From staffing and scheduling changes, to hospital facilities that go out of business: according to a new study, these and other organizational changes are contributing to reported musculoskeletal disorders (MSDs) in nurses.
The study, which sought to determine if aspects aside from the physical job demands of nursing could contribute to neck, back or shoulder pains, questioned 1163 nurses about their industry and, more specifically, about the changes in the facilities in which they worked. Each nurse in the survey had been working as a nurse for a minimum of 12 months, and had neither been injured nor in an accident away from work for at least three months prior to the onset of any possible MSD symptoms. For the study, an MSD case was defined as “moderate pain that lasted at least one week or occurred monthly during the past year.”
Participants were asked questions regarding 12 organizational factors covering changing levels of staffing, severity of patient illnesses, and delivery of nursing care, and were instructed to state whether each saw a “low,” “moderate” or “high” change in the previous year. Participants were then also asked about neck, shoulder or back pain, as well as the physical and psychological demands associated with their jobs.
According to the study’s lead author, Dr. Jane Lipscomb, 29 percent of the nurses reported back pain, 20 percent reported neck pain and 17 percent reported shoulder pain.
Of the organizational changes, three of the 12 were found to be significantly associated with MSDs in all three of the body sites. Specifically, those changes included replacing nurses with part-time or temporary nurses, shutting down a facility or unit, and having unlicensed staff provide direct patient care.
“The odds ratios for neck, shoulder, and back musculoskeletal disorders showed a consistent and increasing trend with the level of reported healthcare system change,” the authors wrote in the American Journal of Public Health. Specifically, the authors noted that nurses in facilities that reported six or more changes in the previous year were found to be five-times as likely to report a neck injury and three-times as likely to report a shoulder or back injury than nurses who reported no organizational changes or just one organizational change in their facilities.
Additionally, the authors concluded that “the adverse impact on health caused by the changing health care system must be addressed to prevent further injuries among nurses.”
Sources: American Journal of Public Health; Reuters