Caregivers injure their backs more than workers in any other industry. Efforts to reduce injuries have been on-going for decades with limited results. Mechanical lift devices have been incorporated into clinical practice over the past 30 years to reduce the risk of injury from patient lifting. Yet injury rates remain high. The use of mechanical lifts may be partly to blame. While these devices assist with lifting patients, they also introduce new activities that result in caregivers experiencing unsafe loading on the spine. We measured loads on the lower back during manoeuvres of the two most common lift types (overhead and floor) as well as during sling insertion. A new device called SlingSerterTM was evaluated for use in the clinical environment. We also investigated spine shrinkage as a measurement tool for estimating cumulative load. Caregivers worked alone and in pairs for both lift maneuvering and sling insertion activities. Overhead lift use resulted in much lower loads than floor lift use. We conclude caregivers can safely operate overhead lifts alone, while floor lift use remained unsafe even with two caregivers. Less-experienced caregivers had higher loads than more-experienced counterparts when using floor lifts. There was no corresponding effect of experience with overhead lift use and we found this to be a further benefit of overhead lifts over floor lifts. Most caregivers exceeded the safe limit for spine compression during sling insertion, though a single caregiver was at no higher risk of injury than two caregivers working together. Clinicians who tested SlingSerterTM agreed the device would be useful in clinical practice, particularly with bariatric patients and other special patient populations that are difficult to roll or turn. Finally, we investigated a novel method for estimating cumulative load based on spine shrinkage. There is growing recognition that excess cumulative load may be responsible for back injury. We found the variability in spine shrinkage was too large to estimate cumulative load directly. However, the technique may still be useful for determining the relative importance of the load from different activities to the cumulative total.

Caregivers injure their backs more than workers in any other industry. Efforts to reduce injuries have been on-going for decades with limited results. Mechanical lift devices have been incorporated into clinical practice over the past 30 years to reduce the risk of injury from patient lifting. Yet injury rates remain high. The use of mechanical lifts may be partly to blame. While these devices assist with lifting patients, they also introduce new activities that result in caregivers experiencing unsafe loading on the spine. We measured loads on the lower back during manoeuvres of the two most common lift types (overhead and floor) as well as during sling insertion. A new device called SlingSerterTM was evaluated for use in the clinical environment. We also investigated spine shrinkage as a measurement tool for estimating cumulative load. Caregivers worked alone and in pairs for both lift maneuvering and sling insertion activities. Overhead lift use resulted in much lower loads than floor lift use. We conclude caregivers can safely operate overhead lifts alone, while floor lift use remained unsafe even with two caregivers. Less-experienced caregivers had higher loads than more-experienced counterparts when using floor lifts. There was no corresponding effect of experience with overhead lift use and we found this to be a further benefit of overhead lifts over floor lifts. Most caregivers exceeded the safe limit for spine compression during sling insertion, though a single caregiver was at no higher risk of injury than two caregivers working together. Clinicians who tested SlingSerterTM agreed the device would be useful in clinical practice, particularly with bariatric patients and other special patient populations that are difficult to roll or turn. Finally, we investigated a novel method for estimating cumulative load based on spine shrinkage. There is growing recognition that excess cumulative load may be responsible for back injury. We found the variability in spine shrinkage was too large to estimate cumulative load directly. However, the technique may still be useful for determining the relative importance of the load from different activities to the cumulative total.