جلوگیری از صدمات با استفاده از رویکرد ارگونومیک

The risk of back injury is a continuing problem for nurses. Patient-handling tasks (eg, transferring patients on and off stretchers, repositioning patients on OR beds) are a major precipitating factor to this problem. Educating nurses about body mechanics has not been the answer to preventing back injuries; however, changing the physical demands of the job (ie, using an ergonomic approach) by using assistive devices (eg, friction reducers) has been proven to decrease perceived stress and injury rates and increase patient comfort. This article focuses on the problem of nurses' back and shoulder overexertion injuries and explores the application of ergonomics in the perioperative setting. AORN J 72 (Dec 2000) 1031–1036. The saying “work can be dangerous to your health” is an important phrase in the nursing profession. In hospital settings, there are several dangers that especially affect nursing personnel. Although needle-stick injuries are the most frequently reported injury among hospital nurses, the most costly for health care facilities are overexertion injuries to workers' shoulders or backs.1 These problems have been studied, and progress has been made to decrease their prevalence.2 For example, the number of needle-stick injuries has decreased significantly in hospitals that use ergonomically designed syringes.3 Ergonomics is the scientific study of human work.4 It involves matching the job to the worker, rather than attempting to fit the worker to the job. The goal in ergonomics is to identify aspects of the job that are particularly hazardous and redesign them to be safer. This can be accomplished by redesigning the task, product, work station, environment, or overall work organization. In the example of needle-stick injuries, the product (ie, syringe) was redesigned so that the needle is shielded or retracted into the barrel immediately after the injection. In this way, nurses cannot self-inject themselves with a used needle, and the product now better fits the worker. Many approaches to decreasing back and shoulder problems have been tried in general industry, as well as in health care settings. Emphasis primarily has been on education and training, with a definite focus on body mechanics.5 These approaches, however, have had little effect on the problem, as the aim has been to change the worker instead of the job or the task.6 Studies indicate that an ergonomic approach involving the assessment of stressful tasks and the development of alternative methods to decrease this stress can reduce the number of overexertion injuries.7 As a result, the assumption that reducing physical stress reduces injuries was true.

Back and shoulder injuries to nurses occur frequently. The precipitating trigger for these injuries seems to be the lifting and transferring of patients. Using an ergonomic approach can decrease the perceived physical stress and the injury rate; however, additional precipitating factors to this problem in the OR need to be studied. Nurses must remember that the majority of overexertion injuries are the result of cumulative trauma. Nurses must develop and share an attitude of making workplaces as safe and healthy as possible for health care workers, as well as patients. It is important to determine which tasks are physically stressful and experiment with different approaches to decrease that stress. Nurses must be encouraged to solve problems and work with managers to make changes that could alleviate overexertion problems. All nurses should take responsibility to protect themselves from injury by implementing improved techniques for performing patient-handling tasks.