The feasibility of using a video-based approach to quantify cumulative low back loads of nurses in an acute care hospital

Overview

Keywords: Nurse; Low back; Biomechanics

Timeline: 2008 - 2009

Researchers: Patricia Weir (Principal Investigator, University of Windsor), David Andrews (University of Windsor), Alan Salmoni (University of Western Ontario), Michael Kerr (University of Western Ontario), Jack Callaghan (University of Waterloo)

Funder: Centre of Research Expertise for the Prevention of Musculoskeletal Disorders (CRE-MSD)

Project type: Seed Grant

Sector/ Workplace type:  Healthcare sector

Themes: 
Theme 1 Injury mechanisms
Theme 2 Risk factors
Theme 3 Risk assessment and hazard identification

Background/rationale

Working nurses perform a large number of tasks that affect low back loading. Because large low back loads may lead to injury, more needs to be done to understand the effects of these job-related duties.

Research question/objectives/methods

The objective of this project was to evaluate the feasibility of using a video-based data collection technique in a hospital setting, in order to quantify the peak and cumulative loads on the low backs of working nurses. Video data were collected on 10 nurses working in a small, rural hospital in Southwestern Ontario for two hours of a shift by our research team. One researcher videotaped their activities and the other documented all aspects of their work including the mass of or forces exerted on objects the nurses interacted with as they performed their regular duties.

Key findings

Overall, the nurses performed 81 different tasks, across nine categories (patient moving and handling, nurse care, housekeeping, etc.), with the majority of their work time being spent in neutral postures. The mean peak compression force across all tasks was 5700N, and the mean cumulative compression forces, expressed over an eight-hour shift, ranged from 32.1 MN·s to 49.3 MN·s.  Generally, peak hand loads were overestimated by nurses, which may have lead to unrealistically high peak low back loads in a few cases. While the video approach was successful in obtaining useable video data, future work must continue to refine perceptual methods for obtaining hand load estimates and their impact on low back loads in nurses as they perform their normal workplace activities.

Implications for the prevention of MSDs

Overall, what this approach provides from an educational perspective is the ability to break down tasks into time-history profiles, and to provide concrete information on posture, hand loads and forces and moments acting at specific joints, which can ultimately be used to assess injury risk.