Back pain in the nursing profession II. The effectiveness of training

Abstract

The role of training in techniques of patient handling with respect to control of the back pain problem within the nursing profession has been examined. An evaluation of some of the methods commonly taught and the ability and time required to acquire such skills have been investigated. In relation to the use of four existing techniques carried out by eight student nurses on a 53 kg subject, it has been shown that the shoulder (Australian) lift produces least stress, as assessed through intraabdominal pressure (IAP). Subjective measures of comfort have shown that the nurses found the shoulder and orthodox lifts more comfortable. No differences were found between techniques for the ‘patient’ comfort ratings. A pilot investigation of training for eight handling procedures has suggested that little improvement, as assessed by IAP, has occurred throughout the trial or at a follow-up session. In many instances a decrement of performance has been observed. Further epidemiology has been presented which shows no relationship between the time spent training in such techniques and subsequent point prevalence of back pain. The current emphasis on training has been questioned and the need for controlled prospective trials is stressed. An approach requiring the development of intrinsically safe systems of work, with particular emphasis on the contribution of ergonomics, has been advanced.