Moving patients is a task that requires force, and poses musculoskeletal risk among practical nurses. The use of an equipment to assist patient lifting and transferring can reduce musculoskeletal risk. This study was a quasi-experimental research measuring the effectiveness of a patient moving device for a period of 4 weeks among practical nurses in a hospital. The 33 subjects were selected based on the inclusion criteria. The data were collected by using the rapid upper limb assessment (RULA) tool. The results showed that the patient moving device could reduce musculoskeletal risk which included the work posture significantly (P < 0.05). This study could be used as a practical basis for hospital to bring in the equipment for assisting moving of patients.
The shortage of nursing staff in Thailand is a national problem that has been continuing for decades. It is due to the change in the population structure, the increase of the elderly population and chronic diseases [
A preliminary study of the risk factors for musculoskeletal disorders of nursing assistants in an eastern Private Hospital found that the high risk activities including patient support, changing posture or positioning patients in beds, and moving patients from a wheelchair or to a wheelchair. The OR were 3.97, 3.82, and 3.73 respectively [
Patients handling continues to represent a high risk of low back pain (LBP) among health care providers. A study that employed the 3-D images showed spine forces imposed upon the lumbar spine when 10 subjects manipulated ceiling-based and floor-based patient lifts through various patient handling conditions and maneuvers. The results indicated that ceiling-mounted patient lift systems imposed spine forces upon the lumbar spine that would be considered safe, whereas floor-based patient handling systems had the potential to increase anterior/posterior shear forces to unacceptable levels during patient handling manoeuvres [
Patient transfer devices are considered a potential intervention; however, few biomechanical analyses had investigated the spine loads and LBP risk associated with these transfer devices [
Based on the above information, the researchers had designed a sliding device to use with the original patients moving board. The main objective of this study was to determine the effectiveness of the device for reducing musculoskeletal risk by using the RULA (rapid upper limb assessment) score.
A quasi-experimental study took place in a hospital in the Chonburi province of Thailand. The 33 female practical nurses were selected based on the inclusion criteria, including no history of Gout or the other related to musculoskeletal diseases and no history of spine surgery.
The data were collected in terms of the Rapid Upper Limb Assessment (RULA) worksheet [
Action level 1: A score of 1 or 2 indicated that posture was acceptable if it was not maintained t0 repeated for long periods.
Action level 2: A score of 3 or 4 indicated that further investigation was needed and changes might be required.
Action level 3: A score of 5 or 6 indicated that investigation and changes were required soon.
Action level 4: A score of 7 indicated that investigation and changes were required immediately.
1) The design of the dimensions of the device used the standard anthropometric data of the shoulder length of the Thai women which was 40.5 cm [
2) Nylon was selected for the material of the sheet and the pulling rope based on its durability and low friction coefficient [
3) The device was tested with the nurse assistants. A problem was found in that the ropes were too long and the nylon sheet was too large. Therefore, we decreased the length of the ropes and the size of the sheet. In addition, we also stitched the corners of the sheet as shown in
4) The device was used by the practical nurses for transferring patients for a period of 4 weeks.
The study protocol was approved by the Ethics Committee of the Faculty of Public Health, Burapha University. Subject participation in this study was on a voluntary basis: every respondent gave a copy of the informed consent. As for the assurance of privacy and confidentiality, the information was kept in a locked cabinet and destroyed after the study was over.
The 33 women practical nurses had an average age of 39.09 years old (S.D.12.06 years). The majority was obese based on the body mass index (57.6%). Approximately 84.9% of the participants completed at least secondary school. The
results of the study indicated that the most common cause of musculoskeletal pain was patient transfer (48.5%), followed by patient lifting, patient wiping, and lifting objects (15.1%, 9.1%, and 9.1%, respectively).
The results of RULA score before using the device was 7 on both left and right sides, as shown in
The result of the risk assessment of working posture while moving patients after using the device was shown in
The comparative results of the RULA scores between before and after using the device indicated that the majority of working posture risk decreased from 7 to 6 (66.67%), followed by 5 (30.30%), and 4 (3.03%), respectively. The average score before using the device was 7.00 (SD = 0.000) and after was 5.64 (SD = 0.096) (P < 0.05).
The results of the risk assessment of working posture while moving patients before using the transfer device showed that the RULA score was 7. The results were consistent with that of Sasigala and Paseillas who found that moving of patients was a high risk task [
| Working posture assessment | Score | ||
|---|---|---|---|
| Left side | Right side | ||
| Group A. Scoring posture of the body part which included the upper arm, the lower arm, and the wrist. | |||
| 1. | The range of upper arm movement | 5 | 5 |
| 2. | The range of lower arm movement | 2 | 2 |
| 3. | The position of wrist | 2 | 2 |
| 4. | The pronation and supination of wrist | 1 | 1 |
| 5. | The summary score for upper arm, lower arm and wrist | 6 | 6 |
| 6. | Muscle usage | 0 | 0 |
| 7. | Force | 3 | 3 |
| 8. | Score A. | 9 | 9 |
| Group B. Scoring the posture of the neck, trunk, and legs. | |||
| 9. | The range of neck movement | 4 | 4 |
| 10. | The range of trunk movement | 4 | 4 |
| 11. | The position of legs | 1 | 1 |
| 12. | The summary score for neck, trunk, and legs | 7 | 7 |
| 13. | Muscle usage | 0 | 0 |
| 14. | Force | 3 | 3 |
| 15. | Score B. | 10 | 10 |
| Final score (Score C.) | 7 | 7 | |
| Working posture assessment | Score | ||||
|---|---|---|---|---|---|
| Left side | Right side | ||||
| Maximun | Minimum | Maximun | Minimum | ||
| Group A. Scoring posture of the body part which included the upper arm, the lower arm, and the wrist. | |||||
| 1. | The range of upper arm movement | 1 | 1 | 1 | 1 |
| 2. | The range of lower arm movement | 1 | 2 | 1 | 2 |
| 3. | The position of wrist | 1 | 2 | 1 | 2 |
| 4. | The pronation and supination of wrist | 1 | 1 | 1 | 1 |
| 5. | The summary score for upper arm, lower arm and wrist | 1 | 2 | 1 | 2 |
| 6. | Muscle usage | 0 | 0 | 0 | 0 |
| 7. | Force | 3 | 3 | 3 | 3 |
| 8. | Score A. | 4 | 5 | 4 | 5 |
| 9. | The range of neck movement | 1 | 3 | 1 | 3 |
| 10. | The range of trunk movement | 1 | 1 | 1 | 1 |
| 11. | The position of legs | 1 | 2 | 1 | 2 |
| 12. | The summary score for neck, trunk, and legs | 1 | 3 | 1 | 3 |
| 13. | Muscle usage | 0 | 0 | 0 | 0 |
| 14. | Force | 3 | 3 | 3 | 3 |
| 15. | Score B. | 4 | 6 | 4 | 6 |
| Final score (Score C.) | 4 | 6 | 4 | 6 | |
has helped adjusting the working posture while moving patients. In addition, the positions of the upper arm, the lower arm, the wrist, the neck, and the trunk were improved. However, the device did not help adjusting the posture of the legs because the length of the pulling ropes could not be altered and the working area was limited. The pulling ropes provided power grip. Future study is recommended to improve the design of the rope for the device.
Meepradit, P., Panyadee, K. and Yingratanasuk, T. (2018) The Effectiveness of the Lateral Patient Transfer Device to Reduce Musculoskeletal Risk among Practical Nurses in a Hospital, Thailand. Journal of Biosciences and Medicines, 6, 45-51. https://doi.org/10.4236/jbm.2018.65006