Examination of the role of the rotating nursing department in the training of nursing staff based on SWOT analysis.

BACKGROUND: The implementation of the rotation system in the Chinese medical industry has achieved significant results. OBJECTIVES: The present study aims to 1) explore the strengths, weaknesses, opportunities and challenges of rotational nursing department implementation and 2) provide references for developing nursing staff's competencies in leadership, performance evaluation, quality of care, communication in relationships and human resources. METHODS: A total of 16 rotational nursing department staff members from a tertiary tuberculosis specialist hospital in Beijing were interviewed, and the interview data were analysed using a strengths, weaknesses, opportunities and threats analysis and class analysis. RESULTS: The advantages of the rotational nursing department included: (1) stimulating the nursing staff's enthusiasm and creativity; (2) strengthening the communication and collaboration between departments; (3) improving the detailed management of nursing quality; and (4) enhancing the nursing staff's comprehensive abilities. The disadvantages included: (1) the design of the rotation programme focusing on practice; (2) a lack of personalisation; and (3) imperfect performance assessment of the rotating staff. Opportunities included: (1) deepening the connotation of nursing job management and (2) developing the construction of nursing discipline and the need for personal career development and value realisation. Threats included the lack of a sound rotation management model to draw on. CONCLUSION: A rotational nursing department is conducive to enhancing the competence of nursing staff in management positions and providing new ideas for hospitals to select and train nursing management talents. By taking full advantage of the benefits of vertical nursing management, designing personalised rotation training programmes, building a diversified learning and training platform and developing a positive performance incentive mechanism is recommended to fully engage the role of rotation in nursing management talent training.

Effect of Job Rotation Concept for Nursing Staff with Special Reference to Private Based Hospital, Vadodara.

Introduction: Employees are placed in various job rotations between two or more tasks or vocations at regular intervals to ensure that they are exposed to all elements of the company. Job rotation is a methodical approach that permits employees to avoid boredom while also allowing them to develop and grow. Both management and personnel objectives are met with this strategy. It aids in the identification of employee potential and abilities. Through job rotation, employees are exposed to all aspects of the company. Employee abilities and competencies are evaluated ahead of time to ensure that the employee is deployed in the best possible position. However, it does permit the pursuit of personal interests while gaining practical knowledge in a variety of industries or processes. The present study was undertaken with an aim to assess the effect of job rotation on the nursing staff in a private hospital of Vadodara. Methodology: The study was cross-sectional in nature where the perception of the nursing staff was gathered through a structured questionnaire. The questionnaire assessed the perception of the staff on a five point likert scale from strongly agree to strongly disagree. The sample size of the study was 126. Mann Whitney Test and Kruskal Wallis test was used to assess the effect of job rotation with respect to gender and age, years of experience respectively. The statistical analysis was undertaken at 95% confidence level with statistical significance at a p value of less than 0.05. Results: The results depicted that there was no difference in the perception towards effect of job rotation with respect to gender and age group. However, with respect to job rotation not interrupting the employees' work life and no effect on personal life, there was statistical significant difference with respect to the years of experience of the nursing staff as the p value was less than 0.05. Conclusion: Job rotation, in their opinion, causes frequent interruptions in both the job and personal life of those who participate in it. The nurses working in the hospital came up with appropriate job rotation ideas that took into consideration their age and years of experience. It appears that most of the criteria indicate that the nursing staff members were satisfied with their job rotation, which lends support to the findings of the study.

New work situations call for familiar work design methods: Effects of task rotation and how they are mediated in a technology-supported workplace.

New digital assistive technologies strive to alleviate the completion of work tasks but thereby often threaten to make jobs increasingly monotonous. To counteract jobs becoming more and more monotonous, task rotation might be an appropriate technology feature. However, it is uncertain whether task rotation has unique positive effects, why it works, and whether there are any boundary conditions. To investigate this, we conducted two experimental vignette studies. In Study 1 (N 1 = 135), we drew on the job characteristics model and self-determination theory to examine perceived task variety, skill variety, and task identity, and expected satisfaction of the need for competence as mediators of the effect of task rotation on anticipated employee attitudes (job satisfaction, intrinsic work motivation), behavior (subjective performance), and well-being (positive and negative affect). The investigated vignette described a job where a digital assistance system either indicated the task rotation or only supported work steps. Regression analyses showed direct effects of task rotation on expected job satisfaction, intrinsic motivation, and positive affect. There were indirect effects of task rotation on all outcomes except expected negative affect. We used Study 2 (N 2 = 159) as an exact replication of Study 1. Additionally, to investigate the boundary conditions of task rotation effects, we drew on person-job fit theory and investigated openness to experience as a moderator of the effects of task and skill variety on the outcomes. Regression analyses showed direct effects of task rotation on expected job satisfaction, subjective performance, and positive affect. There were indirect effects of task rotation on all outcomes except expected negative affect and intrinsic motivation. Thus, the results of Study 1 could only be partly replicated. Openness to experience did not moderate the effects of task and skill variety on the outcomes. The results support the relevance of task rotation as a technology feature and indicate that rotations should offer especially skill variety and task identity, as these were the strongest mediators in our studies.

Relationship between job rotation and work-related low back pain: a cross-sectional study using data from the fifth Korean working conditions survey.

BACKGROUND: Job rotation was introduced in various industries as a strategic form of work for improving workers' job skills and health management. This study aims to examine the relationship between job rotation and work-related low back pain (LBP), one of the typical work-related musculoskeletal symptoms of Korean workers. METHODS: We conducted this study using the data of the 5th Korean Working Conditions Survey (KWCS). As the subject of this study, 27,163 wage workers were selected, and classified into three groups according to occupational type (white-collar, service and sales, and blue-collar). In this study, job rotation means to change the work-related activities with other colleagues periodically and work-related LBP was defined as whether there was work-related LBP in the last 12 months. Chi-square test and logistic regression were used to analyze the relationship between job rotation and work-related LBP. RESULTS: Out of 27,163 workers, 2,421 (8.9%) answered that they had job rotation and 2,281 (8.4%) answered that they experienced work-related LBP. According to the results from logistic regression, job rotation was significantly associated with low prevalence of work-related LBP among blue-collar workers (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58-0.88), whereas no significant relationship was observed among white-collar, service and sales groups. In addition, the negative association between job rotation and work-related LBP among blue-collar workers was more pronounced when exposed to ergonomic risk factors (uncomfortable posture OR: 0.79, 95% CI: 0.64-0.98; heavy work OR: 0.74, 95% CI: 0.57-0.96; repetitive work OR: 0.74, 95% CI: 0.60-0.92). CONCLUSIONS: Job rotation was associated with low prevalence of work-related LBP among workers in the blue-collar occupational group in Korea. It is necessary to evaluate the effect of job rotation by occupational type and introduce an appropriate method of job rotation to reduce workers' work-related musculoskeletal symptoms.

Fatigue, Stress, and Performance during Alternating Physical and Cognitive Tasks-Effects of the Temporal Pattern of Alternations.

In occupational life, performing cognitive work tasks in between fatiguing physical work tasks may allow recovery and reduce stress without losing productive working time. The temporal pattern of such alternations is likely a determinant of the recovery effect, influencing both stress and fatigue; the difficulty of the cognitive task (CT) would also be a likely determinant. The aim of this study was to determine to what extent the temporal pattern of alternations between a repetitive physical task and a CT of different difficulties influenced perceived fatigability, performance fatigability, stress-related outcomes, and performance. Fifteen women performed four work sessions comprising 110 min of repeated bouts of a repetitive physical task (pipetting), alternating with a CT (n-back). Sessions differed in bout cycle time (short: 7 + 3 min versus long: 14 + 6 min) and CT difficulty (CTdiff; easy versus difficult). Fatigue was assessed from recordings of maximal voluntary contraction force in shoulder elevations and handgrip pre- and post-work, electromyography (EMG) from the right trapezius and right forearm extensors during work, and repeated self-ratings of fatigue and pain throughout the session. Stress was assessed using electrocardiography (heart rate variability), salivary alpha-amylase, and self-reports. Perceived fatigue increased significantly over time for all protocols and more in long-cycle than short-cycle conditions. EMG activity did not increase markedly over time in any condition. Neither objective nor subjective indicators suggested that stress increased over time, regardless of the temporal pattern. Pipetting performance remained stable in all conditions. Cognitive performance, measured by the proportions of correct positive and false positive answers, differed between CTdiff levels but remained stable over time, with no significant difference between temporal patterns. In summary, temporal patterns of alternating tasks influenced fatigue to some extent but had no obvious influence on stress indicators or performance. Thus, designing job rotation with alternating physical and cognitive work should consider the temporal patterns of alternations to minimize fatigue.

Validation of the Revised Strain Index for Predicting Risk of Incident Carpal Tunnel Syndrome in a Prospective Cohort.

The Revised Strain Index (RSI), a model that quantifies physical exposure from individual hand/wrist exertions, tasks, and multi-task jobs, was used to quantify exposure for 1372 incident-eligible manufacturing, service and healthcare workers. Workers were followed for an average of 2.5 years (maximum 6 years) and had an average carpal tunnel syndrome (CTS) incidence rate of 4.6 per 100 person-years. Exceeding the a-priori RSI limit of 10.0 showed increased risk of CTS (Hazard Ratio (HR) = 1.45, 95% CI: 1.11-1.91, p = 0.01). There also was a dose-response relationship using proposed low (RSI ≤ 8.5, HR = 1.00), medium (HR = 1.42 (95% CI: 0.96-2.09, p = 0.08)), and high limits (RSI > 15, HR = 1.79 (95% CI: 1.19-2.69, p = 0.01), respectively. RSI as a continuous variable showed CTS risk increased steadily by between 1.9% and 3.3% per unit increase in RSI (p ≤ 0.03). These results suggest that the RSI is a useful tool for surveillance as well as for job intervention/design and continuous improvement processes.Practitioner Summary The Revised Strain Index (RSI) quantifies physical exposure from individual hand/wrist exertions, tasks, and multi-task jobs. Increased cumulative RSI scores (i.e. daily exposure score) are associated with increased risk of carpal tunnel syndrome (CTS). The RSI is potentially useful as a risk surveillance and intervention design tool.

More Hype Than Substance? A Meta-Analysis on Job and Task Rotation.

Although there exist numerous publications on job and task rotation from various disciplines, there is no consistent evidence of their effectiveness. Drawing on theories from industrial and organizational psychology, knowledge management, ergonomics, and management science, we meta-analytically investigated relationships between job/task rotation and employee attitudes, learning and development, psychological and physical health, and organizational performance. Due to a conceptual overlap and frequent confusion of terminology, we analyzed the design of the rotation (job rotation vs. task rotation) as a possible moderator. The three-level meta-analysis on 56 studies (N = 284,086) showed that rotation was significantly associated with job satisfaction (r = 0.27), organizational commitment (r = 0.16), career success (r = 0.31), labor flexibility (r = 0.32), general psychological health (r = 0.20), stress/burnout (r = -0.13), individual performance (r = 0.13), and productivity (r = 0.13). Positive relationships between rotation and physical health could only be found when rotation was compared to high-intensity work. Task rotation yielded stronger relationships with attitudinal outcomes, job rotation with learning and development, psychological health, and organizational performance outcomes. Further moderator analyses showed that individualism decreased relationships between task rotation and attitudes, and correlations with organizational performance and physical health were stronger for subjective measures. The findings indicate that many expectations toward job and task rotation are not fully supported.

Job rotation approach in nursing profession.

BACKGROUND: The nursing profession still needs more attention from decision-makers to enhance satisfaction and commitment in the work environment. AIMS AND OBJECTIVES: This study aims to explore the perceived level of job rotation, job satisfaction, job commitment, job turnover and job conflict among nurses who previously had job rotation experience in Jordan. The study also investigates the correlation between studied variables and job rotation approach based on the type of hospitals. Furthermore, it also evaluates the contribution of job rotation, job commitment and many demographic factors in predicting job satisfaction among nurses who had job rotation experience in Jordan. DESIGN: The study adopted the cross-sectional survey design of the correlational type. METHODS: The study was performed on a stratified convenience sample of 786 nurses from five hospitals in Jordan. The scales used to explore the perceived level of studied variables were obtained from previously published studies, translated to Arabic language and then checked for validity and reliability before being used. RESULTS: Results show that job rotation, job satisfaction, job commitment, job turnover and job conflict are all found to be at high levels. Job rotation approach among nurses seems necessary since job satisfaction and job commitment are positively correlated with job rotation. Also, job commitment, job rotation and gender are identified as significant predictors of job satisfaction among nurses in Jordan. CONCLUSION: Nurses who experienced job rotation are found have high levels of job satisfaction and job commitment. However, job turnover is also found to be at high level which should be emphasised. Nurse leaders are advised to apply the job rotation approach by moving nurses between different departments in a planned manner to increase the level of job satisfaction and job commitment.

The Job Rotation of Nursing Staff and Its Effects on Nurses' Satisfaction and Occupational Engagement.

INTRODUCTION: Job rotation in nursing staff involves moving workers from one department to another to increase their qualities in all areas. AIM: Investigating the effects of job rotation of nursing staff on employee satisfaction and occupational engagement. METHODOLOGY: A total of 211 nurses took part in the study. A structured questionnaire with closed-ended questions was used to collect the data. The questions used were based on previous research tools. The data analysis was performed with the SPSS statistical package v.24.0. RESULTS: Τhe results regarding the correlation of job rotation, job satisfaction, and occupational engagement show that job rotation is positively related to occupational engagement and job satisfaction of nurses. The overall attitude of nursing staff toward job rotation is neutral, and they express moderate to neutral professional satisfaction, moderate degree of vigor and absorption, and moderate-to-high degree of dedication. Regarding the correlation of job rotation, job satisfaction, and occupational engagement with the demographic characteristics of nurses, it was found that the gender and years of work of nurses are not the factors that affect job satisfaction, occupational engagement, and job rotation. On the contrary, it was found that the age of nurses is a factor that only affects their work satisfaction, nursing education is a factor that only affects nurses' occupational engagement, and job position is a factor that affects nurses' occupational engagement and job rotation. CONCLUSIONS: The results highlight the importance of job rotation of nursing staff in their professional satisfaction and occupational engagement.

Stress-Related Responses to Alternations between Repetitive Physical Work and Cognitive Tasks of Different Difficulties.

Alternating between physical and cognitive tasks has been proposed as an alternative in job rotation, allowing workers to recover from the physical work while still being productive. However, effects of such alternations on stress have not been investigated. This controlled experiment aimed at determining the extent to which stress-related responses develop during alternating physical and cognitive work, and to determine the extent to which cognitive task (CT) difficulty influences these responses. Fifteen women performed three sessions of 10 consecutive work bouts each including a seven-minute repetitive physical task (pipetting) and a three-minute CT (n-back) at one of three difficulty levels. Stress was assessed in terms of changes in heart rate variability, blood pressure, salivary alpha-amylase, salivary cortisol, perceived stress, and cognitive performance. The work session did not result in any marked stress response, and CT difficulty did not significantly influence stress, apart from alpha-amylase being higher at the easiest CT (F = 5.34, p = 0.02). Thus, according to our results, alternating between repetitive physical tasks and cognitive tasks may be a feasible alternative to classic job rotation between physical tasks only, even if the cognitive task is quite difficult. Future studies should address possible effects of the temporal pattern of alternations, and combine even other occupationally relevant tasks, preferably for extended periods of time.

Designing Cyclic Job Rotations to Reduce the Exposure to Ergonomics Risk Factors.

Job rotation is an administrative solution to prevent work-related musculoskeletal disorders that has become widespread. However, job rotation schedules development is a complex problem. This is due to the multi-factorial character of the disorders and to the productive and organizational constraints of the real working environments. To avoid these problems, this work presents an evolutionary algorithm to generate rotation schedules in which a set of workers rotate cyclically over a small number of jobs while reducing the potential for injury. The algorithm is able to generate rotation schedules that optimize multiple ergonomics criteria by clustering the tasks into rotation groups, selecting the workers for each group, and determining the sequence of rotation of the workers to minimize the effects of fatigue. The algorithm reduces prolonged exposure to risks related to musculoskeletal injuries and simplifies the assignment of workers to different tasks in each rotation. The presented procedure can be an effective tool for the design of job-rotation schedules that prevent work-related musculoskeletal disorders while simplifying scheduled changeovers at each rotation and facilitating job monitoring.

Job rotation and work-related musculoskeletal disorders: a fatigue-failure perspective.

Job rotation is an organisational strategy that can be used, in part, to reduce occupational exposure to physical risk factors associated with work-related musculoskeletal disorders (MSDs). Recent studies, however, suggest that job rotation schedules may increase the overall risk of injury to workers included in the rotation scheme. We describe a novel optimisation framework evaluating the effectiveness of a job rotation scheme using the fatigue failure model of MSD development and a case study with real injury data. Results suggest that the effect of job rotation is highly-dependent on the composition of the job pool, and inclusion of jobs with higher risk results in a drastic decrease in the effectiveness of rotation for reducing overall worker risk. The study highlights that in cases when high-risk jobs are present, job redesign of those high risk tasks should be the primary focus of intervention efforts rather than job rotation. Practitioner summary: Job rotation is often used in industry as a method to 'balance' physical demands experienced by workers to reduce musculoskeletal disorder (MSD) risk. This article examines the efficacy of reducing MSDs through job rotation using numerical simulation of job rotation strategies and utilising the fatigue failure model of MSD development.

"Wow I had no idea"-How job rotation is experienced by nurses caring for elective orthopaedic patients: A qualitative study.

AIMS AND OBJECTIVES: To explore gains and impacts of job rotation through the experiences of involved nursing personnel responsible for different parts of care during the elective orthopaedic patient's pathway. BACKGROUND: When patients undergo elective orthopaedic surgery, they encounter nurses from different wards. So far, job rotation has only been described through the experiences of the job rotating nurses. This study includes all involved nursing personnel and bases the job rotation on the pathway of the elective orthopaedic patient. DESIGN: This study has an exploratory-descriptive and qualitative approach and follows the Consolidated Criteria for Reporting Qualitative Research guidelines. METHOD: A total of nine focus groups including 16 informants were conducted before, during and after a 5-month trial period. The data were analysed using thematic analysis. RESULTS: The findings show that existing work structures and work content combined with a lack of a common understanding of the job rotation impacted the expectations of the nursing personnel regarding (in)dependence, individual and collegial involvement and investment, as well as the collegial belongingness expressed through terminologies of "home" and "culture." The personal gains among the job rotating nurses showed increased knowledge, skills and influence. When knowledge was shared and exchanged, the job rotating nurses became "cultural translators" of the care to the elective orthopaedic patient. CONCLUSIONS: This study shows personal gains among the job rotating nurses through increased knowledge, skills and influence as well as collegial gains by sharing and exchanging knowledge. When this exchange was utilised, the job rotation was evaluated positively, and contrary, when not utilised the job rotation had a negative impact on the work environment. RELEVANCE TO CLINICAL PRACTICE: Job rotation among nurses following the care of the patient's pathway can be a way of promoting patient safety and quality through increased knowledge across wards by including every aspect and element of the patient's pathway.

A Game-Theory Method to Design Job Rotation Schedules to Prevent Musculoskeletal Disorders Based on Workers' Preferences and Competencies.

Job rotation is an organizational strategy based on the systematic exchange of workers between jobs in a planned manner according to specific criteria. This study presents the GS-Rot method, a method based on Game Theory, in order to design job rotation schedules by considering not only workers' job preferences, but also the competencies required for different jobs. With this approach, we promote workers' active participation in the design of the rotation plan. It also let us deal with restrictions in assigning workers to job positions according to their disabilities (temporal or permanent). The GS-Rot method has been implemented online and applied to a case in a work environment characterized by the presence of a high repetition of movements, which is a significant risk factor associated with work-related musculoskeletal disorders (WMSDs). A total of 17 workstations and 17 workers were involved in the rotation, four of them with physical/psychological limitations. Feasible job rotation schedules were obtained in a short time (average time 27.4 milliseconds). The results indicate that in the rotations driven by preference priorities, almost all the workers (94.11%) were assigned to one of their top five preferences. Likewise, 48.52% of job positions were assigned to workers in their top five of their competence lists. When jobs were assigned according to competence, 58.82% of workers got an assignment among their top five competence lists. Furthermore, 55.87% of the workers achieved jobs in their top five preferences. In both rotation scenarios, the workers varied performed jobs, and fatigue accumulation was balanced among them. The GS-Rot method achieved feasible and uniform solutions regarding the workers' exposure to job repetitiveness.

Examining psychometric properties of the Turkish version of the Nursing Job Rotation Stress Scale (NJRS).

PURPOSE: This study was designed to determine the validity and reliability of the Turkish version of the "Nursing Job Rotation Stress Scale (NJRS)". DESIGN AND METHODS: This methodological study was carried out with 200 nurses in 2018. FINDINGS: The content validity index for NJRS is 0.98, the Cronbach's α coefficient of the whole scale is calculated as .92. The internal reliability of the subscales was 0.86, 0.83, and 0.81 respectively. The goodness of fit indexes are 0.054 for root mean square error of approximation (RMSEA), 0.95 for goodness-of-fit index (GFI), 0.98 for comparative fit index (CFI), 0.98 for incremental fit index (IFI), 0.94 for relative fit index (RFI), 0.96 for normed fit index (NFI), and 0.97 for Tucker-Lewis index (TLI). PRACTICE IMPLICATIONS: The Turkish version of the NJRS was evaluated and it was found to be a valid and reliable measurement tool for Turkish nurses.

Antecedents of Intention to Leave the Organization: A Systematic Review / Antecedentes da Intenção de Sair da Organização: uma Revisão Sistemática / Los antecedentes de la Intención de Salir de la Organización: una Revisión Sistemática

Abstract The intention to leave the organization is a cognitive, deliberate and conscious process of a person quitting the organization he or she works in a near future. This study was designed to systematize the antecedents of the intention to leave the organization in empirical studies published in Portuguese between 2000-2015. We used a systematic review method to research 31 journals, proceedings of the Encontros da Associação Nacional de Pós-Graduação e Pesquisa em Administração (EnANPAD), ScIELO database, Google Scholar, and Theses and Dissertations Catalog - CAPES. Thirty-five publications were selected for analysis, where 18 antecedents were identified. Based on these results and on the theory of planned behavior, a model is proposed for understanding the relationships between the intention to leave, its antecedents, and the actual voluntary behavior of leaving organizations. The article indicates different paths to improve the understanding of behavioral variance related to the intention to leave the organization.

Resumo A intenção de sair da organização é um processo cognitivo, deliberado e consciente da pessoa deixar a organização na qual trabalha em um futuro próximo. Este estudo teve por objetivo sistematizar os antecedentes da intenção de sair da organização em pesquisas empíricas de língua portuguesa, publicadas entre 2000 e 2015. Utilizou-se o método de revisão sistemática de literatura para pesquisar 31 periódicos, anais dos Encontros da Associação Nacional de Pós-Graduação e Pesquisa em Administração (EnANPAD), SciELO, Google Acadêmico e Banco de Teses CAPES. Foram analisadas 35 publicações, nas quais foram identificados 18 antecedentes. A partir destes resultados e da teoria do comportamento planejado, propõe-se um modelo para a compreensão da relação entre a intenção de sair da organização, seus antecedentes e o comportamento de saída voluntária de organizações. O artigo indica diferentes caminhos para que se possa aumentar a explicação da variância do comportamento relacionado à intenção de sair da organização.

Resumen La intención de salir de la organización donde trabaja es un proceso cognitivo, deliberado y consciente de uno para el futuro. Este estudio tuvo como objetivo sistematizar los antecedentes de la intención de salir de la organización en estudios empíricos en portugués, publicados entre 2000 y 2015. Se utilizó el método de revisión sistemática de literatura para investigar 31 periódicos, anales de los Encontros da Associação Nacional de Pós-Graduação e Pesquisa em Administração (EnANPAD), en las bases de datos SciELO, Google Académico y Banco de Tesis Capes. Se analizaron 35 publicaciones, en las cuales se identificaron 18 antecedentes. Desde los resultados y la teoría del comportamiento planeado, se propone un modelo para el entendimiento de la relación entre la intención de salir de la organización, sus antecedentes, y el comportamiento de salida voluntaria de las mismas. El estudio apunta diferentes caminos para que se pueda explicar más la varianza del comportamiento relacionado con la intención de salir de la organización.

Task rotation in an underground coal mine: A pilot study.

BACKGROUND: Task rotation is used to decrease the risk of workplace injuries and improve work satisfaction. OBJECTIVE: To investigate the feasibility, benefits and challenges of implementing a task rotation schedule within an underground coalmine in NSW, Australia. METHODS: A mixed method case control pilot study with the development and implementation of a task rotation schedule for 6 months with two work crews. A questionnaire including The Nordic Musculoskeletal Questionnaire, The Need for Recovery after Work Scale, and The Australian WHOQOL- BREF Australian Edition was used to survey workers at baseline, 3 and 6 months. A focus group was completed with the intervention crew and management at the completion of the study. RESULTS: In total, twenty-seven participants completed the survey. Significant improvements in the psychological and environmental domains of the WHOQOL-BREF questionnaire were found in the intervention crew. Musculoskeletal pain was highest in the elbow, lower back and knee, and fatigue scores improved, across both groups. The intervention crew felt 'mentally fresher', 'didn't do the same task twice in a row', and 'had more task variety which made the shift go quickly'. CONCLUSION: Task rotation was positively regarded, with psychological benefits identified. Three rotations during a 9-hour shift were feasible and practical in this environment.

Risk assessments using the Strain Index and the TLV for HAL, Part II: Multi-task jobs and prevalence of CTS.

The Strain Index (SI) and the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL) have been shown to be associated with prevalence of distal upper-limb musculoskeletal disorders such as carpal tunnel syndrome (CTS). The SI and TLV for HAL disagree on more than half of task exposure classifications. Similarly, time-weighted average (TWA), peak, and typical exposure techniques used to quantity physical exposure from multi-task jobs have shown between-technique agreement ranging from 61% to 93%, depending upon whether the SI or TLV for HAL model was used. This study compared exposure-response relationships between each model-technique combination and prevalence of CTS. Physical exposure data from 1,834 workers (710 with multi-task jobs) were analyzed using the SI and TLV for HAL and the TWA, typical, and peak multi-task job exposure techniques. Additionally, exposure classifications from the SI and TLV for HAL were combined into a single measure and evaluated. Prevalent CTS cases were identified using symptoms and nerve-conduction studies. Mixed effects logistic regression was used to quantify exposure-response relationships between categorized (i.e., low, medium, and high) physical exposure and CTS prevalence for all model-technique combinations, and for multi-task workers, mono-task workers, and all workers combined. Except for TWA TLV for HAL, all model-technique combinations showed monotonic increases in risk of CTS with increased physical exposure. The combined-models approach showed stronger association than the SI or TLV for HAL for multi-task workers. Despite differences in exposure classifications, nearly all model-technique combinations showed exposure-response relationships with prevalence of CTS for the combined sample of mono-task and multi-task workers. Both the TLV for HAL and the SI, with the TWA or typical techniques, appear useful for epidemiological studies and surveillance. However, the utility of TWA, typical, and peak techniques for job design and intervention is dubious.

Risk assessments using the Strain Index and the TLV for HAL, Part I: Task and multi-task job exposure classifications.

BACKGROUND: The Strain Index (SI) and the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value for Hand Activity Level (TLV for HAL) use different constituent variables to quantify task physical exposures. Similarly, time-weighted-average (TWA), Peak, and Typical exposure techniques to quantify physical exposure from multi-task jobs make different assumptions about each task's contribution to the whole job exposure. Thus, task and job physical exposure classifications differ depending upon which model and technique are used for quantification. This study examines exposure classification agreement, disagreement, correlation, and magnitude of classification differences between these models and techniques. METHODS: Data from 710 multi-task job workers performing 3,647 tasks were analyzed using the SI and TLV for HAL models, as well as with the TWA, Typical and Peak job exposure techniques. Physical exposures were classified as low, medium, and high using each model's recommended, or a priori limits. Exposure classification agreement and disagreement between models (SI, TLV for HAL) and between job exposure techniques (TWA, Typical, Peak) were described and analyzed. RESULTS: Regardless of technique, the SI classified more tasks as high exposure than the TLV for HAL, and the TLV for HAL classified more tasks as low exposure. The models agreed on 48.5% of task classifications (kappa = 0.28) with 15.5% of disagreement between low and high exposure categories. Between-technique (i.e., TWA, Typical, Peak) agreement ranged from 61-93% (kappa: 0.16-0.92) depending on whether the SI or TLV for HAL was used. CONCLUSIONS: There was disagreement between the SI and TLV for HAL and between the TWA, Typical and Peak techniques. Disagreement creates uncertainty for job design, job analysis, risk assessments, and developing interventions. Task exposure classifications from the SI and TLV for HAL might complement each other. However, TWA, Typical, and Peak job exposure techniques all have limitations. Part II of this article examines whether the observed differences between these models and techniques produce different exposure-response relationships for predicting prevalence of carpal tunnel syndrome.