Investigating the Risk of Patient Manual Handling Using the Movement and Assistance of Hospital Patients Method among Hospital Nurses in Botswana.

BACKGROUND: Evidence on the prevalence of lower back pain (LBP) among nurses is widespread in the literature, with several risk factors being reported. These include manual handling of patients, repetitive bending and twisting movements, and long working hours. It is reported that LBP has negative health outcomes and causes poor work performance among healthcare workers (HCWs). The magnitude of ergonomic risks associated with these healthcare activities has not been adequately investigated in Botswana. Thus, this study aimed to investigate the ergonomic risk levels associated with the manual handling of patients and its association with the prevalence of LBP among nurses in Botswana. METHODS: This was an observational cross-sectional hospital-based study conducted in a Botswana public tertiary hospital from March to April 2023. The Movement and Assistance of Hospital Patients (MAPO) tool was used to collect data on ergonomic risk levels. Data on the demographic characteristics of participants were collected using a tool adapted from the Nordic Musculoskeletal Questionnaire (NMQ). Odds ratios and 95% confidence intervals were estimated to determine the association between ergonomic risk levels and the prevalence of LBP. RESULTS: A total of 256 nurses participated and completed the study. The self-reported prevalence of LBP in this study was 76.6%. The risk of acquiring LBP was high (90.5%) based on the MAPO index. Although the frequencies of self-reported LBP were high among nurses, these did not show any significant association with the MAPO index data. This could be partly due to the small sample size. CONCLUSIONS: There was a high prevalence of LBP in this study, which was corroborated by the MAPO index data. This has demonstrated the value of the MAPO index in forecasting the risk of patient manual handling. The findings might help Botswana formulate policies intended to address ergonomic preventive measures, directed towards reducing the MAPO index score by addressing the single risk determinants.

Continuous assessment of trunk posture in healthcare workers assigned to wards with different MAPO index.

Healthcare professionals generally experience an above-average incidence of low back disorders (LBDs) compared with workers of other professions, and its level of risk is commonly assessed using observational methods such as the MAPO method (Movement and Assistance of Hospital Patients). In this study, we continuously monitored the trunk posture of 30 healthcare workers using a single inertial sensor to: (1) understand whether the MAPO classification is effective in adequately discriminating the risk associated with the time spent in non-neutral trunk postures and (2) characterise the variability of biomechanical exposure among workers employed in wards with the same MAPO index. The results substantially confirm the validity of the MAPO approach in discriminating among wards characterised by different levels of biomechanical exposure associated with the risk of developing LBDs. However, they also highlight the need to assess workers' exposure on an individual basis due to the high intra-group variability.Practitioner summary: Employing a quantitative measurement setup to monitor trunk posture along with an observational method (ie MAPO) can identify the existence of criticalities or the poor application of ergonomic recommendations given during the training of healthcare workers even in hospital wards characterised by little or no risk of developing low back disorders.

Patient manual handling risk assessment among hospital nurses.

BACKGROUND: Manual patient handling is known to be the major source of musculoskeletal load among hospital nurses. OBJECTIVES: The objectives of this study were to determine prevalence of musculoskeletal disorders (MSDs), assess patient manual handling risk and identify major factors associated with MSDs symptoms among hospital nursing staff. METHODS: This cross-sectional study was conducted among 400 randomly selected nurses from 75 wards of 11 hospitals. Data were collected by demographic and Nordic musculoskeletal questionnaires together with MAPO checklist. Prevalence of MSDs was estimated with confidence interval of 95%. Chi-square test and independent sample t-test were used to investigate differences of MSDs prevalence for demographic variables between the subjects with and without MSDs. Multiple logistic regression analysis was performed (forward: Wald) to determine MSDs associated risk factors. RESULTS: The means of age and job tenure in subjects were 30.76 ± 6.44 and 6.92 ± 5.75 years, respectively. Some form of musculoskeletal symptoms had been experienced during the last 12 months by 88.2% of the subjects. MAPO assessment revealed that 83.5% of the individuals were at risk. Statistical analysis showed that job tenure, nurse to bed ratio, gender, shift working and MAPO score were associated with MSDs (p< 0.05). CONCLUSIONS: Prevalence of MSDs in hospital nursing personnel was high and the occurrence of MSDs was found to be associated with MAPO score. Based on the results, to improve working conditions, it is imperative to provide lifting equipment, implement training programs and increase nurse to bed ratio in hospitals.