Table 4 Studies with barriers and facilitators in the implementation of multiple interventions aimed at patient handling in health
care
| Study | Design (duration) | Population (setting) | Intervention | Outcomes | Type of barrier (B) or facilitator (F) | |||||
| Charney et al (2006)31 | OBS (1–4 years, average 2 years) | 31 hospitals (hospital) | Zero-lift program: (1) replace manual lifting with mechanical lifting; (2) written policy and procedures supporting mechanisation of lifting; (3) training; (4) zero-lift committee; and (5) patient screening procedure to determine ambulatory level of new patients | Significant reduction in time-lost injuries and frequency of injuries | Initial investment not easily allocated in some hospitals (B-2B) Initiated with less equipment and later augmented when funds were available (B-2B) High staff turnover rates (B-2B) Mandatory use of equipment (F-2D) No standardised assessment of patient ambulatory status (B-2D) Each hospital put their individual stamp on the zero-lift model (B-2D) | |||||
| Knibbe and Friele (1999)32 | CT (1 year) | 139 subjects INT and 239 subjects CON (home care) | (1) Patient hoists (40); (2) training; (3) introduction of 12 specially trained lifting coordinators; (4) no intervention | Significant reduction in back pain prevalence and in total number of transfers | Relatives able to care for patients with use of hoist without presence of nurse (F-2B) | |||||
| Nelson et al (2006)33 | OBS (9 months) | 23 high risk units in 7 facilities (home care and hospital) | 6 program elements: (1) ergonomic assessment protocol; (2) patient handling assessment criteria and decision algorithms; (3) peer leader role, “back injury resource nurses”; (4) state-of-the-art equipment; (5) after action reviews; and (6) no lift policy | Significant reduction in injury rates and modified duty days | Patient handling equipment well accepted by staff (F-1A) No viable technology solutions for high-risk, high-volume patient handling tasks, eg repositioning patient in bed or chair (B-2B) Patients less likely to embrace new patient handling technologies and practices at the onset of the program (B-2G) |
-
CON, control group; CT, controlled trial; INT, intervention group; OBS, observational study; RCT, randomised controlled trial. Type of barrier: B-2B represents a barrier (B), within environment (2), category B (convenience and easy accessibility).
