Lower Extremity Discomfort in Registered Nurses: Links to Nursing Unit Layout

Abstract

This study reports objective measurements of lower extremity activity (amount of walking, standing, sitting) in nurses working in medical/surgical (M/S) and intensive care units (ICU), and explores nurses’ perceptions of nursing unit design impact on workload, lower extremity activity, and musculoskeletal discomfort. Nursing units are expanding in size, leading to nurses spending more time on their feet. Though limited in number, studies consistently report elevated prevalence of lower extremity discomfort/injury in nurses. This was a mixed method approach using physical activity measurement and semi-structured interviews of M/S and ICU nurses. Lower extremity discomfort was prevalent in the study participants. Time on feet and step counts differed between nursing units with different layouts. Average hours on feet ranged from 7.3 to 9.5 across units over 12-hour shifts. Nurses’ comments explained ways in which walking and standing activities were influenced by unit layout design and culture. Nurse leaders must advocate for unit designs that maximize patient safety, promote a culture of team spirit, and provide a physically safe working environment for staff. This study reports objective measurements of lower extremity activity (amount of walking, standing, sitting) in nurses working in medical/surgical (M/S) and intensive care units (ICU), and explores nurses’ perceptions of nursing unit design impact on workload, lower extremity activity, and musculoskeletal discomfort. Nursing units are expanding in size, leading to nurses spending more time on their feet. Though limited in number, studies consistently report elevated prevalence of lower extremity discomfort/injury in nurses. This was a mixed method approach using physical activity measurement and semi-structured interviews of M/S and ICU nurses. Lower extremity discomfort was prevalent in the study participants. Time on feet and step counts differed between nursing units with different layouts. Average hours on feet ranged from 7.3 to 9.5 across units over 12-hour shifts. Nurses’ comments explained ways in which walking and standing activities were influenced by unit layout design and culture. Nurse leaders must advocate for unit designs that maximize patient safety, promote a culture of team spirit, and provide a physically safe working environment for staff. Jing Li, PhD is a former graduate research associate at the College of Engineering, The Ohio State University, in Columbus, Ohio. Carolyn Sommerich, PhD, CPE, is associate professor at the College of Engineering and School of Health and Rehabilitation Sciences, The Ohio State University. Esther Chipps PhD, RN, NEA-BC, is clinical nurse scientist, associate professor of clinical nursing, at The Ohio State University Wexner Medical Center and The Ohio State University College of Nursing. She can be reached at [email protected]