Engels J A, Brandsma B, van der Gulden J W
Department of Occupational Medicine, University of Nijmegen, The Netherlands.
Int Arch Occup Environ Health. 1997;69(6):475-81. doi: 10.1007/s004200050176.
The objectives of this study were (i) To establish whether it is possible to assess by means of a check-list in a reliable way errors which violated biomechanical and ergonomical principles during nursing tasks, and (ii) to study the effectiveness of an ergonomic-educational course by using this check-list.
Trainees (n = 12) and a control group of nurses (n = 12) who did not attend the course, performed three nursing activities at three points in time under standardized conditions; once before and twice after the course had ended. Their performances were recorded on video. A check-list was developed to assess the number of ergonomic errors made during the test performances. Two observers completed the check-lists after having watched five videotapes, and one of them did this for a second time 3 weeks later, in order to assess inter- and intra-observer reliability. In addition the tapes of all nurses were scored and analysed on differences in the performance of the two groups at the three points in time. Percentage of agreement and kappa (kappa) was used to express inter- and intra-observer reliability. Student's t-test was used to analyse the differences in mean percentages of errors.
The inter- and intra-observer reliability were 92% with kappa of 0.84 and 93% with kappa of 0.86, respectively. Further results showed that the mean percentages of errors made by the control group remained the same at the three measurement times. However, in the trainee group a significant decrease in errors was found. The trainees made fewer errors at all three points in time than the controls did.
It appears feasible to create a check-list to assess ergonomic errors in a reliable way. Trainees make fewer errors after an ergonomic-educational course. It is necessary, however to evaluate whether trained nurses work more safely in their daily duties than during the study.
本研究的目的是：（i）确定是否有可能通过一份检查表以可靠的方式评估护理任务期间违反生物力学和人体工程学原理的错误；（ii）使用该检查表研究人体工程学教育课程的效果。
未参加该课程的实习护士（n = 12）和对照组护士（n = 12）在标准化条件下于三个时间点进行三项护理活动；一次在课程开始前，两次在课程结束后。他们的操作过程被录像记录。制定了一份检查表以评估测试操作期间出现的人体工程学错误数量。两名观察者在观看五段录像带后完成检查表，其中一人在3周后再次进行，以评估观察者间和观察者内的可靠性。此外，对所有护士的录像带在三个时间点的两组操作表现差异进行评分和分析。一致性百分比和卡帕值（kappa）用于表示观察者间和观察者内的可靠性。使用学生t检验分析错误平均百分比的差异。
观察者间和观察者内的可靠性分别为92%，卡帕值为0.84，以及93%，卡帕值为0.86。进一步结果表明，对照组在三个测量时间点的错误平均百分比保持不变。然而，在实习护士组中发现错误显著减少。实习护士在所有三个时间点的错误都比对照组少。
创建一份检查表以可靠方式评估人体工程学错误似乎是可行的。经过人体工程学教育课程后，实习护士的错误减少。然而，有必要评估接受培训的护士在日常工作中是否比研究期间工作得更安全。
