Case Crossover Study of Factors Associated with Patient Lift Equipment Use

描述（由申请人提供）：先前的研究和实践表明，尽管实施了安全患者处理政策和培训，但患者提升装置并未得到持续使用。使用这些设备的障碍和促进因素包括工人、患者、环境和组织因素。确定存在的因素以及它们在多大程度上影响患者移位设备的使用或不使用决策，将解决并制定更好的策略，以增加这些设备的适当使用和采用，并为未来的政策和培训提供信息和支持。主要研究目的是采用病例交叉研究设计，探讨影响使用或不使用患者移位设备的因素的重要性和程度。从文献和先前的移位设备评估研究中识别出的潜在因素将与现场观察和与医院工作人员进行的访谈相结合，以创建一种评估工具来捕获这些因素在患者移位和转移中的频率。一项新的病例交叉研究将量化100名护理人员在急性护理医院环境中从事患者护理的频率和已确定因素与电梯设备使用之间的关联。参与者将前瞻性地记录患者移位和转移、移位设备的使用以及轮班期间存在的因素。与用于患者移位和转移的移位设备相关的决定因素是最容易干预的，并且将为未来的实践和策略提供信息，以克服这些障碍。这项研究提供了一个有趣的探索的情况下，交叉设计，传统上用于研究损伤的触发，更清楚地了解如何决定暴露。该提案涉及NIOSH医疗保健部门的目标，即增加对采用经证实的干预措施的理解并减少肌肉骨骼疾病。了解决定使用电梯设备的因素，通过提供医院和安全专家可以付诸实践的具体信息来实现r2p倡议，以增加这些设备的适当使用。开发一种新的方法来研究工程控制的使用和可接受性，可以作为一个模型，更普遍适用于卫生保健和其他职业环境中的工人所面临的其他健康和安全问题。

DESCRIPTION (provided by applicant): Previous research and practice indicates despite implementation of Safe Patient Handling polices and training, patient lifting devices are not consistently used. Barriers and promoters for use of these devices include worker, patient, environment, and organizational factors. Determining the factors that are present and to what degree they influence patient lift equipment use or nonuse decisions will address and develop better strategies to increase appropriate use and adoption of these devices and inform and support future policies and training. The primary study aim is to explore the magnitude and importance of factors influencing use or nonuse of patient lift equipment using a case crossover study design. Potential factors identified from the literature and a previous lift equipment evaluation study will be integrated with field observations and interviews conducted with hospital staff to create an assessment tool to capture the frequency of these factors for patient lifts and transfers. A novel case crossover study will quantify the frequency and association between identified factors and lift equipment use among 100 nursing staff engaged in patient care in the acute care hospital setting. Participants will prospectively document patient lifts and transfers, use of lift equipment, and the presence of factors during their shift. Determining factors associated with lift equipment use for patient lifts and transfers that are most amenable to intervention is significant and will inform future practices and strategies to overcoming these barriers. This study provides an interesting exploration of the case crossover design, traditionally used to study triggers for injury, to more clearly understand how decisions about exposure are made. This proposal addresses NIOSH Healthcare Sector goals of increasing the understanding of adoption of proven interventions and decreasing musculoskeletal disorders. Understanding factors that determine use of lift equipment fulfills r2p initiatives by providing specific information that can be put into practice by hospitals and safety specialists to increase appropriate use of these devices. Developing a novel approach to study the use and acceptability of engineering controls could serve as a model with more general applicability to other health and safety issues faced by workers in health care and other occupational settings.