CE Module: Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis

This issue of Workplace Health & Safety contains a Continuing Nursing Education Module for 1.0 contact hour of continuing nursing education credit will be awarded by AAOHN upon successful completion of the posttest and evaluation.

A certificate will be awarded when the following requirements are met by the participant: (1) Participant logs on to the AAOHN LMS website at www.aaohn.org/education/online-learning-center and enrolls in the course ($10 members; $15 non-members); (2) The completed posttest and course evaluation are entered online at http://www.aaohn.org by December 2023; (3) A score of 75% (6 correct answers) is achieved by the participant.

Upon completion of this lesson, the occupational health nurse will be able to:

• Understand the impact of work-related musculoskeletal (WMS) injuries among healthcare workers

• List possible interventions to prevent WMS injuries and the relative effectiveness of these interventions.

• Identify the gaps in the literature related to the efficacy of interventions to prevent WMS injuries.

The American Association of Occupational Health Nurses, Inc. is an Approved Provider of continuing nursing education by the American Association of Occupational Health Nurses, Inc., an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. The American Association of Occupational Health Nurses, Inc. is additionally approved as a CNE provider by the California Board of Registered Nursing (#CEP9283).

Contact hours received for successful completion of the posttest and evaluation may be used for relicensure, certification, and re-certification.

1. In the United States, musculoskeletal disorders (MSDs) accounted for approximately ____ percent of all lost workdays. (Fill in the blank)

2. b. 25

3. c. 34

4. d. 78

Apart from physical injuries, MSD in healthcare workers may result in:

a. Reduced compensation for workers

b. Lost time and medical costs for employers

c. Increased health service costs

d. All the above

Various randomized controlled trials have revealed:

a. Mechanical assistive devices have reduced back, shoulder, and other physical discomfort in nurses

b. No measurable effect from the use of these devices

c. Patient injury due to the use of mechanical devices

d. None of the above

e. Both a. and b.

The authors recommend:

a. Additional studies, including meta-analyses, to identify the effects of various interventions to prevent MSD in healthcare workers

b. Preshift and postshift exercise programs to prevent MSD in healthcare workers

c. Use of lifting education and improved “body mechanics” to prevent MSD in healthcare workers

d. None of the above

Interventions to prevent work-related MSD in healthcare professionals were organized into six categories. These categories included, but were not limited to:

a. Motorized assistive devices

b. Nonmotorized assistive devices

c. Cognitive

d. A combination of cognitive and exercise

e. All the above

f. All but c.

Using inverse variance as a statistical tool in this study:

a. Confounded the results related to the use of motorized assistive devices

b. Was an inappropriate way to analyze results because it skewed the results related to using lifting training to prevent musculoskeletal injuries

c. Both a. and b.

d. Accounted for the precision of individual study estimates and gave more weight to studies with larger population sizes

The authors hypothesized exercise programs may have been less effective in preventing MSD among healthcare workers because:

a. Exercise programs evaluated were too short in duration to have an effect

b. There was no consistency to the exercise programs because of a lack of space in the healthcare facilities

c. Programs evaluated in the studies were too long and compliance may have been low as a result

d. None of the above

The systemic review performed by the authors of this study suggested:

a. Interventions to reduce MSD among healthcare workers were, in general, effective with the use of motorized assistive devices being the most efficacious

b. Exercise was the most effective intervention to prevent MSD among healthcare workers

c. Nonmotorized assistive devices did not have any measurable effect on the number and severity of MSD among healthcare workers

d. None of the studies were high quality enough to draw any conclusions

The authors concluded:

a. Utilizing only random controlled trials to evaluate interventions to prevent MSD in healthcare workers is optimal

b. A combined approach to preventing MSD in healthcare workers, including training in proper patient lifting techniques, the use of assistive devices, and physical conditioning, is optimal

c. Assistive devices are generally not effective in preventing pain and MSD in nurses

d. There is no truly effective way to prevent MSD in healthcare workers

Practical challenges identified by the authors in conducting random controlled trials to evaluate engineering controls to reduce MSD in healthcare workers are:

a. The low level of voluntary participation by healthcare workers

b. The feasibility and ethics of blinding and randomization

c. The standardization of patient lifting protocols and type of equipment across all hospitals

d. Obtaining supervisor and facilities management buy-in