Academic Master

Health Care


Table of Contents

Abstract 3

Introduction 4

Aim, Rationale, and Significance of Project 5

Context and the Setting of the Project 7

Brief Review of Literature Relevant To This Specific Project 7

Project Design and Methods 8

Proposed Timeframe 9

Expected Outcome/S 9

Conclusion 10

References 11

Appendix 14



This proposal will Back injury is one of the most common occupation disorders affecting the nursing profession throughout the world it is characterized by back pain. The pain is either chronic or acute and lowers the productivity and efficiency of nurses. If left unmanaged it can lead to disability. This research proposal reviews how back pain in nursing occupations caused by the use of manual devices can be prevented to increase their capacity to work. It constitutes a literature review to find out more about what has been done on this issue. Data analysis on previous research done on nurses in healthcare facilities on the occurrence of back injuries in the course of their duties will be used.

The aim of the research

This research is aimed at addressing the effect of manual handling devices in reducing back pain and injury in nurses working in nursing homes. This is because previously done research has only concentrated in other sectors of healthcare such as hospitals and clinics or was not comprehensive in their approach.


The practical use of manual handling devices will be used to help nurses to be able to carry out their daily work effectively to control injuries on their backs. Appropriate training should also be done to inform them on available devices and how to use exercises and other methods to control back injuries and back pain.


The research will measure the effectiveness of manual devices in the control of back injuries when used by nurses working in nursing care homes. This study will involve the management responsible for training the nurses and the nurses who will use manual devices for manipulating the patients.

Expected outcomes

Incidents of back injuries among nurses working in nursing home care should be effectively reduced by the use of manual devices. Additionally, the management should successfully reduce the number of lawsuits against them by injured employees, and the cost of compensation should be reduced.


This project will be a major breakthrough to solving a persistent problem that is reducing the productivity of nurses and can, therefore, be adopted by other health practitioners in controlling back injuries on nurses. It will also redirect important funds used in these injuries to better use. Patients will also receive adequate high-quality care.


Medical research so far has not been able to differentiate between back injury caused by occupation and injury caused by non-work related causes. Also, research has suggested that back pain in nursing workers can result from nonphysical psychosocial risk factors such as Perceived high workload, Monotonous work, Lack of decision-making authority, and Job dissatisfaction. This emphasizes the fact that there is a need to carry out further research to help alleviate back pain occurrence in nurses working in nursing homes and other healthcare facilities According to the research done by (Ovayolu, Ovayolu, Genc and, Col-Araz 2015 p,70)Nurses have determined that more than 80 %of nurses experienced lower back pain. Determination of those nursing employees who got training on lower back pain management remained on their feet for an extended duration, repositioned patients, and bent for long periods without using any manual devices had an increased rate of lower back aches. Nursing employees in intensive care units had more incidences as their work called for more bending and shifting patients and frequent body movements such as clasping onto patients’ limbs to support them, hugging them, or even reaching up and other bodily movements. It is estimated that two-thirds to four-fifths of the population are negatively affected in their productivity by a back injury at some point in their lives. Many people do not report back pain or even take time off from work

The aim, rationale, and Significance of the project

. This research will therefore aim to:

  1. determine the number of back injuries to nurses whose manual handling devices in a hospital setting
  2. determine the number of injuries to nurses while using handling devices in a hospital setting
  3. Comparing the number of nurses getting back injuries while handling devices with those who acquire them while not using manual handling devices

The aim of the project is to reduce the incidences of back injury in nursing patients during their care on patients in nursing care homes. The rationale for selecting this topic is to ensure that nurses in nursing homes take care of the patients without getting back injuries. The significance of this is that back pain is common to most people during their lifetime. Previous medical science research suggests that back pain is caused by heavy vibrational impact on the body when operating heavy machines, driving and lifting, pulling, or pushing heavy loads ( Otaibi, 2015, pg,73-77). The risk factors need to be properly identified and may include; when spinal nerves are pinched by a slipped disk, sudden unfamiliar movements leading to muscular back pain, and lack of exercise. There is a need for causes of back pain to be properly quantified so as to arrive at a long-term solution to the problem as this will help in improving the productivity of nurses in providing quality service to nursing home patients. Manual handling has been described as an engagement that calls for use of physical power to manipulate an individual leading to the risk of injury of the person carrying out these activities. It is therefore important to determine what devices are available to nurses to facilitate manual handling of patients both in hospitals and in nursing homes and old age care. Nursing home patients require to be lifted, their position changed and supported during their care. Extended bending when attending to these patients who have unique needs due to their poor health may lead to serious back pains for the nurses offering care to them. The research will therefore focus on the effect of the available manual handling devices that are available in these nursing homes. The picot question for this study will be: Is the issue of manual handling devices(I) compared to hand handling(C) of patients and equipment by nurses(P) more effective in reducing back injuries(o) among nurses working in hospitals (S)

P-Nurses, I-Use of manual handling devices, C-hand handling, O-Reduced back injuries, T-two months S- Hospital,

Context and the setting of the project

The project will take place in a nursing home acre set up where the nurses will be the population. The nurses will be under a health facility manager in charge of the nursing home. The research will be done in the normal daily activities of the nursing home to avoid disruption and stress to the patients and the nurses under investigation.

Brief literature review

. Research shows that nurses are at higher risk of suffering from low back pain and other musculoskeletal disorders in health professionals due to the nature of their work around the world. Although not life-threatening low back pain requires long-term treatment and requires compensation and additional insurance costs from the nurses affected.( Shieh, Sung, Su, Tsai and Hsieh, 2016 pg,525-529)Research investigating measurable effectiveness to reduce and or control back ache or injuries in nursing employees showed that stretching as a form of exercising the body was preferable instead of normal duties only without intervention ( Van et al, 2018 pg. 222-231).combining of manual handling training and exercise had even better results than physiotherapy as an intervention. According to Yassi and Lockhart, the prevalence of back injuries among health workers is a global problem that has been researched without adequate conclusions on the interventions. They argue that multiple interventions are necessary for an effective program to bear desirable results (Yassi, A. and Lockhart, K., 2013 pg. 223-224)

Associated the existence of lower backache in nursing employees to physical violence hence their research was not conclusive and left unanswered questions as the definition and interpretation of physical violence was not clear.(Rezaee and Ghasemi,2014(19)4)Duffy claims that the introduction of mechanical lifts reduces the prevalence of back pains when compared to raising awareness about the problem both with the healthcare management and the nurses. The study recommends training, and installation of mechanical devices to assist in handling heavy loads (Duffy 2017, pg 20. Research done by Budhrani et al indicated other interventions that have been conducted to alleviate and manage back pain include muscle relaxants, education, counseling, physical therapy, and directed exercises. ( (Budhrani-Shani, Berry, Arcari, Langevin, and Wayne, 2016) There was dissatisfaction from both the patients and the physicians on the treatment methods over time and therefore it’s important to carry out further research to determine a better solution to the problem. Turn assist is a bedside mechanism that has been used in the ICU facilities of hospitals to reduce the stress of turning patients. Research carried out reveals that the device helps rotate the patient and ensure comfort during the maneuver for both the patient and the nurse operating it..( Wiggermann., 2016. pp.748-757.)The use of sliding sheets and mechanical lifts was also recommended to be used to avoid back pain or back injury on nurses and the discomfort of patients. The turning space needs to be adequate for the nurse to manipulate the manual turning assisting device when turning a patient to avoid injury.( Wiggermann, Smith, and Kumpar, 2017 p.483.) the following

Project design and methods

The research will involve an interventional design where all the nurses in the nursing home will be involved in the use of manual manipulation devices to move or rotate patients in the course of their daily duties. The focus of the research will be to avoid back injury as they carry out their activities. The team will collect results as to the number of injuries during the use of these devices as compared to the past when manual manipulation devices have not been used.

Proposed time frame

Table 1: Timeline of the Proposed Project Activities

Project Activity Timeframe
Project Initiation and planning 25-27 March
Budgeting for the resources 25-31 March
Education of the nurses 02-09 April
Pre-intervention test 10-011 April
Rollout phase 11-17 April
Post-intervention evaluation 19-21 April
Report writing 22-30 April

Expected outcomes

It has been found that the causes of back injury done in previous research were not comprehensive and only concentrated on certain factors while others were ignored. Most of the research was carried out for hospital setup and not for other health-providing institutions such as nursing homes and old age care homes on which this research will focus. This research will, therefore, give adequate answers as to the effect of manual handling devices in nursing care, old age care, and other similar healthcare facilities. The expected results are the identification of the best interventions for reducing and managing back pain in nurses working in nursing homes. The recommended manual devices will be identified and the necessary combination of interventions identified and implemented.


This project proposal will help determine the effect of using manual devices in manipulating patients in the nursing home to avoid back injury to the nurses. Backache and injury among nurses is expensive in terms of hours not worked and the cost of the health facility on insurance coverage of employees and the compensation of those employees that get injured

Reference list

Al-Otaibi, S. T., 2015 Prevention of occupational Back Pain. Journal of Family & Community Medicine22(2), 73–77.retrieved from: retrieved from,

Budhrani-Shani, P., Berry, D.L., Arcari, P., Langevin, H., and Wayne, P.M., 2016. Mind-body exercises for nurses with chronic low back pain: an evidence-based review. Nursing research and practice2016. 9018036.Retrieved from:

DUFFY, V. G. (2017). Digital Human Modeling. Applications in Health, Safety, Ergonomics, and Risk Management: Ergonomics and Design: 8th International Conference, DHM 2017, Held as Part of HCI International 2017, Vancouver, BC, Canada, July 9-14, 2017, Proceedings, Part I. Retrieved from,

Ovayolu, O., Ovayolu, N., Genc, M. and Col-Araz, N., 2014. Frequency and severity of low back pain in nurses working in intensive care units and influential factors. Pakistan journal of medical sciences30(1), p.70.print

Rezaee, M. and Ghasemi, M., 2014. Prevalence of low back pain among nurses: predisposing factors and role of workplace violenceTrauma monthly19(4).

Shieh, S.H., Sung, F.C., Su, C.H., Tsai, Y. and Hsieh, V.C.R., 2016. Increased low back pain risk in nurses with the high workload for patient care: A questionnaire survey. Taiwanese Journal of Obstetrics and Gynecology55(4), pp.525-529 print

Van Hoof, W., O’Sullivan, K., O’Keeffe, M., Verschueren, S., O’Sullivan, P. and Dankaerts, W., 2018. The efficacy of interventions for low back pain in nurses: A systematic review. International journal of nursing studies77, pp.222-231.Print

Wiggermann, N., 2016. Biomechanical evaluation of a bed feature to assist in turning and laterally repositioning patients. Human factors58(5), pp.748-757.

Wiggermann, N., Smith, K., and Kumpar, D., 2017. What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to turn in Bed. Nursing Research66(6), p.483.

Yassi, A. and Lockhart, K., 2013. Work-relatedness of low back pain in nursing personnel: a systematic review. International journal of occupational and environmental health19(3), pp.223-244.


Survey questionnaire for outcome analysis

  1. Have you ever used a manual manipulating device?
  • Yes
  • No
  1. On a scale of 0-10, how do you rate your level of effectiveness in protecting your back at work? (Where 0 means effective and 10 is extremely Ineffective)
  • ______________________________________
  1. How difficult is it when using a manual manipulating device on a patient?
  • Easy
  • Very easy
  • Difficult
  • Very difficult
  1. Are manual manipulation devices effective in back injury protection?
  • yes
  • No
  • May be
  1. What is the frequency of back injuries throughout the month when using the manual manipulating device?
  • Extremely frequent
  • Very frequent
  • Frequent
  • Rare
  • Extremely rare
  1. Do you experience back injuries due to your workload when not using manual manipulating devices?
  • Yes
  • No
  1. ? What is the frequency of back injuries throughout the month when not using the manual manipulating device?
  • None
  • Less than thrice
  • Less than five times
  • More than five times
  1. Have you experienced self-injury or near self-injury since you started using manual manipulation devices?
  • Yes
  • No
  1. How long are you willing to stay in the nursing profession in your current placement after your training and using manual manipulation devices?
  • Very long period
  • Long period
  • Short period
  • Very short period
  1. Can you recommend training on due care of your back and body against injuries and the use of manual manipulation devices in your work to other nurses?
  • Yes
  • No



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