Continuous assessment of work activities and posture in long-term care nurses

Abstract

The high prevalence of low back injuries in nursing has prompted the use of mechanical lift assists while overall assessment of activities and postures remains limited. The purpose of this study was to chronicle trunk posture and work tasks of long-term healthcare professionals. An inclinometer monitored trunk posture for 27 workers, 20 of whom were also observed continuously throughout their shift. Patient lifts and transfers accounted for less than 4% of the shift while patient care, unloaded standing and walking and miscellaneous tasks accounted for 85%. Manual lifts and transfers occurred twice as often as mechanically assisted lifts but took only half the time. The workers had a median trunk flexion angle of 9.2°, spent 25% of their time flexed beyond 30° and had peak flexion angles greater than 75° in many tasks. Analysis of posture throughout the entire working shift indicates that, in addition to lifts and transfers, emphasis needs to be placed on patient care and miscellaneous activities when assessing injury risk for nurses.

Statement of Relevance: Patient handling has been the focus in the effort to reduce back pain and injury in nursing. In addition to the use of mechanical lifts, there is a need to examine other aspects of nursing, including patient care and other ancillary tasks, which comprise the majority of the work shift and, while often unloaded, exhibit extreme postures that may also lead to injury.

Keywords:

• low back
• nursing
• patient handling
• posture

Acknowledgements

This study was supported by the Ontario Ministry of Health and Long Term Care, as well as the National Sciences and Engineering Research Council of Canada (Discovery grant #217382–04). Special thanks to Dr P.W. Johnson for initial assistance with the Virtual Corset.