Patient Lifting Research Articles

Early mobilisation using a mobile patient lift in the intensive care unit: protocol for a randomised controlled trial

IntroductionIt is important to prevent the deterioration of activities of daily living to improve the long-term prognoses of patients in the intensive care unit (ICU). The patients’ conditions, along with...

병원과 의원 종사자의 근로 환경과 건강관련 문제의 비교

Objective: This study analyzes occupational risk factors and health-related problems of healthcare workers and compares hospital workers with clinic workers.BRBackground: There are differences in the working environment, health problems, and health status between hospital and clinic workers. However, comparative studies between hospital and clinic workers have been insufficient so far.BRMethod: 1,135 workers were extracted from the 5th Korean Working Condition Survey data. Among them, 644 were hospital workers, and 491 were clinic workers. BRResults: Hospital workers were more exposed to risk factors such as patient lifting and carrying, heavy material handling, and infection. On the other hand, clinic workers had more exposure to risk factors such as vibration, standing posture, and repetitive movements. Both hospital and clinic workers complain of musculoskeletal pain and depression. The rate of complaints regarding upper limb, back pain, and depression was higher for hospital workers compared to clinic workers.BRConclusion: Healthcare workers are exposed to risk factors and have musculoskeletal pains and depression. Therefore, it is required to make efforts to improve working conditions of the healthcare workers.BRApplication: The results can be used as basic data for improving working conditions and for reducing work-related risk factors and health-related problems of healthcare workers.

Occupational injuries and patient lift usage among physical rehabilitation therapists

Physical therapists (PTs) and physical therapist assistants (PTAs) are at high risk for work-related musculoskeletal pain and discomfort. Determine the prevalence and exposure risk factors for work-related injuries (WRIs) among rehabilitation PTs and PTAs. A cross-sectional research survey was conducted among 170 PTs and 67 PTAs at 51 free-standing rehabilitation hospitals and rehabilitation units embedded in general hospitals in the Midwestern states of Iowa, Kansas, Missouri and Nebraska. The prevalence of WRIs and significant risk factors for developing WRIs were determined for PTs and PTAs. The 1-year prevalence of WRIs among PTs and PTAs working in physical rehabilitation was 29.5%. Multifaceted causes were identified including frequently bending/twisting, over-exerting force during patient handling activities, inadequate lifting devices, and lack of ongoing training for mechanical lifting device usage. Equipment usage barriers point to a critical need for technology creation, research, and education to advance worker safety while simultaneously enhancing patient outcomes.

Asian Face Lift with the Composite Face Lift Technique.

The composite face lift is becoming increasingly popular following recent advances in understanding of facial anatomy that enable safe sub-superficial musculoaponeurotic system (SMAS) dissection. This article presents the authors' technique for composite face lift in Asian patients and reviews their experience and outcome with this procedure. Composite face lifts were performed on 128 Asian patients between January of 2010 and June of 2020. Ninety-four were primary face lifts, and 34 were secondary or tertiary face lifts. The authors' surgical technique and adaptations for the specific requirements of Asian patients are described in detail. The mean follow-up was 26 months (range, 6 to 108 months). Fat grafting was an integral part of our procedure, with 95 percent having concomitant facial fat grafting with their face lift. Patients were followed up in accordance with a standardized schedule. The majority of patients reported high satisfaction with the aesthetic outcome of the technique, with natural, long-lasting results. The face lift plane of dissection is through the facial soft-tissue spaces, which provide atraumatic sub-SMAS access with precise release of the intervening retaining ligaments for effective flap mobilization. By emphasizing tension on the composite flap with no tension on the skin closure, the scars were discrete in the great majority of patients. Complications were few, with no hematomas or skin flap necrosis. The temporary nerve injury rate was 1.5 percent, with no patient having a permanent nerve injury. The composite face lift is an ideal technique for Asian patients, as it delivers natural, long-lasting results; a quick recovery; and high patient satisfaction. Therapeutic, IV.

Evaluation of lifting and lowering velocities while using a patient lift for transfer during nursing care

Using a patient lift to assist in transfer can alleviate physical burden and reduce the risk of lower back disorders. However, it requires more time than applying manual transfer techniques, often resulting in caregivers opting out of its use. This study used two experiments to examine the lifting and lowering velocities experienced by caregivers and residents when using a patient lift during nursing care. In experiment 1, the usability, subjective assessment of velocity, heart rate (HR), electromyography (EMG), working time, and so on were measured at eight lift velocities (ranging from 0.01 to 0.15 m/s in 0.02 m/s intervals) during the transfer task of 10 female students in a laboratory. In experiment 2, the same measured parameters as in experiment 1 except for HR and EMG were measured at four lift velocities (ranging from 0.03 to 0.09 m/s in 0.02 m/s intervals) during the transfer task of six elderly residents by 12 caregivers at an elderly care facility. The residents and caregivers rated 0.05–0.09 m/s as appropriate velocities in both experiments. Specifically, the best velocities for lowering the lift without the resident, lifting with the resident, and lowering were 0.07–0.09 m/s, 0.05–0.07 m/s, and 0.05 m/s, respectively. We conclude that the studied velocities are appropriate when the lift is used by caregivers at an elderly care facility. Since the appropriate velocity is different for each transfer subtask, we suggest that manufacturers should program suitable velocities into lifts according to the subtasks deemed important by the caregivers.

Occupational exposures in the operating room: Are surgeons well-equipped?

BackgroundOccupational health hazards are ubiquitously found in the operating room, guaranteeing an inevitable risk of exposure to the surgeon. Although provisions on occupational health and safety in healthcare exist, they do not address non-traditional hazards found in the operating room. In order to determine whether surgeons or trainees receive any form of occupational health training, we examine the associations between occupational health training and exposure rate.Study designA cross-sectional survey was distributed. Respondent characteristics included academic level, race/ethnicity, and gender. The survey evaluated seven surgical disciplines and 13 occupational hazards. Multivariable logistic regression was used to examine the association between academic level, surgical specialty, and exposure rate.ResultsOur cohort of 183 respondents (33.1% response rate) consisted of attendings (n = 72, 39.3%) and trainees (n = 111, 60.7%). Surgical trainees were less likely to have been trained in cytotoxic drugs (OR 0.22, p<0.001), methylmethacrylate (OR 0.15, p<0.001), patient lifting (OR 0.43, p = 0.009), radiation (OR 0.40, p = 0.007), and surgical smoke (OR 0.41, p = 0.041) than attending surgeons. Additionally, trainees were more likely to experience frequent exposure to bloodborne pathogens (OR 5.26, p<0.001), methylmethacrylate (OR 2.86, p<0.001), cytotoxic drugs (OR 3.03, p<0.001), and formaldehyde (2.08, p = 0.011), to name a few.ConclusionAlthough surgeon safety is not a domain in residency training, standardized efforts to educate and change the culture of safety in residency programs is warranted. Our study demonstrates a disparity between trainees and attendings with a recommendation to provide formal training to trainees independent of their anticipated risk of exposure.

The Edmonton Obesity Staging System as a predictor for postoperative complications after medial thigh lift in massive weight loss patients

This study investigates the correlation between the Edmonton Obesity Staging System (EOSS) and the occurrence of postoperative complications after medial thigh lift in formerly obese patients. A single-institution retrospective review of patients undergoing medial thigh lift between 2009 and 2019 after massive weight loss. Data on demography, comorbidities, surgery, and postoperative outcome were extracted from patients' charts. Patients were grouped into EOSS categories. Complications were classified into minor and major. Logistic regression analysis was performed to determine the association between risk factors and complications. One hundred and eight patients were included in the study. Complications occurred in 76 (70%) of the patients, most of which were minor (60/108, 56%). Complications increased with increasing EOSS stage, and all EOSS 3 patients had complications. Classification as EOSS 2 or 3 significantly associated with occurrence of postoperative complications (OR 99.3, p<0.001) as well as minor and major complications individually (OR 3.1 and 6.5, p<0.05). This effect was independent of body mass index (BMI), maximum BMI loss, type of weight loss, volume of liposuction, weight of resected tissue, and type of surgery. EOSS is a robust and independent predictor for postoperative complications in medial thigh lift surgery after massive weight loss.

Increased heart rate functions as a signal of acute distress in non-communicating persons with intellectual disability

Intellectual disability (ID) affects approximately 1% of the population. Some patients with severe or profound ID are essentially non-communicating and therefore risk experiencing pain and distress without being able to notify their caregivers, which is a major health issue. This real-world proof of concept study aimed to see if heart rate (HR) monitoring could reveal whether non-communicating persons with ID experience acute pain or distress in their daily lives. We monitored HR in 14 non-communicating participants with ID in their daily environment to see if specific situations were associated with increased HR. We defined increased HR as being > 1 standard deviation above the daily mean and lasting > 5 s. In 11 out of 14 participants, increased HR indicated pain or distress in situations that were not previously suspected to be stressful, e.g. passive stretching of spastic limbs or being transported in patient lifts. Increased HR suggesting joy was detected in three participants (during car rides, movies). In some situations that were previously suspected to be stressful, absence of HR increase suggested absence of pain or distress. We conclude that HR monitoring may identify acute pain and distress in non-communicating persons with ID, allowing for improved health care for this patient group.

119 Prostatic Urethral Lift in Patients with Obstructive Median Lobes: A Single Surgeon Experience at an Academic Center

Although the prostatic urethral lift (PUL) is approved by the FDA for use in men suffering from lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH), the AUA advises against its use in men specifically with an obstructive median lobe (OML). This study examined all consecutive patients with BPH, including those with OMLs, treated with PUL by a single academic surgeon.

Prevalence of Low Back Pain and Associated Risk Factors among Nurses at King Abdulaziz University Hospital.

Aim: To determine the prevalence of LBP and the associated risk factors among nurses at King Abdulaziz University Hospital (KAUH). Methods: A cross-sectional study design was adopted with a convenience sample of 234 nurses recruited from nine different departments at KAUH in Jeddah, Saudi Arabia. Participants completed the questionnaire, which had two parts: Part I: Socio-demographic data, medical factors, and work-related factors; and Part II: Standardized Nordic Musculoskeletal Questionnaire was used to obtain data. Data collection was carried out from March to April 2020. Data were analyzed using the SPSS version 22. Results: Cumulative prevalence of LBP was 82.9%, annual prevalence was 85.5%, while one-week prevalence of LBP was 53.6%. The factor significantly associated with LBP over the past 12 months was manual lifting of patients (p = 0.030). Nurses working in surgical wards had higher prevalence of LBP. About 24.7% of them changed their working unit, hospitalization was necessary for 11.9%, and 39.8% sought medical care. Conclusions: The findings from this study may better enable policymakers to adopt certain strategies toward reducing the burdens and challenges of LBP among nurses.

Prostatic Urethral Lift in Patients With Obstructive Median Lobes: A Single Surgeon Experience at an Academic Center

ObjectiveTo examine the long-term efficacy of prostatic urethral lift (PUL) for treating men, with or without an obstructive median lobe (OML), who suffer from lower urinary tract symptoms attributed to benign prostatic hyperplasia. Materials and MethodsA retrospective review was performed on all consecutive PUL cases with or without OML from October 2017 to November 2019 by a single academic surgeon. Outcomes were measured using the International Prostate Symptoms Survey (IPSS) with quality of life (QoL) scores. Comparative testing and mixed-effects linear regression analysis were utilized with significance set at α = 0.05 and performed with Stata (College Station, TX). ResultsA total of 110 PUL procedures were performed on 106 patients (4 repeat surgeries) with a median age of 66.5 (interquartile range: 60.4-73.7). Twenty-three patients (21.7%) had an OML. Following PUL, patients in both groups showed significant improvements in IPSS (P <.001) and QoL (P <.001) scores. When stratifying by OML and controlling for confounding, IPSS scores in both groups displayed statistically significant improvement at follow-up visits, with no statistically significant intergroup difference (P = .32). The same held true for QoL improvements, with no statistically significant difference between groups (P = .18). The presence of an OML resulted in minimal effects on perioperative outcomes and complications but required significantly more implants (P = .008). ConclusionPUL is a minimally invasive procedure effective at reducing lower urinary tract symptoms and improving the lives of men with benign prostatic hyperplasia without incurring risks of serious complications. These improvements were equivalent and upheld in patients who presented with OML.

Direct Neck Lift in Massive Weight Loss Patients – Classification and Treatment Algorithm

The neck is an often-neglected part of body lift procedures after massive weight loss. The objective of this study was to classify massive weight loss patients undergoing direct neck lift procedures and provide a standardized treatment algorithm. A retrospective review of all neck lift procedures performed between January of 2012 and December of 2019 was conducted. Patients were classified as follows: Grade I, no skin excess with remaining preplatysmal fat and no platysmal laxity; Grade IIa, moderate submental skin excess with subplatysmal fat deposits and platysmal laxity; Grade IIb, moderate anterior neck skin excess with no fat deposits and platysmal laxity; Grade III, considerable anterior skin excess with no or limited fat deposits and platysmal laxity and bands. Grade I patients had Liposuction, Grade IIa patients Submental Neck Lift with anterior fat excision and central platysmaplasty, Grade IIb Submental Neck Lift with central platysmaplasty, and Grade III patients Median Z-Plasty with fat excision (if needed) and central platysmal resection and tightening. Thirty-one patients were included for analysis. One underwent liposuction, twenty-five a Submental Neck Lift and five a Median Z-Plasty. Concomitant surgery was carried out in all cases. A recurrent skin laxity occurred in 2 (11.8%) patients, so in local anesthesia an operative revision was required. A standardized algorithmic approach for neck lift in massive weight loss patients may optimize the result without increasing the complication rate. Direct neck lift procedures prove to be reliable techniques with rare complication rates that can be performed together with other postbariatric procedures.

A modified method for corner mouth lift in scar-prone patients.

Corner mouth lift is in increasing demand among young patients in East Asia. Although various surgical methods exist for corner mouth lift, many patients are reluctant to undergo surgery due to fears of postsurgical scarring. We present a new technique aimed at reducing postoperative scarring. The technique involves triangular excision of the corner of the mouth and incision of the commissure with transposition of a lateral vermilion flap to lift the corner of the mouth. The muscle around the corner of the mouth is dissected to release tension. The corner mouth lift was successfully performed in all patients. It can be effectively used even in patients, such as young Asian women, who are susceptible to hypertrophic scars.

Development and Feasibility Testing of a Contextual Patient Movement Intervention

IntroductionNurses and emergency medical services workers frequently suffer musculoskeletal injuries at a disproportionate rate in relation to the rest of the population. The most common form of this musculoskeletal injury is lumbar spine injury. The purpose of this study was to develop and conduct phase 1 feasibility testing of a contextual lifting intervention that reduces the risks of low back injury. MethodsThis study was an intervention development and phase 1 feasibility test. The intervention was created on the basis of weightlifting techniques to specifically reduce the incidence injury related to valgus knee, asymmetrical lifting technique, and rotation of the trunk and pelvis. Motion capture technology (Xsens; Xsens Technologies) was used while 17 nursing students completed the direct patient lift from the floor, the lift from the floor with a manikin attached to a rigid spine board, the push portion of the horizontal transfer, and the pull portion of the horizontal transfer. Pre- and postintervention data were collected. Linear mixed model regression, with pairwise comparisons, was conducted for each lift at the time points of preintervention, immediately after the intervention, and 1-month postintervention. ResultsSignificant changes were noted between the initial lifting techniques used and those used after the intervention. The maximum lever arm distance, defined as the distance from L5-S1 to the center of the force applied to the load, showed a significant reduction after the intervention in 3 of the 4 movements. DiscussionOur results support the idea that injury risk can be reduced through appropriate contextual training methods.

Occupational Injury Claims Related to Patient Lifting and Moving in a Safety-Oriented Emergency Medical Services Agency.

Background: Patient lifting injuries remain a significant hazard to Emergency Medical Services (EMS) providers despite preventative and mitigative strategies.Objective: To better characterize the nature of occupational injury involving patient and stretcher handling.Methods: A retrospective review of existing de-identified claims data was performed for the study period of January 1, 1999, through December 31, 2017. Independent reviewers analyzed each claim to determine if the claim was related to lifting or moving a patient. Any discrepancies between the two reviewers were analyzed by a third reviewer.Results: Eighty-two claims were identified as resulting from lifting or maneuvering patients. Fifty-two of these injuries (63.4%) resulted in at least one lost workday (LWD). Strains and sprains accounted for the majority of injuries with 63.4% (n=52) and 18.3% (n=15) respectively. Forty-two (51.2%) of these reports occurred when the provider was moving a patient, not involving a stretcher, while 37.8% (n=31) occurred due to lifting or maneuvering a stretcher with or without a patient. Conclusion: While the overall incidence of lifting injuries was less than reported in other occupational health data series, these injuries continue to occur, and cause significant operational and fiscal impact for EMS systems. This occurrence is despite advances in engineering controls and the organizational embracement of a culture of safety that focuses on risk identification and mitigation. Understanding the types of lifting/moving injuries, circumstances surrounding the injury, and contributing factors will help to maintain a heightened awareness of potential injuries associated with EMS work, and opportunities to reduce them.

214 - 12 month symptom and urodynamic outcomes of the prostatic urethral lift in patients with acute urinary retention (PULSAR)

214 - 12 month symptom and urodynamic outcomes of the prostatic urethral lift in patients with acute urinary retention (PULSAR)

Three-Dimensional Finite Element Analysis of Stress Distribution and Displacement to Design of Patient Lifting Equipment

The patients with stroke, especially hemiplegia and paraplegia cases, need to be transferred whether from bed to wheelchair or wheelchair to bed and be transferred whether from wheelchair or bed to car or car to a wheelchair or bed while the patient is admitted to the hospital or stay at home. The accuracy of movement handling is required to be in accordance with the principles of physiology in order to increase the safety of patient moving. The utilization of patient lifting equipment will improve patient handling more efficiently for both patients and staff during health care. Patient-lifting equipment is absolutely helpful in lifting patient movement. The study on the analysis of stress distribution as well as the displacement of the device in the analysis of strength in the structure design is rarely found because of computer program limitations. For appropriate usage in each situation, it is important to apply a comprehensive understanding of principles of strength analysis to design patient-lifting equipment. The objective of the proposed research is to design a spreader bar of the patient lift equipment to support use for transferring from a wheelchair or bed to car or car to a wheelchair or bed. The details regarding concept design and analysing the strength of the structure is solved by finite element method (FEM) with a three-dimensional model. The simulated results obtained from the computational solution are investigated and validated against those obtained from the analytical solution. The study focuses attention on the effects of different angles of the spreader bar on the stress distribution and displacement at various points. It is found that the change in the angle adjustment of the spreader bar directly affects the change in the stress distribution, as well as displacement. The maximum stress distribution, as well as maximum displacement, are reduced when the degree increases. The obtained results can be a helpful information to use as the guideline to design a spreader bar of the patient- lifting equipment to transfer patients suitably under each situation.

Early results of bidirectional cone sutures for mid-face lifting in Asian patients

Phoebe Kar Wai Lam, MBCHB, MRCS, MSCPD, James Yui Lam, MBBS, MRCSED, PGDIPCLINDERM, Edwin Kwan Chark Lau, MBBS, Wang Lung Luk, MBBS, MSc, FCOHK, FCSHK. J Cosmet Med 2020;4:12-6. https://doi.org/10.25056/JCM.2020.4.1.12

The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units.

Working at intensive care units (ICUs) is considered a risk factor for developing musculoskeletal complaints (MSC). This study was conducted between January 2017 and June 2019 in two ICUs of a university hospital. It was designed as a pre- and post-assessment of the intervention group (IG) (N = 27) compared with a control group (CG) (N = 23) to determine the effects of a multifaceted ergonomics intervention program in reducing MSC. The IG (N: 35) received a multifaceted ergonomic intervention program, which was implemented by an ERGO team over an 18 month period. Four ergonomic interventions were planned as follows: individual level interventions such as training; stretching exercises and motivation meetings; administrative intervention such as a daily 10 min stretching exercises break; engineering interventions such as lifting and usage of auxiliary devices. The CG (N:29) did not receive any intervention. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess MSC in both groups. At the start of the intervention, both groups were similar concerning the number of visits to doctors due to MSC, the number of sick leave days, and total CMDQ scores (p > 0.05 for all). Two factor repeated ANOVA measures were performed for between-groups and within-group analyses. The mean of the initial CMSDQ total scores in both groups increased significantly in the 18th month (p < 0.001). However, the interaction effect of group and time (between and within factors) was not significant (p = 0.992). Work-related MSC is a common occupational health problem among nurses. This study showed that individual-level interventions are not likely to succeed in eliminating manual patient lifting by nurses. Our results suggested that interventions without administrative measures might have limited success

An ergonomic analysis and computer simulations of nursing activities while raising the patients in hospitals and nursing homes

Background: The use of trolleys for transporting the patients and lifting and lowering them in the trolley is a repeated activity in the daily work of a nurse, and a very common cause of the load of the lumbosacral part of the spine and the consequent pathological deformity, and the onset of clinical symptomatology of painful lumbo-sacral syndrome. The high level of excessive biomechanical stress is associated with the established practice of using standard medical wheelchairs to move patients inside the hospital. The process itself depends on the characteristics of the patient, his or her weight, as well as his/her cooperativeness, but primarily depends on the nurse's mobility. Although nurses strive to be in a position that reduces the load on the lumbosacral part of the spine during practice, this is often impracticable due to the patient's inconsistency. Objective: To present the ergonomic analysis of the medical nurse's workplace while lifting the patient into the wheelchair and to display solution for improving working conditions and prevention of musculoskeletal disorders. Results: By ergonomic module of this software, we got results that present load on lumbosacral region of spine of medical nurses during their daily activities, especially in the position of lifting and lowering patients. It was concluded that maximal spinal loading decreases significantly and becomes less than critical (3,100 N) in the case of a wheelchair that has ability to automatically lift and lower patient. Conclusions: The use of hospital wheelchairs with an mechanism for the automatic lifting and lowering of patients and with a sliding seat will reduce the load on the lumbosacral region of the spine, prevent the onset of lumbosacral pain syndrome, facilitates work for the medical nurse and allows nurse to handle the patient on her own. The prevention of lumbosacral pain syndrome improves the quality of work of the nurse and extends the working life. Use of this type of wheelchair is justified in terms of cost-benefit analysis.