 2018;77:222–231. doi: 10.1016/j.ijnurstu.2017.10.015. [PubMed] [CrossRef] [Google Scholar]
4. Alnaami I., Awadalla N.J., Alkhairy M., Alburidy S., Alqarni A., Algarni A., Alshehri R., Amrah B., Alasmari M., Mahfouz A.A. Prevalence and factors associated with low back hurting among health care workers in southwestern Saudi arabia. BMC Musculoskelet. Disord. 2019;20:56. doi: 10.1186/s12891-019-2431-v. [PMC complimentary article] [PubMed] [CrossRef] [Google Scholar]
5. Al Dajah Due south., Al Daghdi A. Prevalence and risk factors of low back hurting amidst nurses in Sudayr region. ESJ. 2013;9:198–205. [Google Scholar]
6. International Arrangement for Standardization . Ergonomics—Manual Handling of People in the Healthcare Sector. Iso/TR Certificate 12296. International Organization for Standardization; Geneva, Switzerland: 2012. [Google Scholar]
7. Hegewald J., Berge W., Heinrich P., Staudte R., Freiberg A., Scharfe J., Girbig M., Nienhaus A., Seidler A. Practise Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?—A Systematic Review of Intervention Studies. Int. J. Environ. Res. Public Wellness. 2018;fifteen:476. doi: 10.3390/ijerph15030476. [PMC gratis article] [PubMed] [CrossRef] [Google Scholar]
8. World Wellness System . International Classification of Functioning, Disability and Health, WHO Library Cataloguing-in-Publication Information International Classification of Functioning, Disability and Wellness: ICF. World Health Organisation; Geneva, Switzerland: 2007. [Google Scholar]
nine. Olkowski B.F., Stolfi A.G. Safety Patient Handling Perceptions and Practices: A Survey of Astute Care Concrete Therapists. Phys. Ther. 2014;94:682–695. doi: 10.2522/ptj.20120539. [PubMed] [CrossRef] [Google Scholar]
ten. Genaidy A.M., Mital A., Bafna K.Yard. An endurance training plan for frequent transmission carrying tasks. Ergonomics. 1989;32:149–155. doi: x.1080/00140138908966075. [PubMed] [CrossRef] [Google Scholar]
11. De Castro A.B., Hagan P., Nelson A. Prioritising condom patient handling: The American Nurses Association's Handle with Care Campaign. J. Nurs. Adm. 2006;36:363–369. doi: 10.1097/00005110-200607000-00009. [PubMed] [CrossRef] [Google Scholar]
12. Clemes Due south.A., Haslam C.O., Haslam R.A. What constitutes effective manual treatment training? A systematic review. Occup. Med. 2010;lx:101–107. doi: 10.1093/occmed/kqp127. [PubMed] [CrossRef] [Google Scholar]
xiii. Vendittelli D., Penprase B., Pittiglio L. Musculoskeletal injury prevention for new nurses. Work. Health Saf. 2016;64:573–585. doi: 10.1177/2165079916654928. [PubMed] [CrossRef] [Google Scholar]
fourteen. Lee S.J., Faucett. J., Gillen. Chiliad., Krause Northward., Landry L. Factors associated with safe patient handling behaviors amongst critical care nurses. Am. J. Ind. Med. 2010;53:886–897. doi: 10.1002/ajim.20843. [PubMed] [CrossRef] [Google Scholar]
fifteen. Lee Southward.J., Lee J.H. Safe patient handling behaviors and lift use among hospital nurses: A cross-sectional written report. Int. J. Nurs. Stud. 2017;74:53–60. doi: 10.1016/j.ijnurstu.2017.06.002. [PubMed] [CrossRef] [Google Scholar]
16. D'Arcy L.P., Sasai Y., Stearns S.C. Do assistive devices, training, and workload impact injury incidence? Prevention efforts by nursing homes and back injuries amongst nursing assistants. J. Adv. Nurs. 2012;68:836–845. [PMC free article] [PubMed] [Google Scholar]
17. Thomas D.R., Thomas Y.50.N. Interventions to reduce injuries when transferring patients: A critical appraisement of reviews and a realist synthesis. Int. J. Nurs. Stud. 2014;51:1381–1394. doi: 10.1016/j.ijnurstu.2014.03.007. [PubMed] [CrossRef] [Google Scholar]
xviii. Carta A., Parmigiani F., Roversi A., Rossato R., Milini C., Parrinello Yard., Apostoli P., Alessio L., Porru Southward. Training in safer and healthier patient handling techniques. Br. J. Nurs. 2010;xix:576–582. doi: 10.12968/bjon.2010.nineteen.9.48057. [PubMed] [CrossRef] [Google Scholar]
19. Taulaniemi A., Kankaanpää M., Rinne Thousand., Tokola Thousand., Parkkari J., Suni J.H. Fear-avoidance behavior are associated with do adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low dorsum pain. BMC Sports Sci. Med. Rehabil. 2020;12:28. doi: ten.1186/s13102-020-00177-w. [PMC costless commodity] [PubMed] [CrossRef] [Google Scholar]
20. Resnick 1000., Sanchez R. Reducing patient handling injuries through contextual preparation. J. Emerg. Nurs. 2009;35:504–508. doi: 10.1016/j.jen.2008.10.017. [PubMed] [CrossRef] [Google Scholar]
21. Nastasia I., Lortie Chiliad., Delisle A., Gagnon Thou. Perception and Biomechanics Information in a Transmission Handling Chore: A Comparative Study. Ergonomics. 2007;50:2059–2081. doi: 10.1080/00140130701369387. [PubMed] [CrossRef] [Google Scholar]
22. Paul D. Metodo di Movimentazione del Malat. Piccin; Padua, Italy: Oct, 2008. [Google Scholar]
23. Mann Grand., Gordon J., MacLeod A. Reflection and reflective practice in health professions education: A systematic review. Adv. Health Sci. Educ. 2009;14:595–621. doi: ten.1007/s10459-007-9090-2. [PubMed] [CrossRef] [Google Scholar]
24. Von Elm E., Altman D.G., Egger K., Pocock S.J., Gøtzsche P.C., Vandenbroucke J.P. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann. Intern. Med. 2007;147:573–577. doi: 10.7326/0003-4819-147-8-200710160-00010. [PubMed] [CrossRef] [Google Scholar]
26. Jäger M., Jordan C., Theilmeier A., Wortmann N., Kuhn S., Nienhaus A., Luttmann A. Lumbar-Load Analysis of Transmission Patient-Treatment Activities for Biomechanical Overload Prevention Among Healthcare Workers. Ann. Occup. Hyg. 2013;57:528–544. [PubMed] [Google Scholar]
27. Yoshinaga N., Nakamura Y., Tanoue H., MacLiam F., Aoishi Chiliad., Shiraishi Y. Is modified brief assertiveness training for nurses constructive? A unmarried-group study with long-term follow-up. J. Nurs. Manag. 2018;26:59–65. doi: 10.1111/jonm.12521. [PubMed] [CrossRef] [Google Scholar]
28. Ziam South., Laroche Due east., Lakhal S., Alderson K., Gagne C. Awarding of MSD prevention practices by nursing staff working in healthcare settings. Int. J. Ind. Ergon. 2020;77:102959. doi: 10.1016/j.ergon.2020.102959. [CrossRef] [Google Scholar]
29. Skotte J.H., Essendrop M., Hansen A.F., Schibye B. A dynamic 3D biomechanical evaluation of the load on the depression back during different patient-handling tasks. J. Biomech. 2002;35:1357–1366. doi: 10.1016/S0021-9290(02)00181-1. [PubMed] [CrossRef] [Google Scholar]
30. Salmani Nodooshan H., Choobineh A., Razeghi M., Shahnazar Nezhad Khales T. Designing, prototype making and evaluating a mechanical assist device for patient transfer betwixt bed and stretcher. Int. J. Occup. Saf. Ergon. 2017;23:491–500. doi: x.1080/10803548.2016.1274161. [PubMed] [CrossRef] [Google Scholar]
31. Kang Yard.H., Choi South.H., Oh J.S. Postural taping applied to the low back influences kinematics and EMG activeness during patient transfer in physical therapists with chronic low back pain. J. Electromyogr. Kinesio. 2013;23:787–793. doi: 10.1016/j.jelekin.2013.02.009. [PubMed] [CrossRef] [Google Scholar]
32. Jordan C., Luttmann A., Theilmeier A., Kuhn Due south., Wortmann Northward., Jäger Thousand. Feature values of the lumbar load of transmission patient handling for the application in workers' compensation procedures. J. Occup. Med. Toxicol. 2011;six:17. doi: x.1186/1745-6673-half dozen-17. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
33. Smedley J., Trevelyan F., Inskip H., Buckle P., Cooper C., Coggon D. Touch on of ergonomic intervention on back pain amongst nurses. Scand. J. Work Environ. Health. 2003;29:117–123. doi: x.5271/sjweh.713. [PubMed] [CrossRef] [Google Scholar]
34. Garg A., Kapellusch J.One thousand. Long-term efficacy of an ergonomics programme that includes patient-handling devices on reducing musculoskeletal injuries to nursing personnel. Hum. Factors: J. Hum. Factors Ergon. Soc. 2012;54:608–625. doi: 10.1177/0018720812438614. [PubMed] [CrossRef] [Google Scholar]
35. Kuijer P.P., Verbeek J.H., Visser B., Elders 50.A., Van Roden N., Van den Wittenboer M.East., Lebbink M., Burdorf A., Hulshof C.T. An evidence-based multidisciplinary practise guideline to reduce the workload due to lifting for preventing work-related low back pain. Ann. Occup. Environ. Med. 2014;26:16. doi: x.1186/2052-4374-26-16. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
36. Nelson A., Baptiste A.S. Evidence-based practices for safe patient handling and movement. Online J. Problems Nurs. 2004;9:4. [PubMed] [Google Scholar]
37. Krill C., Raven C., Staffileno B.A. Moving from a clinical question to enquiry: The implementation of a safe patient handling programme. Medsurg Nurs. 2012;21:104–116. [PubMed] [Google Scholar]
38. Dawson A.P., McLennan S.Due north., Schiller Southward.D., Jull Chiliad.A., Hodges P.Westward., Stewart Southward. Interventions to prevent back pain and dorsum injury in nurses: A systematic review. Occup. Environ. Med. 2007;64:642–650. doi: 10.1136/oem.2006.030643. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
39. Seo D.C. An explicative model of unsafe piece of work behavior. Saf. Sci. 2005;43:187–211. doi: x.1016/j.ssci.2005.05.001. [CrossRef] [Google Scholar]
40. Felknor S.A., Aday 50.A., Burau K.D., Delclos Thou.L., Kapadia A.Due south. Safety climate and its association with injuries and safety practices in public hospitals in Costa Rica. Int. J. Occup. Environ. Health. 2000;6:xviii–25. doi: x.1179/oeh.2000.6.1.18. [PubMed] [CrossRef] [Google Scholar]
41. Rønning Southward.B., Bjørkly S. The use of clinical role-play and reflection in learning therapeutic communication skills in mental health education: An integrative review. Adv. Med. Educ. Pract. 2019;x:415–425. doi: x.2147/AMEP.S202115. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
42. Daniels G., Auguste T. Moving Forwards in Patient Safety: Multidisciplinary Squad Preparation. Semin. Perinatol. 2013;37:146–150. doi: x.1053/j.semperi.2013.02.004. [PubMed] [CrossRef] [Google Scholar]
43. De Oliveira Sato T., Ferreira Faisting A.L. Effectiveness of ergonomic training to reduce physical demands and musculoskeletal symptoms—An overview of systematic reviews. Int. J. Ind. Ergon. 2019;74:102845. [Google Scholar]
44. Novack D.H., Suchman A.Fifty., Clark Westward., Epstein R.M., Najberg Due east., Kaplan C. Calibrating the md. Personal awareness and constructive patient intendance. Working Grouping on Promoting Physician Personal Awareness, American Academy on Physician and Patient. JAMA. 1997;278:502–509. doi: 10.1001/jama.1997.03550060078040. [PubMed] [CrossRef] [Google Scholar]
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399987/
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