RESUMO
Objective: To investigate the prevalence of work-related musculoskeletal disorders(WMSDs) among intensive care unit (ICU) nurses, assess its relationship with ergonomic load and overall exposure levels. Methods: A total of 272 ICU nurses from two tertiary hospitals in a city were selected as the research subjects using convenient sampling method. The Chinese Musculoskeletal Disorder Questionnaire was used to investigate the prevalence of WMSDs among the ICU nurses. The Quick Exposure Check (QEC) was used to assess the ergonomic load on the back, shoulder/arm, hand/wrist, and neck during different clinical nursing operations. Results: The annual prevalence of WMSDs was 75.7% among ICU nurses. The annual prevalence of WMSDs in different body parts, from high to low, was as follows： lower back, neck, shoulder/arm, back, knee, hip/leg, hand/wrist, ankle/foot, and elbow (54.8% vs 43.4% vs 40.8% vs 36.0% vs 21.3% vs 19.9% vs 18.8% vs 18.4% vs 8.1%, P<0.01). ICU nurses had the highest QEC scores on the back (dynamic), shoulder/arm, hand/wrist, and neck with assisting patient turning (all P<0.05) among the six clinical nursing items. During the operation of patient turning, patient lifting, patient bathing, and bed sheet changing for bedridden patients, the back (dynamic) and shoulder/arm were at a high load level, while the hand/wrist and neck were at a mild load level. When nurses were providing tracheostomy care and oral care for intubated patients, their back (static), shoulder/arm, hand/wrist, and neck were at a mild load level. The overall exposure rate for assisting patient turning, patient lifting, oral care for intubated patients, bed sheet changing for bedridden patients, patient bathing, and tracheostomy care were 77.8%, 66.5%, 63.6%, 60.2%, 58.5%, and 57.4%, respectively. The risk for assisting patient turning was classified as level four, while the risk for other clinical nursing items was level three. Conclusion: The prevalence of WMSDs in ICU nurses is high. Both ergonomic load level and total exposure rate of back, shoulder/arm, hand/wrist and neck were high during clinical nursing operations.
RESUMO
Objective:To explore the role of scenario simulation exercise combined with formative assessment in the teaching of operating room interns.Methods:A total of 86 interns received by the operating room from April 2019 to March 2020 were selected and divided into control group and study group according to the order of internship, with 43 interns in each group. Traditional clinical teaching was used in the control group, and the clinical teaching of scenario simulation exercise combined with formative assessment was used in the study group. The assessment results of theoretical knowledge and operational skills, the changes of clinical comprehensive ability before and after practice and the recognition of teaching were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:After practice, the scores of theoretical knowledge and operational skills in the study group were significantly higher than those in the control group ( P < 0.05). There was no statistical difference in the scores and total scores of professional knowledge application ability, health education ability, basic skill operation, professional skill operation, evaluation and diagnosis ability, information processing ability, communication and communication ability, adaptability, teamwork ability and professional attitude of the two groups before the internship. After the internship, the above scores and total scores were higher than those before the internship, with statistically significant differences ( P<0.05), and the scores and total scores of the study group were higher than those of the control group ( P<0.05). The total recognition rate of teaching in study group (93.02%, 40/43) was higher than that in the control group (76.74%, 36/43), with statistically significant differences ( P<0.05). Conclusion:The teaching method of scenario simulation exercise combined with formative assessment applied to the practice of physicians in the operating room can significantly improve the mastery level of theoretical knowledge and operational skills, clinical comprehensive ability and recognition of teaching.