A partnership between AORN, the Veterans Health Administration, and the National Institute for Occupational Safety and Health resulted in development of a series of ergonomic guidelines for safe patient handling in the OR environment. The guidelines incorporated the latest scientific knowledge in biomechanics, psychophysics, and physiology to develop safe recommended exposure limits for various patient handling and lifting tasks with high risk of causing musculoskeletal disorders, such as back and shoulder disorders. The guidelines address recommendations for: 1) transferring a patient laterally from a stretcher to an OR bed; 2) positioning a patient on an OR bed; 3) lifting and holding the patient's Iimbs; 4) prolonged standing in the OR; 5) manual retraction tasks; 6) lifting supplies and equipment in the OR; and 7) pushing and pulling wheeled objects and equipment. From a safety engineering standpoint, the data used to derive the guidelines (.ie., muscle strength capability, spinal force limits, and physiological fatigue limits) were selected with the goal of providing a safe level of exposure for nearly all OR personnel. The goal of ergonomics is to design jobs and work tasks so they are safe for workers, but to also maintain productivity and efficiency. These two goals are not always in alignment and do not necessarily result in agreement about what ergonomic intervention or job design is best. Therefore, the goal of the AORN guidelines is to maximize what can be done in the workplace, but at the same time to make sure that the work is performed in the safest way possible. As noted in the guidelines, use of technology, such as specially designed patient lifting devices and equipment, is recommended to ensure that the work is done safely, but the equipment must also allow the work to be done in an efficient and timely manner. Widespread application of the AORN ergonomic guidelines should result in a number of positive benefits. First, use of the guidelines should lead to a significant reduction in the number and severity of work-related back, shoulder, and elbow disorders for personnel who routinely perform patient handling tasks in the OR environment. The most obvious result of a decrease in severe injuries would be a reported reduction in the number of expensive debilitating work disability cases and lost work time cases. Second, workers should be able to extend their careers for longer periods, resulting in a larger percentage of highly skilled workers remaining in the workforce. Finally, application of the ergonomic guidelines should improve the work environment by making the work easier for the workers, who should be less tired, fatigued, and stressed at the end of each work day. Physical fatigue builds in a cumulative manner over the course of the work week and work necessitating high physical demands requires longer recovery periods between exposures. Risk of a musculoskeletal disorder is increased, therefore, when physical demands and task repetition are high or when recovery is inadequate. If the AORN ergonomic guidelines for patient handling are followed, the physical task demands should be sufficiently low to ensure that typical recovery periods between work days will be sufficient to reduce the risk of developing a work-related musculoskeletal disorder caused by patient handling and lifting in the OR.
Ergonomics; Health-care-personnel; Safety-climate; Safety-measures; Safety-practices; Work-practices; Occupational-medicine; Operating-rooms; Work-operations; Worker-health; Transport-mechanisms; Manual-lifting; Medical-personnel; Nurses; Nursing; Human-factors-engineering; Humans; Biomechanics; Psychophysiology; Physiology; Exposure-limits; Musculoskeletal-system-disorders; Muscle-function; Physical-capacity; Work-capability; Force; Engineering; Hospital-equipment; Fatigue; Job-analysis; Hoisting-equipment; Equipment-design; Injury-prevention; Repetitive-work