Participatory Organizational Intervention for Improved Use of Assistive Devices for Patient Handling

Study Overview
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Brief Summary
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Epidemiological studies have shown that patient transfer is a risk factor for back pain, back injuries and long term sickness absence, whereas consistent use of assistive devices during patient transfer is associated with reduced risk of back injury. In consequence, Danish hospitals have made great efforts to increase knowledge, availability and use of assistive devices to reduce work-related physical strain due to patient transfer. Yet, a recent survey among more than 300 nurses and nurses' aides showed that two thirds rarely uses assistive devices during patient transfer. Thus it seems relevant to investigate barriers, opportunities and practical solutions for increasing use of assistive devices among healthcare workers. The purpose of this study is to evaluate a participatory organizational intervention for improved use of assistive devices during patient transfer.

Official Title
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Deltagerinvolverende Intervention for Bedre Brug af hjælpemidler i hospitalsvæsenet

Conditions
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Musculoskeletal Disorders, Occupational Injuries

Intervention / Treatment
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* Behavioral: Participatory Organizational Intervention


Participation Criteria
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Eligibility Criteria
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At the department level: Hospital departments with frequent patient handling will be eligible for participation in the cluster-randomized study. At the individual level (questionnaire replies): Inclusion Criteria: Healthcare workers with daily patient handling (based on questionnaire reply at baseline) Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Participatory Organizational Intervention<br>Participatory intervention (workshops) with workers, consultants and leaders. The workshops will find solutions for increased use of assistive devices | Behavioral: Participatory Organizational Intervention<br> <br> |
| No Intervention: Control<br>This group will go through the same baseline and follow-up tests as the intervention group, but will not receive any intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Use of assistive devices (push-button) | The healthcare workers are encouraged to push one of the following two buttons every time they leave the room after having performed patient transfer; button 1 Press this button if you used the necessary assistive devices for your patient transfer and button 2 Press this button if you did not use the necessary assistive devices for your patient transfer. The number of Button 1 counts as a percentage of total counts (Button 1+2) will be calculated for set of counters and used as primary outcome. | Average use during the entire 1-year follow-up (i.e. continous measurement during 1 year) adjusted for use during 4 weeks prior to the intervention (baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Use of assistive devices (accelerometer) | Accelerometers will be placed on the assistive devices. The method is currently being validated in the laboratory and will be finalized before initiation of the 1 year follow-up measurement. Accelerations of a certain time frame will be defined as use, whereas brief accelerations will be considered as noise | change from baseline to 1-year follow-up | 
| Pain intensity (VAS scale) | Pain intensity in the low-back is rated subjectively using a 0-10 modified VAS scale, where 0 indicates no pain at all and 10 indicate worst pain imaginable | change from baseline to 1-year follow-up | 
| Perceived physical exertion (Borg CR10 scale) | Perceived physical exertion during patient handling. Borg CR10 scale | change from baseline to 1-year follow-up | 
| Back injury | The specific question reads: Have you within the last 12 months injured your back during patient transfer? (Think of situation where the pain appeared suddenly and unexpectedly). The respondent replies yes or no | change from baseline to 1-year follow-up | 
| Work ability (Index questionnaire) | The full Work Ability Index questionnaire (Ilmarinen) | change from baseline to 1-year follow-up | 
| Social capital (Questionnaire) | Questionnaire concerning bonding, bridging, linking A, and linking B social capital (Andersen LL 2015 Scandinavian Journal of Public Health) | change from baseline to 1-year follow-up | 
| Knowledge (Questionnaire) | Specific questionnaire about knowledge about patients transfer and safety at work | change from baseline to 1-year follow-up | 
| Organizational Readiness to Change (Questionnaire) | Questionnaire about Organizational Readiness to Change | change from baseline to 1-year follow-up | 
| Use of assistive devices (Questionnaire) | Questionnaire about frequency of use of the different types of assistive devices | change from baseline to 1-year follow-up |