Mitigating Musculoskeletal Disorder (MSD) risksAlthough two decades of research have demonstrated the work-relatednessof MSD, use of single-approach intervention methods to reduce MSD exposures(e.g., engineering controls, administrative changes, or worker training only) hasshown inconsistent outcomes, likely due to the combination of factors relatedto MSD and the need for broad organizational involvement to mitigate MSDproblems. Despite these concerns, important evidence-based successes havebeen demonstrated in reducing MSD, especially during patient lifting andtransfer. Interventions incorporating participatory ergonomics have beenfound to improve upon previous approaches by allowing for extensive workerinput into the design and adoption of preventive practices. In aparticipatory ergonomics approach, employees participate in the identificationof ergonomic risk factors, brainstorm alternatives and solutions, handleimplementation of controls, and assess control effectiveness along with symptomidentification, ultimately becoming champions for ergonomicschange.
Participatory ergonomics also has the potential for changing theculture of health care organizations, as employees begin to use ergonomicprinciples to improve jobs and the workplace. Because participatoryinterventions incorporate both management commitments to reducing injuries,along with workers who are involved in developing solutions, positive andeffective workplace changes can occur. Interventions for Musculoskeletal Disorder (MSD)Three common interventions used to prevent work-related musculoskeletalinjuries associated with patient handling are (1) classes in body mechanics,(2) training in safe lifting techniques, and (3) back belts. Despite their widespread use, these strategies are based on tradition rather than scientificevidence; there is in fact strong evidence these strategies are not effective. Recentlythere has been a major paradigm shift away from these approaches toward thefollowing evidence-based practices: (1) patient handling equipment/devices, (2)no-lift policies, (3) training on proper use of patient handling equipment/devices,and (4) patient lift teams.Chemical Occupational ExposuresThere are thousands of chemicals and other toxic substances to whichnurses are exposed in practice. Hazardous chemical exposures can occur in avariety of forms—including aerosols, gases, and skin contaminants—frommedications used in practice. Exposures can occur on an acute basis, up tochronic long-term exposures, depending upon practice sites and compoundsadministered; primary exposure routes are pulmonary and dermal.
Substancescommonly used in the health care setting can cause asthma or trigger asthmaattacks, according to a recent report. The report explores the scientificevidence linking 11 substances to asthma, including cleaners and disinfectants,sterilants, latex, pesticides, volatile organic compounds (includingformaldehyde), and pharmaceuticals. An important criterion for the selection ofthe substances in the report was the presence of safer alternative products orprocesses.
The evidence is derived from an array of peer-reviewed sources ofscientific information, such as the National Academy of Science Institute ofMedicine.
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