Pompeii Lisa A, Lipscomb Hester J, Schoenfisch Ashley L, Dement John M
Division of Environmental and Occupational Health Sciences, School of Public Health, The University of Texas, Houston, Texas 77030, USA.
Am J Ind Med. 2009 Jul;52(7):571-8. doi: 10.1002/ajim.20704.
The purpose of this study was to evaluate musculoskeletal injuries and disorders resulting from patient handling prior to the implementation of a "minimal manual lift" policy at a large tertiary care medical center. We sought to define the circumstances surrounding patient handling injuries and to identify potential preventive measures.
Human resources data were used to define the cohort and their time at work. Workers' compensation records (1997-2003) were utilized to identify work-related musculoskeletal claims, while the workers' description of injury was used to identify those that resulted from patient handling. Adjusted rate ratios were generated using Poisson regression.
One-third (n = 876) of all musculoskeletal injuries resulted from patient handling activities. Most (83%) of the injury burden was incurred by inpatient nurses, nurses' aides and radiology technicians, while injury rates were highest for nurses' aides (8.8/100 full-time equivalent, FTEs) and smaller workgroups including emergency medical technicians (10.3/100 FTEs), patient transporters (4.3/100 FTEs), operating room technicians (3.1/100 FTEs), and morgue technicians (2.2/100 FTEs). Forty percent of injuries due to lifting/transferring patients may have been prevented through the use of mechanical lift equipment, while 32% of injuries resulting from repositioning/turning patients, pulling patients up in bed, or catching falling patients may not have been prevented by the use of lift equipment.
The use of mechanical lift equipment could significantly reduce the risk of some patient handling injuries but additional interventions need to be considered that address other patient handling tasks. Smaller high-risk workgroups should not be neglected in prevention efforts.
本研究旨在评估在一家大型三级医疗中心实施“最小手动抬举”政策之前,因患者搬运导致的肌肉骨骼损伤和疾病。我们试图确定患者搬运损伤周围的情况,并确定潜在的预防措施。
利用人力资源数据定义队列及其工作时间。利用工伤赔偿记录(1997 - 2003年)识别与工作相关的肌肉骨骼索赔,同时利用工人对损伤的描述识别因患者搬运导致的损伤。使用泊松回归生成调整后的率比。
所有肌肉骨骼损伤中有三分之一(n = 876)是由患者搬运活动导致的。大部分(83%)的损伤负担由住院护士、护士助理和放射技师承担,而护士助理的损伤率最高(8.8/100全时当量,FTEs),包括急救医疗技术人员(10.3/100 FTEs)、患者转运员(4.3/100 FTEs)、手术室技师(3.1/100 FTEs)和停尸房技师(2.2/100 FTEs)在内的较小工作群体的损伤率也较高。通过使用机械抬举设备,40%因抬举/转移患者导致的损伤可能得以预防,而因重新安置/翻身患者、将患者在床上拉起或接住跌倒患者导致的损伤中,32%可能无法通过使用抬举设备预防。
使用机械抬举设备可显著降低某些患者搬运损伤的风险,但需要考虑针对其他患者搬运任务的额外干预措施。在预防工作中不应忽视较小的高风险工作群体。