Schoenfisch Ashley L, Kucera Kristen L, Lipscomb Hester J, McIlvaine Jennifer, Becherer Lori, James Tamara, Avent Susan
Ashley Schoenfisch, PhD, MSPH, is Assistant Professor, Duke University School of Nursing, and Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina. Kristen L. Kucera, PhD, MSPH, ATC, LAT, is Assistant Professor, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, and Director, National Center for Catastrophic Sport Injury Research, University of North Carolina at Chapel Hill. Hester J. Lipscomb, PhD, is Professor Emeritus, Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina. Jennifer McIlvaine, PT, MSPT, CSPHA, is Physical Therapist, Safe Patient Handling Specialist, Duke Occupational and Environmental Safety Office, Durham, North Carolina. Lori Becherer, BS, is Staff Specialist, Duke Occupational and Environmental Safety Office, Durham, North Carolina, and Injury Prevention Research Center, University of North Carolina at Chapel Hill. Tamara James, MA, CPE, CSPHP, is Director, Ergonomics, Duke Occupational and Environmental Safety Office, and Assistant Professor, Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina. Susan Avent, MSN, MBA, MHA, RN, NEA-BC, is Associate Chief Nursing Officer, Quality, Duke University Health System, Durham, North Carolina.
Nurs Res. 2019 Jan/Feb;68(1):3-12. doi: 10.1097/NNR.0000000000000325.
Devices to lift, transfer, and reposition patients are recommended for healthcare workers' and patients' safety, but their intended use has yet to be fully realized.
The aim of this study was to describe hospital nursing staff use of lift/transfer devices and the presence of factors at the time of lifts/transfers with potential to influence whether devices are used.
Participants were 108 US nursing staff in a university-based medical center and two community hospitals. A self-completed questionnaire was used to collect demographic and work characteristics, typical frequency of patient lifts/transfers, training in and typical use of lift equipment, and specific factors that could influence use. Proportional distributions of lifting/transferring and repositioning frequencies in a typical shift, amount of equipment use, and factors present were examined overall and across worker and work-related characteristics.
Although trained in equipment use, only 40% used equipment for at least half of lifts/transfers. During lifts/transfers, factors often present included patient unable to help with lift/transfer (91.3%) or of a size/weight where participant needed assistance to help lift/transfer (87.5%); availability of others who could assist with manual lift (86.3%) or use of lift equipment (82.4%); and equipment functioning properly (86.4%), having supplies available (82.5%), and being easy to retrieve from storage (81.6%). During repositioning tasks, physical assistance was "always/almost always" provided from coworkers (83.3%) and often perceived as "very helpful" (92.6%) in reducing physical demands. Physical assistance from patients was less common (14.0% "always/almost always") yet perceived as "very helpful" by 66.3%. One fifth always used friction-reducing devices.
Despite training in their use, nursing staff use of available lift equipment and assistive devices is limited. Factors present at the time of lifts/transfers that may influence equipment/device use reflect a complex mix of patient, worker, equipment, and situational characteristics.
为保障医护人员和患者的安全，推荐使用用于抬起、转移和重新安置患者的设备，但其预期用途尚未得到充分实现。
本研究旨在描述医院护理人员对升降/转移设备的使用情况，以及在升降/转移时存在的可能影响设备使用与否的因素。
研究对象为美国一家大学医学中心和两家社区医院的108名护理人员。采用自填式问卷收集人口统计学和工作特征、患者升降/转移的典型频率、升降设备的培训及典型使用情况，以及可能影响使用的具体因素。总体以及按工作人员和与工作相关的特征，对典型班次中升降/转移和重新安置的频率比例分布、设备使用量和存在的因素进行了检查。
尽管接受过设备使用培训，但只有40%的人至少一半的升降/转移使用了设备。在升降/转移过程中，经常出现的因素包括患者无法协助升降/转移（91.3%）或患者的体型/体重需要参与者获得协助才能进行升降/转移（87.5%）；有其他人可协助手动升降（86.3%）或使用升降设备（82.4%）；设备运行正常（86.4%）、有可用物资（82.5%）且易于从储存处取出（81.6%）。在重新安置任务中，同事“总是/几乎总是”提供身体协助（83.3%），并且在减轻体力需求方面通常被认为“非常有帮助”（92.6%）。患者提供的身体协助较少见（14.0%“总是/几乎总是”），但66.3%的人认为“非常有帮助”。五分之一的人总是使用减摩设备。
尽管接受了设备使用培训，但护理人员对现有升降设备和辅助设备的使用仍然有限。升降/转移时可能影响设备/装置使用的因素反映了患者、工作人员、设备和情境特征的复杂组合。
