Load Survey
P.Meijsen RN. Eindhoven Netherlands
Introduction: This study was possibly the first of its kind to explore the physical strain among OR nurses. The three practical research studies were preceded by a study of the available literature in order to obtain a general picture and the status quo concerning physical complaints and strain among operating room staff.
The practical research was carried out in the operating wards of 16 Dutch hospitals. One OR nurse from each of these hospitals took part in a national research circle. Ten central meetings were organized during which the practical research was prepared, processed and discussed. Between the meetings the research was conducted "on the shop floor" in the sixteen hospitals. Expert support was provided by scientists in kinesiology. This system made it possible to conduct reliable research with a large study group. An estimated 10 percent of Dutch OR nurses contributed to the study.
The studies were chiefly financed by the Sectoral Funds for Health and Welfare. Additional funding was also provided by the National Association of OR Nurses (LVO).
Method and Results
Study on standing time (prolonged standing)
The study on standing time (226 OR nurses, on n=678 working days) revealed that workers often spend too much time on tasks that require extensive periods of standing. It emerged that, every day, two out of three OR nurses exceed the standards for standing work as laid down in the guidelines relevant to daily practice in the Occupational Health and Safety Agreement, and are thereby putting their health at risk. In the stoplight model used, 17% of the working days scored red, indicating high strain and a significantly increased risk of complaints. The subsequent recommendation was that direct actionm be taken. Amber was scored on 47% of the working days. This is indeed a lower risk, but is also considered unacceptable on account of the frequent occurrence. The most stressful factor in this regard is remaining standing for too long during every working day. On only 36% of the working days did the OR nurses not exceed the maximum.
Study of working postures
The posture study was conducted by means of a newly developed technique. This so-called Houdini method can be used reliably by OR nurses. Although the method was simple, its practicability and validity were found to be adequate. The method is a multi-moment snapshot technique which makes a distinction between neutral and stressful neck, shoulder and back postures. It showed that the percentages of stressful postures among staff who stand for extensive periods while assisting in surgical procedures are high: neck 81%, shoulder 67%, back 51% (n= 35, number of multi-moment snapshots =1,979).
| Complaints percentage (3-month prevalence) n= 463< | Exceeding of practical guidelines n=678 | Number of stressful postures during instrumentation n=35, 1,979 observations | |
| Neck |
53%
|
-
|
74%
|
| Shoulder & arm |
-
|
62%
|
|
| Back |
58%
|
66%
|
53%
|
| Legs |
43%
|
-
|
Table 1. The key results of the practical studies. High complaints percentages go hand in hand with a high degree of stressful postures.
The full version with the conclusions and solutions can be downloaded here as a Word document and here as a PDF file.
Our special thanks to Paul Meijsen for allowing his survey to be quoted.
