The longitudinal relationship of extended work schedules to musculoskeletal problems in nurses.
Trinkoff A; Geiger-Brown J; Brady B; Lipscomb J
NORA Symposium 2006: Research Makes a Difference! April 18-26, 2006, Washington, DC. Washington, DC: National Institute for Occupational Safety and Health, 2006 Apr; :156
Importance: Nurses are at high risk for work-related musculoskeletal injury/disorders (MSD). Because of the movement by health care organizations to reduce costs, generally by downsizing the nursing workforce, the occurrence of unhealthy scheduling practices has been increasing. Purpose: Therefore, the purpose of this study was to examine the relationship of extended work schedules in nurses to the incidence of MSD. Methods: Using a longitudinal, three wave survey of a probability sample of 2617 registered nurses, we related Wave 1 work schedule data to neck, shoulder and back (MSD) cases occurring in Waves 2 or 3. Findings: Adverse schedules were significantly related to nurse MSD. Schedule characteristics increasing MSD risk included 13+ hour/days; off-shifts (other than days); weekend work; working while sick, on days off, or without breaks; on-call hours, and mandatory overtime. These increases in MSD risk were not explained by psychological demands, but were largely explained by physical demands of the job. Advances: Our research was the first to examine the impact of mandatory overtime, being on-call, working while sick or on a day off, and with less than 10 hours off, on nurse health. All of these scheduling practices were related to increased risk of MSD. Use of Findings to improve Workplace Safety and Health: Based on these findings, preventive efforts should focus on adopting more healthful scheduling practices. Healthier schedules, including minimizing or eliminating mandatory overtime hours, and reducing work on scheduled days off would lower MSD risk and promote recovery from symptoms. Health Care Sector Implications: Although schedule modifications may initially require additional nursing staff, retention of a stable and healthier workforce has been shown to reduce employer costs, while greatly benefiting nurses and patient care quality.
Nurses; Nursing; Workers; Work-environment; Medical-personnel; Shift-work; Musculoskeletal-system; Musculoskeletal-system-disorders; Injuries; Needlestick-injuries; Risk-factors; Exposure-levels; Humans; Men; Women
Alison Trinkoff, RN, ScD, FAAN, University of Maryland School of Nursing,Baltimore, Maryland 21201-1579
NORA Symposium 2006: Research Makes a Difference! April 18-26, 2006, Washington, DC
University of Maryland, School of Nursing, Baltimore