Tamara James

Exploration of work and health disparities among black women employed in poultry processing in the rural south.

We describe an ongoing collaboration that developed as academic investigators responded to a specific request from community members to document health effects on black women of employment in poultry-processing plants in rural North Carolina. Primary outcomes of interest are upper extremity musculoskeletal disorders and function as well as quality of life. Because of concerns of community women and the history of poor labor relations, we decided to conduct this longitudinal study in a manner that did not require involvement of the employer. To provide more detailed insights into the effects of this type of employment, the epidemiologic analyses are supplemented by ethnographic interviews. The resulting approach requires community collaboration. Community-based staff, as paid members of the research team, manage the local project office, recruit and retain participants, conduct interviews, coordinate physical assessments, and participate in outreach. Other community members assisted in the design of the data collection tools and the recruitment of longitudinal study participants and took part in the ethnographic component of the study. This presentation provides an example of one model through which academic researchers and community members can work together productively under challenging circumstances. Notable accomplishments include the recruitment and retention of a cohort of low-income rural black women, often considered hard to reach in research studies. This community-based project includes a number of elements associated with community-based participatory research.

Gender Effects on Musculoskeletal Symptoms among Physician Computer Users in Outpatient Diagnostic Clinics

A survey of computer use patterns among 179 physicians within multiple outpatient diagnostic clinics of a major healthcare system in the USA showed significant gender effects. A majority of physicians reported daily use of a desk mounted computer. Female physicians spent more time using a computer, were more likely to adjust the keyboard, but felt less familiar with the adjustability features. Over half of respondents reported upper body musculoskeletal discomfort. Female physicians experienced more frequent neck, shoulder, upper back and right hand musculoskeletal discomfort symptoms which seem to relate to their hours of computer use. Implications for the increased use of computers in healthcare are described.

An Ergonomic Approach to Modifying Microscope Design for Increased Comfort: A Case Study

This paper describes the approach used and the results of selected measures obtained from an ergonomic analysis of microscopes and associated workstations in a medical laboratory. The configuration of current microscopes and workstations in this lab caused a great deal of neck, back, forearm, and wrist discomfort or pain for workers who use microscopes to screen microslides for cancer and infectious conditions an average of 6 − 8 hours per day. Modifications to workstations and microscopes were developed and are being introduced within the Cytopathology Screening Laboratory at Duke University Medical Center. Prior to developing modifications to the microscopes and workstations, surveys of body part discomfort and anthropometric data were used to identify areas of concern. It is believed that users will be more comfortable and injury and error rates will decrease as a result of making modifications that allow users to utilize neutral body postures while using microscopes.

A Lift Assist Team in an Acute Care Hospital—Prevention of Injury or Transfer of Risk during Patient-Handling Tasks?

A Lift Assist Team (LAT) was created on three units at a medical center where nursing staff were at high risk for patient-handling injuries. LAT members were drawn from the hospitals pool of patient transporters. Using qualitative and quantitative data, this case study summarizes the development, implementation, and experiences of the LAT. Nursing staff valued the LAT, reporting increased staff safety and improved patient care. LAT members reported greater job satisfaction and a newfound sense of assimilation into the nursing group compared to when their role was patient transport only. However, over time, their job responsibilities expanded beyond those officially designated for LAT members. Active, ongoing surveillance of the LATs exposures and outcomes is warranted to understand whether patient-handling injury risk is shifting from nursing personnel to LAT members.

Detrimental Effects of an Electronic Health Records System on Musculoskeletal Symptoms among Health Professionals

A survey of 204 health professionals (physicians, physicians’ assistants and nurse practitioners) in private diagnostic clinics of a major healthcare system was conducted after the introduction of an electronic health records (EHR) system. Results showed considerable daily use of computers in various configurations and some 90% of respondents said the EHR had substantially increased their daily computer use. Less than half of the health professionals found the EHR easy to use. Almost half of the physicians said that use of the EHR reduced their face-to-face interactions with patients. Around two-thirds of respondents reported increased frequency of neck, shoulder and back discomfort and some 50% reported an increased frequency of right wrist discomfort since introduction of the EHR. Results demonstrate the importance of incorporating ergonomic workstation designs and ergonomics education when an EHR is being implemented.

Preventing our Caregivers from Becoming Patients – Challenges, Successes, and Trends Faced by Hospital Risk Managers and Ergonomists

Healthcare workers suffer musculoskeletal disorders at rates that exceed most other industries. Despite this, many healthcare facilities do not follow best practices that are proven to reduce risk of injury. This discussion panel will explore the reasons for why the healthcare industry struggles to prevent injuries and will outline successful strategies for protecting workers. The panelists are leaders and advisors for large medical systems and their specialties include ergonomics, safe patient handling, and patient safety. The panelists relate the critical challenges faced when preventing caregiver injuries. Such challenges include underreporting of staff injuries, lack of funding or administrative support, and inability to sell the connections among caregiver safety, caregiver productivity, and patient safety. The panelists also share success stories of when they have achieved positive change and explain the strategies that were effective. Practitioners should gain new insights for implementing successful change, and researchers will be exposed to new and important research questions.

An Intervention Study Comparing Traditional and Ergonomic Microscopes

In recent years, manufacturers have produced new microscopes with claims of “ergonomic design” for reduced musculoskeletal stress among users. To test this claim, we measured posture of the neck, back, and upper extremities, and the prevalence of musculoskeletal and visual symptoms among cytotechnologists while using traditional microscopes (baseline) and again after the introduction of ergonomically designed microscopes. Participants were five full-time cytotechnologists, who used the microscope 6–8 hours per day and had reported discomfort while using traditional microscopes. Results showed the ergonomically designed microscopes were significantly more comfortable to use than the traditional microscopes for the neck and shoulders. Significant improvement in joint angles of the elbows (flexion) and shoulders (abduction) was noted with the ergonomically designed microscopes. These results suggest that ergonomically designed microscopes may reduce some of the risk factors for musculoskeletal disorders (MSDs) and benefit individuals who use microscopes for prolonged periods of time.

Evidence for Applying Ergonomic Principles to the Design of new Facilities

This application involves the design of two new facilities at a major medical center. Both facilities were built at approximately the same time and both house people performing similar functions. The design group for one facility (A) enlisted the help of an ergonomist and the design group for the other facility (B) chose not to involve the ergonomist. After one year of occupancy, numerous employees in Facility B have requested ergonomic evaluations to help rid them of neck, back, shoulder, and wrist discomfort or pain. Only one employee in Facility A has asked for an evaluation or complained of musculoskeletal pain. These observations indicate the importance of involving an ergonomist in the design of new facilities.