Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme.

OBJECTIVE: With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. METHODS: Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. RESULTS: Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. CONCLUSIONS: Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.

Worker assessments of organizational practices and psychosocial work environment are associated with musculoskeletal injuries in hospital patient care workers.

BACKGROUND: Hospital patient care (PC) workers have high rates of workplace injuries, particularly musculoskeletal injuries. Despite a wide spectrum of documented health hazards, little is known about the association between psychosocial factors at work and OSHA-recordable musculoskeletal injuries. METHODS: PC-workers (n = 1,572, 79%) completed surveys assessing a number of organizational, psychosocial and psychological variables. Associations between the survey responses and injury records were tested using bivariate and multivariate analyses. RESULTS: A 5% of the PC-workers had at least one OSHA-recordable musculoskeletal injury over the year, and the injuries were significantly associated with: organizational factors (lower people-oriented culture), psychosocial factors (lower supervisor support), and structural factors (job title: being a patient care assistant). CONCLUSIONS: The results show support for a multifactorial understanding of musculoskeletal injuries in hospital PC-workers. An increased focus on the various dimensions associated with injury reports, particularly the organizational and psychosocial factors, could contribute to more efficient interventions and programs.

Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers.

The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations.