การศึกษาความชุกของความผิดปกติทางระบบโครงร่างและกล้ามเนื้อและการประเมินความเสี่ยงด้านการยศาสตร์ในการเคลื่อนย้ายผู้ป่วยด้วยแรงกายของพยาบาลหอผู้ป่วยวิกฤตผู้ใหญ่ โรงพยาบาลสงขลานครินทร์

Abstract

Intensive care is a manual patient-handling activity that requires strong pulling and pushing, lifting, moving, or supporting the patient are the leading causes of musculoskeletal disease, MSDs. Therefore, researchers were interested in studying the ergonomic risk assessment of patients transferred by adult intensive care unit nurses. This study aims to estimate MSDs prevalence, work stress and stress levels, and the rate of MSDs' sick leave. The study collected data from nursing volunteers in four adult intensive care units: Surgical Intensive Care Units (SICU), Medical Intensive Care Unit (MICU), Cardiac Care Unit (CCU), and Cardiovascular and Thoracic Intensive Care Unit (CVT ICU) Songklanagarind Hospital. The data collection period is from March to June 2022. The data collection methods are to take a video when the nurse moves the patient with physical strength, answer the questionnaire, interview the head of the ward, explore mobility help devices, and conduct a workplace environment inspection. Use the tools recommended by ISO/TR 12296 for Ergonomic manual handling of healthcare sector personnel to assess ergonomic risks that are Patient Transfer Assessment Instrument (PTAI), Movement and Assistance of Hospital Patients (MAPO), Rapid Intestinal Body Assessment (REBA) and Tilthermometer. The study found that most volunteers were women (94.7 percent). Most are classified as active collectives, accounting for 42.5 percent. The average age of each ward was between 30.5 and 33.2 years old. The average working age was 6.7-9.7 years, with most working less than two years (29.2 percent). The incidence rate of MSDs was 84. percent, and the first four most areas that volunteers had pain rates: Shoulder, neck, lower back, and upper back (left/right) 51.3/52.2, 44.2/45.1, 38.1/37.2, and 37.2/36.3 percent, respectively. Assessing the risks of lifting and moving patients with the tools, the PTAI workload index in all adult intensive care units was moderate for all lifting activities, and the MAPO index was at a slight risk in all wards. Tillthermometer evaluation found that no ward had a physical workload exceeding 100%. However, there is a recommendation for using the materials such as sliding sheets move the patients. Furthermore, the last, the whole-body work posture assessment with REBA found that the high-risk patient transfer activities in all wards were lateral patient transfer activities. (Between the bed and the cot/bed) with an average score of 7.8-8.6 points. In conclusion, the incidence of MSDs in this study was not higher than that of previous studies. Moreover, none of the volunteers were classified as high strain isolated, which may have adverse effects on personnel on various sides and affect the occurrence of MSDs. In addition, the assessment of the risk of ergonomics in lifting patients with physical force was mostly moderate. However, although the risk was not found to be very high, improvements should be made based on the recommendations made from the assessments to ensure worker safety and reduce the risk of MSDs, which may contribute to worker well-being more or less.