Manual Handling Workload and Musculoskeletal Discomfort in Nursing Personnel

Nursing staff members (registered nurses, licensed practical nurses, and nursing aides) have one of the highest incidence rates of work-related musculoskeletal disorders (WMSDs) of all occupations. Ergonomic research has identified patient handling and movement tasks that put the caregiver at high risk for a WMSD each time they are performed. The purpose of this study was to determine whether the frequency of performing the highest risk tasks, as well as certain other risk factors affecting physical workload, were related to the frequency of musculoskeletal discomfort. Also investigated was whether the manual handling workload varied by job category. The cross-sectional study was conducted at a Veterans\u27 Administration hospital in Tampa, Florida in August 2001 on 11 in-patient units with 113 participants, who completed musculoskeletal discomfort and demographic surveys at the end of a week of observation of their workloads. Multiple regression analysis indicated that the number of high risk patient handling and movement tasks performed per hour, the number of patients cared for who weighed 212 pounds or more, and the interaction of the two were associated with the frequency of knee and wrist pain, but not with low back pain. The following variables were not associated with the frequency of musculoskeletal discomfort in any body part: patient census/able bodied staff ratio, patient classification rating, or number or use of patient handling and movement equipment. Manual handling workload did differ significantly among job categories, with registered nurses performing the fewest at- risk patient handling tasks and nursing aides the most. The seven-day prevalence rate of at least moderate discomfort in at least one body part was 62%. Recommendations include instituting recorded patient assessments to standardize the type of equipment and the number of staff members needed for specific handling and movement activities, as well as improved staff training. Further research is needed on the following: biomechanical forces on the wrist and knee during patient handling and movement tasks; the effect of patient weight on the risk of patient handling and movement tasks; and psychosocial stressors in addition to the physical workload of nursing staff