Abstract
Background
Back injury is one of the most common occupational disorders affecting the nursing profession throughout the world. It is characterized by back pain. The pain may be either chronic or acute and can lower 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 manual patient handling can be prevented through the use of handling devices to increase nurses’ capacity to work. It consists of a literature review to determine what has already been done on this issue. Data from previous research on nurses in healthcare facilities and the occurrence of back injuries in the course of their duties will be analyzed.
The Aim Of The Research
This research aims to address the effect of manual handling devices on reducing back pain and injury among nurses working in nursing homes. This is because previous research has concentrated on other sectors of healthcare, such as hospitals and clinics, or has not been comprehensive in its approach.
Methods
The practical use of manual handling devices will be evaluated to determine whether they help nurses carry out their daily work effectively while reducing back injuries. Appropriate training should also be provided to inform nurses about available devices and how to use exercise and other methods to control back injuries and back pain.
Measures
The research will measure the effectiveness of manual devices in controlling back injuries when used by nurses working in nursing care homes. This study will involve the management responsible for training nurses and the nurses who will use manual devices to handle patients.
Expected Outcomes
Incidents of back injuries among nurses working in nursing-home care should be effectively reduced through the use of manual devices. Additionally, management should successfully reduce the number of lawsuits involving injured employees, and compensation costs should be reduced.
Conclusion
This project could be a major step toward solving a persistent problem that reduces nurses’ productivity and could therefore be adopted by other healthcare practitioners seeking to control back injuries among nurses. It could also redirect funds currently spent on these injuries to better uses. Patients would also receive adequate, high-quality care.
Introduction
Medical research so far has not been able to clearly differentiate between back injuries caused by occupational factors and injuries caused by non-work-related factors. Research has also suggested that back pain among 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 need for further research to help reduce the occurrence of back pain among nurses working in nursing homes and other healthcare facilities. According to research by Ovayolu, Ovayolu, Genc, and Col-Araz (2015, p. 70), more than 80% of nurses experienced lower back pain. The study found that nursing employees who had received training on lower-back-pain management but remained on their feet for extended periods, repositioned patients, and bent for long periods without using manual devices had increased rates of lower back pain. Nursing employees in intensive care units had more incidents because their work required more bending, shifting of patients, and frequent body movements such as supporting patients’ limbs, holding patients, reaching upward, and performing other physical tasks. It is estimated that two-thirds to four-fifths of the population experience reduced productivity because of a back injury at some point in their lives. Many people do not report back pain or take time off from work.
The Aim, Rationale, And Significance Of The Project
This research will therefore aim to:
- determine the number of back injuries among nurses using manual handling devices in a hospital setting;
- determine the number of injuries among nurses while using handling devices in a hospital setting; and.
- compare the number of nurses who sustain back injuries while using handling devices with the number who sustain them while not using manual handling devices.
The aim of the project is to reduce the incidence of back injury among nurses while they care for patients in nursing homes. The rationale for selecting this topic is to help ensure that nurses in nursing homes can care for patients without sustaining back injuries. The significance of this issue is that back pain is common among many people during their lifetime. Previous medical research suggests that back pain can be caused by heavy vibration affecting the body when operating heavy machines, driving, and lifting, pulling, or pushing heavy loads (Otaibi, 2015, pp. 73-77). Risk factors need to be properly identified and may include spinal nerves being pinched by a slipped disk, sudden unfamiliar movements leading to muscular back pain, and lack of exercise. There is a need to properly quantify the causes of back pain in order to develop a long-term solution to the problem, as this will help improve nurses’ productivity in providing quality service to nursing-home patients. Manual handling has been described as an activity that requires the use of physical force to move or support an individual, thereby creating a risk of injury to the person performing the activity. It is therefore important to determine what devices are available to nurses to facilitate the handling of patients in hospitals, nursing homes, and old-age-care facilities. Nursing-home patients may need to be lifted, repositioned, and supported during care. Extended bending while attending to patients who have unique needs because of poor health may lead to serious back pain among the nurses providing care. The research will therefore focus on the effects of manual handling devices available in these nursing homes. The PICOT question for this study will be: Is the use of manual handling devices (I), compared with manual 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-care setting where nurses will be the study population. The nurses will work under a healthcare-facility manager in charge of the nursing home. The research will be conducted during the normal daily activities of the nursing home to avoid disruption and stress to the patients and nurses under investigation.
Brief Literature Review
Research shows that nurses are at higher risk than other health professionals of suffering from low back pain and other musculoskeletal disorders because of the nature of their work. Although it is not life-threatening, low back pain can require long-term treatment and compensation and can generate additional insurance costs for affected nurses (Shieh, Sung, Su, Tsai, and Hsieh, 2016, pp. 525-529). Research investigating measurable effectiveness in reducing or controlling back pain or injuries among nursing employees showed that stretching as a form of exercise was preferable to carrying out normal duties without intervention (Van et al., 2018, pp. 222-231). Combined manual-handling training and exercise produced even better results than physiotherapy as an intervention. According to Yassi and Lockhart, the prevalence of back injuries among healthcare workers is a global problem that has been researched without adequate conclusions regarding interventions. They argue that multiple interventions are necessary for an effective program to produce desirable results (Yassi and Lockhart, 2013, pp. 223-224).
Rezaee and Ghasemi associated the existence of lower back pain among nursing employees with physical violence; however, their research was not conclusive and left unanswered questions because the definition and interpretation of physical violence were unclear (Rezaee and Ghasemi, 2014, 19(4)). Duffy claims that the introduction of mechanical lifts reduces the prevalence of back pain compared with raising awareness about the problem among healthcare management and nurses. The study recommends training and the installation of mechanical devices to assist in handling heavy loads (Duffy, 2017, p. 20). Research by Budhrani et al. identified other interventions that have been used to alleviate and manage back pain, including muscle relaxants, education, counseling, physical therapy, and directed exercises (Budhrani-Shani, Berry, Arcari, Langevin, and Wayne, 2016). There was dissatisfaction among both patients and physicians with treatment methods over time; therefore, it is important to conduct further research to determine a better solution to the problem. Turn Assist is a bedside mechanism that has been used in hospital ICU facilities to reduce the physical strain involved in turning patients. Research reveals that the device helps rotate the patient and ensures 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 avoid back pain or back injury among nurses and reduce patient discomfort. The turning space needs to be adequate for the nurse to manipulate the manual turning-assistance device when turning a patient to avoid injury (Wiggermann, Smith, and Kumpar, 2017, p. 483).
Project Design And Methods
The research will use an interventional design in which all nurses in the nursing home will use manual handling devices to move or rotate patients during their daily duties. The focus of the research will be on avoiding back injury while nurses carry out their activities. The team will collect data on the number of injuries occurring during the use of these devices and compare the results with the period before manual handling devices were 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
Previous research on the causes of back injury has not been comprehensive and has concentrated on certain factors while ignoring others. Most research was conducted in hospital settings rather than in other healthcare institutions, such as nursing homes and old-age-care homes, on which this research will focus. This research will therefore provide further evidence about the effect of manual handling devices in nursing care, old-age care, and other similar healthcare facilities. The expected outcomes include identifying the best interventions for reducing and managing back pain among nurses working in nursing homes. Recommended manual devices and an appropriate combination of interventions will be identified and implemented.
Conclusion
This project proposal will help determine the effect of using manual devices to handle patients in nursing homes in order to avoid back injuries among nurses. Back pain and injury among nurses are costly in terms of lost working hours, healthcare-facility spending on employee insurance coverage, and compensation for employees who are injured.
Reference List
Al-Otaibi, S. T., 2015 Prevention of occupational Back Pain. Journal of Family & Community Medicine, 22(2), 73–77.retrieved from: retrieved from, https://doi.org/10.4103/2230-8229.155370
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 practice, 2016. 9018036. Retrieved from: https://doi.org/10.1155/2016/9018036
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, https://dx.doi.org/10.1007/978-3-319-58463-8.
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 Sciences, 30(1), p. 70.print
Rezaee, M. and Ghasemi, M., 2014. Prevalence of low back pain among nurses: predisposing factors and role of workplace violence. Trauma Monthly, 19(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 Gynecology, 55(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 Studies, 77, pp. 222-231. Print
Wiggermann, N., 2016. Biomechanical evaluation of a bed feature to assist in turning and laterally repositioning patients. Human factors, 58(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 Research, 66(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 Health., 19(3), pp. 223-244.
Appendix
Survey questionnaire for outcome analysis
| Have you ever used a manual manipulating device? Yes No |
| 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). ______________________________________ |
| How difficult is it to use a manual manipulating device on a patient? Easy Very easy Difficult Very difficult |
| Are manual manipulation devices effective in protecting against back injury? Yes No Maybe |
| What is the frequency of back injuries throughout the month when using the manual manipulating device? Extremely frequent Very frequent Frequent Rare Extremely rare |
| Do you experience back injuries due to your workload when not using manual manipulation devices? Yes No |
| What is the frequency of back injuries throughout the month when not using the manual manipulating device? None Less than three times Less than five times More than five times |
| Have you experienced self-injury or near self-injury since you started using manual manipulation devices? Yes No |
| How long are you willing to stay in the nursing profession in your current placement after your training and use of manual manipulation devices? Very long period Long period Short period Very short period |
| Would you recommend training on protecting the back and body against injuries and on the use of manual manipulation devices to other nurses? Yes No |
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