OR Manager April 2022 - 14
Move Well: Teaching OR staff to avoid musculoskeletal injuries
Employee Safety
urses have the highest incidence
of work-related musculoskeletal
injuries in the US, and
OR nurses have the highest incidence
among all nursing specialties.
Estimates in the literature say more
than 50% report chronic back pain,
and 10% must leave their profession
entirely because of back injuries. It is
also estimated that 90% of nurses will
report musculoskeletal injuries in their
careers.
N
" This isn't surprising
because nurses carry
out an array of highrisk
tasks in their daily
practice, " says Christina
Garbarino, BSN, RN,
perioperative nursing
professional development
specialist, Hospital
of the University of
Pennsylvania, Philadelphia.
Even more concerning is that current
nursing curricula do not have adequate
education programs on how to prevent
musculoskeletal injuries, she says.
Spur to action
A personal injury sustained by Garbarino
when transferring a patient from the OR
table to a stretcher, a rise in musculoskeletal
injuries in the perioperative
setting, and an increase in new OR staff
who had not been educated on musculoskeletal
injuries spurred Garbarino
and her colleagues in the perioperative
unit council to take action and start an
education program on musculoskeletal
injury risks and prevention.
Christina
Garbarino,
BSN, RN
Years of repetitive high-risk tasks,
such as lifting and repositioning
patients, lifting heavy instrument trays
and supplies, and moving heavy equipment
account for the vast majority of
injuries.
The key word, says Garbarino, is repetitive
because the injuries are cumulative
over time, and they build upon
each other and magnify. " What's really
troubling about these injuries is that
they are often silent, " she says. " You
reposition a patient and feel an ache
in your back, but you continue on with
your work that day. You have the next
day off, and your back feels better. You
go to work the next day after that, and
the pain is subtle, and by the end of the
day, it's gone. "
Even though the pain disappeared,
that does not mean the injury did not
happen, says Garbarino, and such injuries
accumulate over time. Musculoskeletal
disorders can result in a decrease
in job efficiency, job satisfaction, and
quality of life. More serious ramifications
are chronic pain and career-ending
disability.
14
OR Manager | April 2022
They presented their idea to the
nursing leadership team members in
perioperative services, who were " extremely
supportive, " she says, and they
sought the support of staff members,
who also were supportive.
Next, they formed a core team that
included Taneka Curtis, MHA, BSN, RN,
CNOR, the nursing leadership representative;
three frontline nurses, including
Garbarino; an injury prevention specialist
from the health system; and the perioperative
nursing educator. Garbarino
says the frontline nurses were invaluable
because ergonomic challenges are
part of their daily lives.
The team began with a literature review,
which proved invaluable in their
journey, and then identified their areas
of focus. An important finding from the
literature review was that the number of
articles related to ergonomics in the OR
had grown each year.
Results from the review showed that
a lack of knowledge in ergonomic principles,
practices, and risks led to an increase
in injury. They also showed that
when an increase in knowledge was
made possible by a strong educational
program, overall injuries decreased,
time off work decreased, and staff were
more satisfied with their jobs.
The literature further recommended
that ergonomic training sessions be
BY JUDITH M. MATHIAS
held at least yearly or in mini sessions
throughout the year.
Another important finding was the
impact that work-related musculoskeletal
disorders and injuries had on staffing,
accounting for one third of sick
leave. In addition, 12% of nurses were
leaving the profession yearly, and 70%
of the time, one reason nurses chose
to leave the profession for good was because
of work-related musculoskeletal
injuries.
In addition, the team learned of
AORN's seven ergonomic tools and articles
on how to implement the tools,
which cover high-risk tasks in the OR
and algorithms for safely and appropriately
carrying out these tasks and mitigating
the risks (sidebar, AORN's seven
ergonomic tools).
Four-part structure
Garbarino notes that one major finding
from their literature review that became
the " bones " of their project and gave
it structure was the Cairo University
Hospital study on occupational risk factors
for musculoskeletal disorders and
AORN's seven
ergonomic tools
➤ Tool 1: Lateral transfer of a patient
from a stretcher to the OR bed
➤ Tool 2: Positioning and repositioning
the supine patient on the OR bed
➤ Tool 3: Lifting and holding the patient's
legs, arms, and head while
prepping
➤ Tool 4: Solutions for prolonged standing
➤
Tool 5: Tissue retraction
➤ Tool 6: Lifting and carrying supplies
and equipment
➤ Tool 7: Pushing, pulling, and moving
equipment on wheels
https://www.aorn.org/about-aorn/
aorn-newsroom/periop-todaynewsletter/2018/2018-articles/
ergonomic-tools
www.ormanager.com
https://www.aorn.org/about-aorn/aorn-newsroom/periop-today-newsletter/2018/2018-articles/ergonomic-tools
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OR Manager April 2022
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