A randomized controlled trial to prevent patient lift and transfer injuries of health care workers

Study Design. Randomized controlled trial (RCT). Objectives. To compare the effectiveness of training and equipment to reduc e musculoskeletal injuries, increase comfort, and reduce physical demands o n staff performing patient lifts and transfers at a large acute care hospit al. Summary of Background Data. Back injury to nursing staff during patient han dling tasks is a major issue in health care. The value of mechanical assist ive devices in reducing injuries to these workers is unclear. Methods. This three-armed RCT consisted of a "control arm," a "safe lifting " arm, and a "no strenuous lifting" arm. A medical, surgical, and rehabilit ation ward were each randomly assigned to each arm. Both intervention arms received intensive training in back care, patient assessment, and handling techniques. Hence, the "safe lifting" arm used improved patient handling te chniques using manual equipment, whereas the "no strenuous lifting" arm aim ed to eliminate manual patient handling through use of additional mechanica l and other assistive equipment. Results. Frequency of manual patient handling tasks was significantly decre ased on the "no strenuous lifting" arm. Self-perceived work fatigue, back a nd shoulder pain, safety, and frequency and intensity of physical discomfor t associated with patient handling tasks were improved on both intervention arms, but staff on the mechanical equipment arm showed greater improvement s. Musculoskeletal injury rates were not significantly altered. Conclusions, The "no strenuous lifting" program, which combined training wi th assured availability of mechanical and other assistive patient handling equipment, most effectively improved comfort with patient handling, decreas ed staff fatigue, and decreased physical demands. The fact that injury rate s were not statistically significantly reduced may reflect the less sensiti ve nature of this indicator compared with the subjective indicators.