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Determinants of implementation of primary preventive interventions on patient handling in healthcare: a systematic review
  1. Elin Koppelaar (e.koppelaar{at}
  1. Department of Public Health, Netherlands
    1. Hanneke Knibbe (j.j.knibbe{at}
    1. Locomotion, Netherlands
      1. Harald Miedema (h.miedema{at}
      1. Netherlands Expert Center for Workrelated Musculoskeletal Disorders and Expert Center participation, Netherlands
        1. Alex Burdorf (a.burdorf{at}
        1. Department of Public Health, Netherlands


          Objective: This systematic review aims (1) to identify barriers and facilitators during implementation of primary preventive interventions on patient handling in healthcare, and (2) to assess their influence on the effectiveness of these interventions.

          Methods: PubMed and Web of Science were searched from January 1988 to July 2007. Studies were included with anevaluation of a primary preventive intervention on patient handling; quantitative assessment of the effect of the intervention on physical load or musculoskeletal disorders or sick leave; and information on barriers or facilitators in the implementation of the intervention. In total, 19 studies were included, comprising engineering (n=10), personal (n=6), and multiple interventions (n=3). Barriers and facilitators were classified as individual and environmental categories of factors that hampered or enhanced the appropriate implementation of the intervention.

          Results: In total, 16 individual and 45 environmental barriers and facilitators were identified. The most important environmental categories were ‘convenience and easily accessible’ (56%), ‘supportive management climate’ (18%), and ‘patient-related factors’ (11%). An important individual category was motivation (63%). None of the studies quantified their impact on effectiveness, nor on compliance and adherence to the intervention.

          Conclusion: Various factors may influence the appropriate implementation of primary preventive interventions, but their impact on effectiveness of the interventions was not evaluated. Since barriers in implementation are often acknowledged as cause of ineffectiveness of patient handling devices, there is a clear need to quantify the influence of these barriers on the effectiveness of primary preventive interventions in healthcare.

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