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Ergonomics and Health Care

Why is it Important?

In the healthcare system we see a variety of types of employment. About one in ten vocations in the United States is in the private sector health care industry. The industry consists mainly of hospital workers, workers in small clinics and most of the remainder is in nursing homes. 

Nursing

Within the health care system nursing care facilities have been dominant in on-the-job injuries followed by home health care industries and then followed by hospitals.  

Although it has been known since the 1960s that patient handling by nurses and nursing assistants posed a significant risk for low back injuries it has only been in the last decade that the industry has shown any real interest in ergonomics. Traditionally, the problem was approached by imposing lifting restrictions on the injured worker and only recently has there been an emphasis on ergonomic solutions to patient lifting through the implementation of mechanical lifting assists.

Injuries and Ergonomic Aids Associated with Nursing Care 

In hospitals it has been found that nurses experience an inordinate number of injuries compared to other workers particularly in the realm of sprain/strain injuries. The hospital maintenance infrastructure also accounts for a large number of these injuries. 

Nursing and personal care facilities have demonstrated an incidence of sprain/strain injuries (especially involving the low back) at about three times that of all other health industries combined.  

Home health aides have been found to be particularly at risk because they usually work alone and are under equipped with the patient handling devices usually found in hospitals. It is most practical for the patient to lease these devices through home care organizations. These organizations conduct patient assessments to determine what is appropriate for the patient.  

Some of these devices include hospital type beds, portable patient hoists and shower chairs, portable commodes and riser attachments for toilet bowls, transfer boards and portable stand-assist lifts. Also helpful are transfer belts worn by the patient which have loops in the back and sides that can be held by aids during transfers. 

Injuries Associated with Dental Offices 

One study that looked at the postures of dentists at work with patients found that the dentists spent 82% of their time with the neck in flexion at more than 30 degrees. They also spent about 30% of their time with arms in more than 30 degrees of abduction. Although these postures largely tend to be what is termed low level static muscle contractions it is not surprising that as a group they tend to experience various musculoskeletal complaints mainly low back and neck in nature. 

Dental hygienists also undergo similar positions involving postures with shoulder muscles in static contraction. A recent survey indicated that Danish hygienists experienced rates of neck and shoulder problems much higher than could be found for women in the corresponding general working population. 

It is imperative that any worker experiencing these low level static muscle contractions take frequent pre-planned exercise/stretching breaks interspersed with muscle relaxation to restore blood flow into the muscles. 

It has also been found that dental hygienists are vulnerable to carpal tunnel syndrome due to the involvement of postures and forces exerted by their wrists. We suggest that these hygienists take frequent breaks and perform wrist range of motion stretching exercises.

Sources:
1). Jensen, Roger C. “Ergonomics in Health Care Organizations.” The Occupational Ergonomics Handbook. Ed. Waldemar Karwowski and William S. Marras. Boca Raton: CRC Press, LLC, 1999