School of Public Health, Institute for Health Policy, The University of Texas, Houston, TX, USA.
J Occup Rehabil. 2010 Jun;20(2):199-219. doi: 10.1007/s10926-010-9231-y.
Health care work is dangerous and multiple interventions have been tested to reduce the occupational hazards.
A systematic review of the literature used a best evidence synthesis approach to address the general question "Do occupational safety and health interventions in health care settings have an effect on musculoskeletal health status?" This was followed by an evaluation of the effectiveness of specific interventions.
The initial search identified 8,465 articles, for the period 1980-2006, which were reduced to 16 studies based on content and quality. A moderate level of evidence was observed for the general question. Moderate evidence was observed for: (1) exercise interventions and (2) multi-component patient handling interventions. An updated search for the period 2006-2009 added three studies and a moderate level of evidence now indicates: (1) patient handling training alone and (2) cognitive behavior training alone have no effect on musculoskeletal health. Few high quality studies were found that examined the effects of interventions in health care settings on musculoskeletal health.
The findings here echo previous systematic reviews supporting exercise as providing positive health benefits and training alone as not being effective. Given the moderate level of evidence, exercise interventions and multi-component patient handling interventions (MCPHI) were recommended as practices to consider. A multi-component intervention includes a policy that defines an organizational commitment to reducing injuries associated with patient handling, purchase of appropriate lift or transfer equipment to reduce biomechanical hazards and a broad-based ergonomics training program that includes safe patient handling and/or equipment usage. The review demonstrates MCPHI can be evaluated if the term multi-component is clearly defined and consistently applied.
医疗工作存在危险，已经测试了多种干预措施来降低职业危害。
采用最佳证据综合方法对文献进行系统评价，以解决一般问题“医疗保健环境中的职业安全和健康干预措施对肌肉骨骼健康状况是否有影响？”随后评估了特定干预措施的有效性。
最初的搜索确定了 1980-2006 年期间的 8465 篇文章，根据内容和质量减少到 16 项研究。对于一般问题观察到中等水平的证据。观察到中等证据的有：（1）运动干预；（2）多组分患者搬运干预。对 2006-2009 年期间的更新搜索增加了三项研究，现在表明有中等水平的证据：（1）单独的患者搬运培训；（2）单独的认知行为培训对肌肉骨骼健康没有影响。很少有高质量的研究发现干预措施对医疗保健环境中的肌肉骨骼健康的影响。
这里的发现与以前的系统评价一致，支持运动提供积极的健康益处，而单独的培训无效。鉴于中等水平的证据，建议将运动干预和多组分患者搬运干预（MCPHI）作为需要考虑的实践。多组分干预包括一项政策，该政策定义了减少与患者搬运相关的伤害的组织承诺，购买适当的提升或转移设备以减少生物力学危害以及广泛的人体工程学培训计划，包括安全的患者搬运和/或设备使用。该审查表明，如果明确定义和一致应用多组分术语，可以评估 MCPHI。
