Application of MAPO (movement and assistance of hospitalized patients) method in hospitals and nursing homes: 20 years of experience and evolution - part 1.

This article illustrates the evolution of the MAPO method for quantifying the risk of musculoskeletal disorders associated with patient handling.The main factors that have influenced MAPO risk determinants include the rising number of disabled patients (D), growing understaffing, and the increased availability of equipment and training.Hospital wards and especially nursing homes have been provided with lifting equipment since 2008; however, 73.8% of the workforce in nursing homes is exposed to a high level of MAPO risk versus only 8.1% of hospital workers. This study presents organisational data in hospital wards (no.=528) and nursing homes (no.=214) involving 14,246 caregivers: the D/Op ratio in nursing homes is significantly higher compared to the corresponding ratio in hospital wards (p-value < 0.001). Moreover, the number of healthcare workers involved in manual patient handling activities over the night shift in nursing homes is much lower than the corresponding number in hospital wards. Practitioner summary: The purpose of this article is to illustrate organisational data from hospital wards and nursing homes, gathered over 20 years of implementing the MAPO method. The protocols for adapting the method to recent changes in care delivery are also presented.

MAPO Method to Assess the Risk of Patient Manual Handling in Hospital Wards: A Validation Study.

OBJECTIVE: To validate the effectiveness of MAPO method (Movement and Assistance of Hospital Patient) after the introduction of some changes to improve assessment objectivity. BACKGROUND: The number of operators exposed to patient manual handling is increasing considerably. MAPO, proposed in 1999 as a useful tool to estimate the risk of patient manual handling, is a method characterized by analytical quickness. It has recently been improved to better match the 2012 ISO (International Organization for Standardization) technical report. METHODS: A multicenter study was conducted between 2014 and 2016 involving 26 Italian hospitals in the Apulia Region. MAPO method was used to assess the risk of patient manual handling in 116 wards. A total of 1,998 exposed subjects were evaluated for the presence or absence of acute low back pain in the previous 12 months. RESULTS: Only 12% of the investigated wards fell in the green exposure level (MAPO index = 0.1-1.5), 37% resulted in the average exposure level (MAPO index = 1.51-5) and the remaining 51% in the higher exposure level (MAPO index >5). The results confirmed a positive association between increasing levels of MAPO index and the number of episodes of acute low back pain (adjusted p trend = .001). CONCLUSION: The improvements made over the past years led to a more objective assessment procedure. Despite the changes, the study confirmed the effectiveness of MAPO method to predict low back pain. APPLICATION: MAPO method is an accurate risk assessment tool that identifies and evaluates workplace risks. The proper application of the method significantly improves working conditions.

Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.