Bernice D. Owen

Four methods for identification of most back-stressing tasks performed by nursing assistants in nursing homes

Abstract Ergonomists are often asked to evaluate selected jobs because of excessive back injury rates. One key step in the evaluation process is identification of specific tasks that impose the largest stresses on the backs of workers who perform the job. Four techniques for identifying the most back-stressing tasks were used in an ergonomic study of nursing assistants working in a nursing home. Two techniques were based on worker perceptions and two were based on a static biomechanical model. The rank order of tasks was similar for each technique. It was concluded that when the purpose is to identify which of several tasks should be evaluated in greater detail, the most programmatic technique is a rating scale.

NIOSH research initiatives to prevent back injuries to nursing assistants, aides, and orderlies in nursing homes.

Over the past 100 years, advances in nutrition, modern medicine, public health, and a multitude of public health improvements have increased the life expectancy of U.S. residents. The fact that Americans are living longer has resulted in extensive growth in our elderly population and a rapid employment growth that delivered about 2 million new jobs between 1980 and 1989 in the health care workforce. The Bureau of Labor Statistics Injury and Illness Data for nursing homes rose from 10.7 to 18.6 injuries or illnesses per 100 full-time workers between 1980 and 1992. The injury and illness rates among nursing home workers are partly due to the physical stress of providing round-the-clock assistance with the basic activities of daily living, such as getting in and out of a bed or chair, as well as bathing and toileting. The National Institute for Occupational Safety and Health (NIOSH) is conducting a series of research studies to identify strategies to reduce the risk of musculoskeletal injuries to workers in nursing homes. NIOSH has funded two laboratory evaluations of resident transferring methods and one field study in an actual nursing home. The purpose of this paper is to describe the key findings from past NIOSH research initiatives and to present an overview of future research.

Back Stress Isn't Part of the Job

Lifting and transferring patients takes a heavy toll: Nurses have been ranked fifth among all workers nationally filing compensation claims for back injury(l). And even that estimate may be low. A 1989 study found that only one-third of those nurses who said they had episodes of occupation-related back problems (63 out of 189) actually filed an incident report; most accepted back pain as part of the job and took sick days(2). Commonly, health-care-facility managers have relied on education in back care and lifting techniques to help prevent back injuries. There is no evidence, however, that this approach by itself does any good. Equally or more important is an ergonomic approach-that is, altering the design of the workplace or the job to fit the worker. Under a contract from the National

Safe Patient Handling and Movement: Preventing back injury among nurses requires careful selection of the safest equipment and techniques. The second of two articles.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording , or otherwise, without the prior permission of Springer Publishing Company, Inc. Safe patient handling and movement : a guide for nurses and other health care providers / edited by Audrey L. Nelson. p. ; cm. Includes bibliographical references and index.

What are we teaching about lifting and transferring patients

Lifting patients under the axilla has been found to be physically stressful for nurses and uncomfortable for patients. The goals of this study were to find out: how often educators teach this method and observe it in the clinical field; which assistive devices are used in teaching; and what authors of textbooks teach about the under-axilla method. A questionnaire was sent to 546 baccalaureate (BS) and associate (AD) degree programs; 358 educators responded and 337 responses were analyzed. Eighty-three percent of the educators teach the under-axilla method for in- and out-of-bed transfers; 94% observe it used in the clinical field. For lifting up in bed, 56% teach the under-axilla method; 86% observe it in the clinical field. When assistive devices are included in teaching, the hydraulic lift and gait belt are taught most often; less stressful and more comfortable devices are not taught or observed by most respondents. None of the authors of the 3 most frequently used textbooks describe the use of the under-axilla method; authors of 2 textbooks state patients should not have pressure placed on the axilla area.