| Study | Design (duration) | Population (setting) | Intervention | Outcomes | Type of barrier (B) or facilitator (F) | |||||
| Chhokar et al (2005)19 | OBS (3 years) | All staff who handle patients (nursing home) | 65 ceiling lifts and education on use | Significant reduction in MSI claims, claims costs and days lost | Time required to fully implement intervention (B-2B) Time required to alter work culture (B-2B) | |||||
| Engst et al (2005)20 | CT (1 year) | 34 care staff INT, 16 care staff CON (hospital) | (1) Ceiling lifts and training session to introduce lifts; (2) no intervention | Decreased total claim costs, but increased claim costs associated with repositioning patients | Ceiling lifts require more time than manually repositioning residents (B-2B) | |||||
| Evanoff et al (2003)12 | OBS (2–3 years) | 36 nursing units (hospital and nursing home) | 25 full-body and 22 stand-up lifts and instructional course on lift operation | Significant decrease in MSI, lost workday injuries and total lost days due to injury | Think they do not need lifting devices (B-1A) Lack of knowledge (B-1B) Too time consuming (B-2B) Devices misplaced or not enough available (B-2B) Patients in isolation/connected to too many lines (B-2B) Aides or patient care technicians use lifting devices (F-2B) Policy of mandatory lift usage (F-2D) Patients do not like lifting devices/feels unstable (B-2G) Established care activities and patient characteristics (F-2G) | |||||
| Fujishiro et al (2005)21 | OBS (2 years) | 100 work units (nursing home and hospital) | Financial support and ergonomic consultation for installing ergonomic devices | Significant decrease in MSD | Lower employee-to-ergonomic device ratio (F-2B) | |||||
| Garg and Owen (1992)22 | OBS (1–10 months) | 57 nursing assistants in 2 units (nursing home) | Hoist, walking belt, shower chairs and training in use of devices | Reduction in back injuries | Adequate staffing (F-2B) Saves time to perform transfer with 1 nursing assistant (F-2B) Reduction in number of patient transfers compensated for longer transfer times associated with devices (F-2B) | |||||
| Li et al (2004)18 | OBS (7 months) | 138 nurses in 3 nursing units (hospital) | 1 portable full-body sling lift, 2 stand-up sling lifts and a single hands-on training session on lift usage | Number of injuries and lost-day injuries decreased | Lack of perceived need (B-1A) Inexperience in lift use (B1B) Lack of time (B-2B) Lack of manoeuvring space (B-2B) Staff turnover (B-2B) | |||||
| Miller et al (2006)23 | CT (1 year) | 45 nurses INT and 29 nurses CON (nursing home) | (1) Portable ceiling lifts and training with regard to the ceiling lift; (2) no intervention | Decreased MSI claims and claim costs | Ceiling lifts preferred method for lifting and transferring (F-1B) | |||||
| Owen et al (2002)24 | CT (5 years) | 37 nurses INT and 20 nurses CON (hospital) | (1) 5 assistive devices and training in use; (2) traditionally scheduled in-service training | Decreased number of back injuries, lost work and restricted days | Patient more comfortable and secure when assistive devices used (F-2G) | |||||
| Ronald et al (2002)13 | OBS (5 years) | 34 RNs and 95 aides (hospital) | 62 ceiling lifts and training in use | No significant reduction in total MSI. Significant decline in MSI due to lifting and transferring | Preference by staff for mechanical options (F-1B) Ceiling lifts not used for repositioning due to problems with slings (B-2B) Incompatibility with pre-existing structures of older building (B-2B) | |||||
| Yassi et al (2001)25 | RCT (1 year) | 103 nurses INT, 116 nurses INT and 127 nurses CON (hospital) | (1) Training in back care, patient assessment, and handling techniques using manual equipment; (2) training in back care, patient assessment, and handling techniques using mechanical and other assistive equipment; (3) no intervention | Number of injuries did not change significantly | Increased perception of safety among staff (F-1A) More comfortable performing patient-handling tasks (F-1B) Increasing demand by staff for mechanical equipment (F-2A) Other workplace dynamics than patient population (B-2D) Changing patient population (B-2G) |
CON, control group; CT, controlled trial; INT, intervention group; MSD, musculoskeletal disorders; MSI, musculoskeletal injuries; 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).