The literature cites several recurrent barriers that contribute to the under-utilization of patient lifting devices (PLDs) by caregivers (CGs), resulting in the profession being at high-risk for musculoskeletal injury. There is considerable evidence that training is a barrier to PLD use, due to the staff shortages and time constraints that result when CGs attend (provincially mandated) off-site hands-on practical training. Therefore, the current research program aims to contribute towards a better understanding of the barriers to the chronic concern of low PLD use by CGs, and, to evaluate an alternative approach that could be used to reduce the time CGs spend off the floor and enhance musculoskeletal health and well-being. Study 1 will conduct focus groups and administer a Theory of Planned Behaviour (TPB)-based questionnaire to better understand the barriers between (a) CGs’ knowledge (training/education) and intent to use PLDs, and (b) CGs’ intent to use PLDs and actual PLD use (i.e., behaviour). Also, patients and their family members will be interviewed to better understand the role of the patient as a potential barrier to PLD use. Study 2 will conduct focus groups with: (i) hospital staff who design, develop and deliver PLD training programs, (ii) unit managers, and (iii) new CG hires. Via questionnaire, Preceptors will evaluate the impact of the barrier subcategories identified on the perceived overall effectiveness of a PLD training program. Study 3 will explore the feasibility of implementing vicarious learning through observation (two intervention groups) as an effective alternative to off-site hands-on learning (control group) for new CG hires, with Preceptors evaluating the three groups’ effectiveness via a questionnaire. It is hypothesized that (a) training is an important barrier to the under-utilization of PLDs by CGs (Study 1), (b) there is a need for an effective alternative to off-site hands-on learning that does not remove CGs from units (Study 2), and (c) vicarious learning through observation is as effective as hands-on learning for the utilization of PLDs by new CG hires. / Thesis / Master of Science in Kinesiology

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.