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PERIOPERATIVE NURSES CHAPTER

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40TH ANNUAL SCIENTIFIC CONFERENCE

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DIAMOND LEISURE LODGE

SYLVESTER KIBET

KRPON/KRN

15TH NOVEMBER 2023

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MUSCULOSKELETAL DISORDERS IN OPERATING ROOM STAFF

  • Work related musculoskeletal disorders(WRMSDs) are injuries affecting connective tissues of the body and are leading causes of occupational injury and disability in the world( Micky Olutende et al., 2022)
  • MSP top the list of the most common work related ailments in Austria and is the second leading cause for taking sick leave. (Peter Hoppe et al., 2018)
  • WRMSDs represent a high prevalence issue among perioperative nurses. OR nurses are steadily exposed to both physical and temporal risk factors. (Marco Clari et al., 2021)

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Cont.

  • MSDs were mostly seen among OR and ICU nurses and were the main cause of absenteeism, demanding change of duty or job and visiting a physician.
  • WRMSDs associated with cumulative trauma and repetitive tasks included: Lifting, transferring or repositioning, prolonged standing and awkward postures e.g. stooping, bending and reaching out.(Pinar Soylar, Ali Ozer 2018)

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Prevalence and distribution of MSP�

  • Commonly affected body regions include Lower back, Shoulder, Neck, Knees and Wrists/hands.(Pinar Soylar, Ali Ozer 2018)
  • Back pain 84%, Ankle/foot 74%, Shoulder 74%
  • Causes of absenteeism from work Lower back pain at 31%, Ankle/knee 24%
  • According to Ali Sheikhzadah et al in the journal in Elsevier Vol 40 issue 5 2009

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Cont.

  • According to Marco Clari et al (2021), Lower back pain 62%, Knee 47%, Shoulder 44%, Waist 42%, Neck 39% Ankle/feet 35%, Upper back 34%, Hand/Wrist 29% and Elbow at 18%.
  • Elnaz Asghari et al (2019), Observed that High prevalence of MSP was distributed as: Lower back 61.9%, Knees 60.5%, Ankle/ Feet 55.8%

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Cont.

  • B.Tanui (2015), in her study Assessment of WRMSDs among nurses in Mombasa county studied responses of 130 nurses 70.8% had WRMSDs at any part of the body. Low back at 76.9%, Neck at 53.8% and Shoulder, ankle and feet 48.5%

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NH OR

  • Experienced shoulder pains (53.8%)
  • Attributed to
  • Lifting of patients (42.8%)
  • Awkward posture(57.2%)
  • Lack of proper ergonomics

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Knowledge on Work ergonomics

  • Aware-38.5%
  • Little knowledge-53.8%
  • I do not understand-7.7%
  • Strongly recommended training on ergonomics

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Interventions to relieve pain

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What are the risk factors(Other studies)

  • Lifting patients/ Loads
  • Repetitive tasks
  • Repositioning patients/loads
  • Prolonged standing
  • Awkward postures e.g. Bending, stooping, reaching out
  • Working for long in the same position
  • LACK OF PROPER ERGONOMICS

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What is suggested

  • Use of lifting equipment
  • Interchanging tasks regularly
  • Breaks in between tasks
  • Simple ergonomic solutions be adopted to improve work environment
  • Training and exercise programs to ease pain

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Found this helpful

  • Neutral body position while operating
  • Shoulder and arms: Limit hand reach to a maximum of 16-18 inches
  • Keep your hands between your waist and the midline of your chest.
  • Position the angle of your elbows between 90 and 120 degrees
  • Neck: Avoid rotation and do not tilt more than 15 degrees

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Cont.

  • Back: Do not flex or extend the spine, Shift your weight occasionally from one foot to the other
  • Equipment consideration
  • Table height: Adjust to 70-80% of elbow height
  • Monitors: Usually placed too high and far away. Should be 80-120cm away from your eyes and level.

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Cont.

  • Preferably HD monitors to reduce eye strain
  • Optimal lighting to reduce eye strain
  • Stepping stools: Ensure sufficient stepping area to avoid compromising your foot balance
  • Lead aprons: Appropriate sizing and construction

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Ergonomics

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References

  • Marco,C., Alessandro,G., Giacomo,Garzaro., Gianluca,V., Maria,G., Giuseppe,M., Attilia, G., Catalina,C., and Valerio,D. (2021) Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and META-analysis:
  • Pinar Soylar., Ali Ozer. (2018) Evaluation of the prevalence of musculoskeletal disorders in nurses: A systematic review. Medicine Science 2018;7(3):479-85
  • Ali,S., Chaitrali,G., Joseph D.Z., Margareta,N.,(2009) Perioperative nurses and technicians’ perceptions of ergonomic risk factors in the surgical environment. Applied Ergonomics 2009: 40(5): 833-839

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