Work organization factors associated with patient handling injuries among nurses and nurses' aides

Qualitative and quantitative research findings were used to investigate the effects of personal and workplace characteristics on musculoskeletal symptoms and patient handling injuries among nurses and nurses' aides. Data were collected through focus groups and questionnaires as part of an ongoing 4-year study to evaluate interventions aimed at reducing physical demands of nursing staff. During focus groups, nurses and aides described difficulties of a sicker and heavier patient population, increased workloads when co-workers were injured and social pressure to participate in manual lifting and transferring of patients, despite the availability of patient handling equipment. Through anonymous questionnaires, reports of low back symptoms in the past 6 months were prevalent among both nurses and aides (50% and 59%, respectively); however, compared to nurses, aides reported higher symptom frequency, duration and severity, as well as more patient handling injuries. We also observed disparities between nurses and aides regarding aspects of work organization; compared to nurses, aides reported lower skill discretion, decision latitude, and co-worker support and higher physical demands, job dissatisfaction, and job insecurity. Furthermore, aides reported a higher frequency of patient moves/assists per shift than nurses. Work performed by nurses' aides is crucial to fulfilling tasks of direct patient care; however, a relative lack of autonomy in the workplace makes these individuals less able to prevent or cope with health consequences of physical, psychological, or social burdens. Our findings suggest that interventions aimed at reducing musculoskeletal disorders should focus on physical and psychosocial factors of direct patient care and work organization.