Randomized controlled trial (RCT).
To compare the effectiveness of training and equipment to reduce musculoskeletal injuries, increase comfort, and reduce physical demands on staff performing patient lifts and transfers at a large acute care hospital.
Back injury to nursing staff during patient handling tasks is a major issue in health care. The value of mechanical assistive devices in reducing injuries to these workers is unclear.
This three-armed RCT consisted of a “control arm,” a “safe lifting” arm, and a “no strenuous lifting” arm. A medical, surgical, and rehabilitation ward were each randomly assigned to each arm. Both intervention arms received intensive training in back care, patient assessment, and handling techniques. Hence, the “safe lifting” arm used improved patient handling techniques using manual equipment, whereas the “no strenuous lifting” arm aimed to eliminate manual patient handling through use of additional mechanical and other assistive equipment.
Frequency of manual patient handling tasks was significantly decreased on the “no strenuous lifting” arm. Self-perceived work fatigue, back and shoulder pain, safety, and frequency and intensity of physical discomfort associated with patient handling tasks were improved on both intervention arms, but staff on the mechanical equipment arm showed greater improvements. Musculoskeletal injury rates were not significantly altered.
The “no strenuous lifting” program, which combined training with assured availability of mechanical and other assistive patient handling equipment, most effectively improved comfort with patient handling, decreased staff fatigue, and decreased physical demands. The fact that injury rates were not statistically significantly reduced may reflect the less sensitive nature of this indicator compared with the subjective indicators.
From the *Department of Community Health Sciences, Faculty of Medicine, and the
‡School of Medical Rehabilitation, University of Manitoba, and the
†Department of Occupational and Environmental Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Supported by the Workers Compensation Board of Manitoba, ARJO Canada, and the Winnipeg Health Sciences Centre.
Address reprint requests to
A. Yassi, MD
Occupational and Environmental Health Unit
University of Manitoba
S112-750 Bannatyne Avenue
Winnipeg, Manitoba, R3E 0W3, Canada
Acknowledgment date: March 29, 2000.
Acceptance date: December 1, 2000.
Device status category: 9.
Conflict of interest category: 15.