Table 4 Studies with barriers and facilitators in the implementation of multiple interventions aimed at patient handling in health care
StudyDesign (duration)Population (setting)InterventionOutcomesType of barrier (B) or facilitator (F)
Charney et al (2006)31OBS (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 patientsSignificant reduction in time-lost injuries and frequency of injuriesInitial 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)32CT (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 interventionSignificant reduction in back pain prevalence and in total number of transfersRelatives able to care for patients with use of hoist without presence of nurse (F-2B)
Nelson et al (2006)33OBS (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 policySignificant reduction in injury rates and modified duty daysPatient 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).