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Biomedical subjects

A Yassi

Publications and source records attributed to A Yassi.

At least 19 recordsLinked to original sources
PubMed2005

Electromyography as a measure of peak and cumulative workload in intermediate care and its relationship to musculoskeletal injury: an exploratory ergonomic study.

Injury rates in Intermediate Care (IC) facilities are high and the factors related to these injuries are unclear. The objectives of this exploratory sub-study, which is part of a large multi-faceted study in 8 IC facilities are to: (1) evaluate EMG measured over a full-shift in the back and shoulders of 32 care aides (CAs) as an indicator of peak and cumulative workload (n = 4 x 8 facilities); investigate the relationship between EMG measures and injury indicators; and explore the relationship between EMG measures and other workload measurements. Lumbar EMG was converted to predicted cumulative spinal compression and ranged in CAs from 11.7 to 22.8 MNs with a mean of 16.4 MNs. Average compression was significantly different during different periods of the day (p < 0.001) with highest compression during pre-breakfast when CAs assist most with activities of daily living. Significant differences were found in average compression between low and high injury facilities for 3 of 5 periods of the day (p < 0.010). Peak compressions exceeding 3400 N occurred for very little of the workday (e.g. 11.25s during the 75 min period pre-breakfast). Peak neck/shoulder muscle activity is low (99% APDF ranged from 8.33% to 28% MVC). Peak and cumulative spinal compression were significantly correlated with lost-time and musculoskeletal injury rates as well as with total tasks observed in the CAs (p < 0.01). Perceived exertion was only correlated with peak compressions (p < 0.01). Facilities with low injury rates provided significantly more CAs (p < 0.01) to meet resident needs, and subsequently CAs performed fewer tasks, resulting in less peak and cumulative spinal loading over the day.

Back↗
PubMed2005

Effectiveness of overhead lifting devices in reducing the risk of injury to care staff in extended care facilities.

Patient and/or resident handling is a major cause of injury to healthcare workers. The effectiveness of an overhead ceiling lift programme at mitigating the risk of injury from resident handling was evaluated by comparing injury data and staff perceptions before and after implementation of the programme, and by comparison with a similar unit that did not implement an overhead ceiling lift programme. A questionnaire was used to assess perceived risk of injury and discomfort, preferred resident handling methods, frequency of performing designated resident handling tasks, perceived physical demands, work organization, and staff satisfaction. Staff preferred overhead ceiling lifts to other methods of transfer (manual or floor lifts) when lifting or transferring residents. A significant reduction was observed in the perceived risk of injury and discomfort to the neck, shoulders, back, hands, and arms of care staff. Compensation costs due to lifting and transferring tasks were reduced by 68% for the intervention unit and increased by 68% for the comparison unit. Overhead ceiling lifts were not beneficial in reducing the perceived risk of injury, pain or discomfort, or compensation costs when used to reposition residents. The study demonstrated an overall cost-savings associated with the installation of the overhead lifts, and highlighted areas for further improvement.

Accidents, Occupational↗
PubMed2005

Health promotion in the workplace--the merging of the paradigms.

PURPOSE: To synthesize the lessons from both occupational health and health promotion, to improve workplace health. APPROACH: This article briefly outlines the evolution in defining and understanding health promotion as well as current thinking in occupational health and safety. It also discusses an approach taken in the healthcare sector in British Columbia, Canada, where evidence-based practices and collaboration became the cornerstones to bringing about change and achieve impressive cost-beneficial results in healthcare workforce health. CONCLUSION: Traditionally, workplace health promotion and occupational health and safety have been two solitudes. Workplace health promotion is rooted in "wellness" and healthy lifestyle choices, while occupational health is heavily dictated by workplace health and safety requirements and legislation. Recently however, there has been increasing recognition of the need for a more holistic approach that focusses on workplace culture, addressing both primary and secondary prevention [1], as well as interventions aimed both at the individual as well as the organisation [2].

Canada↗
PubMed2003

Work organization and patient care staff injuries: the impact of different care models for "alternate level of care" patients.

BACKGROUND: The number of elderly patients who do not have acute-care needs has increased in many North American hospitals. These alternate level care (ALC) patients are often cognitively impaired or physically dependent. The physical and psychosocial demands on caregivers may be growing with the increased presence of ALC patients leading to greater risk for injury among staff. METHODS: This prospective cohort study characterized several models for ALC care in four acute-care hospitals in British Columbia, Canada. A cohort of 2,854 patient care staff was identified and followed for 6 months. The association between ALC model of care and type and severity of injury was examined using multinomial and ordinal logistic regression. RESULTS: Regression models demonstrated that the workers on ALC/medical nursing units with "high" ALC patient loads and specialized geriatric assessment units had the greatest risk for injury and the greatest risk for incurring serious injury. Among staff caring for ALC patients, those on dedicated ALC units had the least risk for injury and the least risk for incurring serious injury. CONCLUSIONS: The way in which ALC care is organized in hospitals affects the risk and severity of injuries among patient care staff.

Accidents, Occupational↗
PubMed2001

A randomized controlled trial to prevent patient lift and transfer injuries of health care workers.

STUDY DESIGN: Randomized controlled trial (RCT). OBJECTIVES: To compare the effectiveness of training and equipment to reduce musculoskeletal injuries, increase comfort, and reduce physical demands on staff performing patient lifts and transfers at a large acute care hospital. SUMMARY OF BACKGROUND DATA: Back injury to nursing staff during patient handling tasks is a major issue in health care. The value of mechanical assistive devices in reducing injuries to these workers is unclear. METHODS: This three-armed RCT consisted of a "control arm," a "safe lifting" arm, and a "no strenuous lifting" arm. A medical, surgical, and rehabilitation ward were each randomly assigned to each arm. Both intervention arms received intensive training in back care, patient assessment, and handling techniques. Hence, the "safe lifting" arm used improved patient handling techniques using manual equipment, whereas the "no strenuous lifting" arm aimed to eliminate manual patient handling through use of additional mechanical and other assistive equipment. RESULTS: Frequency of manual patient handling tasks was significantly decreased on the "no strenuous lifting" arm. Self-perceived work fatigue, back and shoulder pain, safety, and frequency and intensity of physical discomfort associated with patient handling tasks were improved on both intervention arms, but staff on the mechanical equipment arm showed greater improvements. Musculoskeletal injury rates were not significantly altered. CONCLUSIONS: The "no strenuous lifting" program, which combined training with assured availability of mechanical and other assistive patient handling equipment, most effectively improved comfort with patient handling, decreased staff fatigue, and decreased physical demands. The fact that injury rates were not statistically significantly reduced may reflect the less sensitive nature of this indicator compared with the subjective indicators.

Back Injuries↗
PubMed2001

Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer injury of health care workers.

Back injuries are a serious problem for nursing personnel who perform frequent patient-handling activities. Common prevention strategies include body mechanics education, technique training, and ergonomic interventions such as the introduction of assistive equipment. This investigation assessed and compared the effectiveness of two patient-handling approaches to reducing injury risk. One strategy involved using improved patient-handling technique with existing equipment, and the other approach aimed at eliminating manual patient handling through the use of additional mechanical and other assistive equipment. Both intervention arms received training in back care, patient assessment, and use of the equipment available on their particular wards. An analysis of compliance with interventions and the effects of patient-handling methods on both peak and cumulative spinal compression and shear during various tasks was conducted. Results showed greater compliance with interventions that incorporated new assistive patient-handling equipment, as opposed to those consisting of education and technique training alone. In several tasks, subjects who were untrained or non-compliant with interventions experienced significantly higher peak spinal loading. However, patient-handling tasks conducted with the aid of assistive equipment took substantially longer than those performed manually. This, along with variations in techniques, led to increases in cumulative spinal loading with the use of patient-handling equipment on some tasks. Thus, the use of mechanical assistive devices may not always be the best approach to reducing back injuries in all situations. No single intervention can be recommended; instead all patient-handling tasks should be examined separately to determine which methods maximize reductions in both peak and cumulative lumbar forces during a manoeuver.

Adult↗
PubMed2001

Chiropractors and return-to-work: the experiences of three Canadian focus groups.

OBJECTIVES: To explore the views of chiropractors about timely return-to-work in treating patients with musculoskeletal injuries, to identify the approaches used by chiropractors when treating injured workers with musculoskeletal disorders, and to learn about chiropractors' perspectives on the barriers and facilitators of successful return-to-work. DESIGN: Qualitative study of 3 focus groups of chiropractors. METHODS: Focus groups of 8 to 11 chiropractors were conducted in 3 large Canadian cities. The selected participants were experienced in treating patients with occupational musculoskeletal injuries. Standard questions were used to collect data. The data from each focus group were coded and analyzed separately and then considered in relation to each other. RESULTS: The participants indicated that timely return-to-work depends on patients' characteristics, severity of injury, clinical progress, the availability of work accommodation, and clinical judgment. The chiropractors commented that their treatment of injured workers rests on their strength in diagnosis and treatment and on providing patient-centered care. Positive human relations within workplaces and the ability to accommodate the work of an injured worker were described as important in return-to-work programs. The participants believed that a bias against chiropractic is present within the medical profession and workers' compensation boards. They viewed this bias as an important barrier when assisting their patients to successfully return to work. CONCLUSION: The broad approaches described by the participating chiropractors to return injured workers to work are consistent with those proposed in evidence-based practice guidelines. Better communication among chiropractors, medical doctors, and workers' compensation boards would likely decrease interprofessional tensions and improve the recovery of workers with musculoskeletal injuries.

Adult↗
PubMed2000

Work-related musculoskeletal disorders.

Work-related musculoskeletal disorders continue to be extremely common and to present an important challenge to clinicians. Debate regarding terminology and case definitions has discouraged practitioners from aggressively approaching the diagnosis and management of these conditions. Considerable progress has, however, been made recently. Previously more commonly referred to as repetitive strain injuries or cumulative trauma disorders, the new term work-related musculoskeletal disorders has fewer etiological implications. These disorders, affecting the back, lower limbs, and especially upper limbs and neck, can be extremely costly if not addressed appropriately. Generally resulting from a combination of physical factors (including repetition, force, and awkward postures) as well as other workplace environmental or organizational factors (including excessive work rates or durations, inadequate breaks, and a variety of psychosocial workplace characteristics), work-related musculoskeletal disorders can often be remediated when these factors are appropriately assessed and addressed. Clinicians must play a positive role in ensuring that this approach prevails.

Humans↗
PubMed1999

Predictors of time loss after back injury in nurses.

STUDY DESIGN: A 2-year prospective inception cohort study of back injury in nurses. OBJECTIVES: To determine the extent to which characteristics of nurses, of the injury, and of the workplace predict occurrence and duration of time loss from work after back injury. SUMMARY OF BACKGROUND DATA: During 2 years, 320 nurses incurred 416 back injuries at a large teaching hospital in Winnipeg, Canada. Nurses injured on preselected wards were targeted for early intervention, including provision of modified work, whereas nurses injured on other wards received the usual care. METHODS: Time loss attributable to the back injury during the 6 months after injury was analyzed. Three statistical models were used to examine occurrence of time loss (logistic regression), duration of time loss (Tobit regression), and duration of time loss once an injury incurring time loss had been documented (least-squares regression). RESULTS: In 218 of the 416 injuries, the injured nurse consented to interview. Whereas perceived disability was related to whether a time loss injury would ensue, self-reported pain was strongly related to the duration of time loss once an injury had become a time loss injury. Duration of time loss was reduced by participation in the return-to-work program. Mechanism of injury, specifically injury occurring while lifting patients, resulted in greater time loss. CONCLUSIONS: Focusing on reducing the perception of disability at the time of injury is critical to preventing time loss, but once time loss has occurred, offer of modified work and attention to pain reduction are warranted. The findings add to the evidence that workplace-based intervention programs can be effective in reducing the morbidity resulting from back injury.

Accidents, Occupational↗
PubMed1998

Components of initial and residual disability after back injury in nurses.

STUDY DESIGN: A pre- versus postintervention with concurrent control group design was used to investigate the effect of a workplace-based early intervention program on perception of disability in nurses with low back injury. OBJECTIVES: This report examines changes over time in the components of the Oswestry Low Back Pain and Disability Questionnaire in two groups of back-injured nurses-those who received the early intervention program (study) and those who were not offered the program (control). SUMMARY OF BACKGROUND DATA: Early intervention programs can decrease morbidity, time lost from work, and compensation costs. Although perception of disability decreases, some residual disability remains, the nature of which is not clear. METHODS: The Oswestry Low Back Pain and Disability Questionnaire scores of 40 study nurses and 118 control nurses at time of injury and at 6 months after injury were examined. Analysis of variance was used to compare changes in mean overall scores over time. The proportion of nurses reporting disability on individual components of the Oswestry Low Back Pain and Disability Questionnaire at each time period was compared with the results of a chi-square test. RESULTS: Overall Oswestry Low Back Pain and Disability Questionnaire scores were similar between study and control nurses at time of injury, but were significantly lower in study nurses at 6 months after injury. However, scores of individual Oswestry Low Back Pain and Disability Questionnaire components that related to job demands increased over time; this was most apparent in lifting, particularly in study nurses. CONCLUSIONS: Although overall perception of disability decreased 6 months after injury, particularly in study nurses, disability in job-related activities persisted. Residual disability after back injury should be addressed in workplace-based prevention programs.

Adult↗
PubMed1998

Cultural environmental health risk perception in the Canadian north.

This paper examines perceptions of various sources of environmental health risk in one Aboriginal community in Northern Canada to better understand how community members view those risks. The central question addressed is whether there is a pattern of perception, or form of cultural rationality, that informs risk perception generally, or are health risk perceptions created in an ad hoc manner, depending on local circumstances. A case study approach, involving both ethnographic and survey methods, was employed in three aboriginal communities in Quebec, Saskatchewan, and Manitoba. This paper reports on one of those communities. Distinct cultural patterns of perception were found: a pattern that recognizes contingencies and conditions that produce dangerous circumstances--a pattern that is open to new forms of knowledge and sensitive to uncertainty.

Canada↗
PubMed1998

Utilizing data systems to develop and monitor occupational health programs in a large Canadian hospital.

With rapid change in health care requiring greater emphasis on productivity and quality management, occupational health hazards in hospitals have been receiving increasing recognition, now not only focusing on controlling infection, but also on chemical, physical, mechanical as well as psychosocial hazards. Reducing costly time loss from musculoskeletal injuries is a particular imperative. The Department of Occupational and Environmental Medicine at Winnipeg's Health Sciences Centre, developed databases to help priorize, monitor and improve occupational health programs for its 6,000 employees. Risk assessment/risk management models were adopted to identify hazards, quantify risks and priorize intervention. Using the databases permitted the targeting of groups requiring immunization, resulting in increased coverage. New safety products were introduced and found to be cost-beneficial. A return-to-work post-injury program was particularly cost-beneficial. Over the five years following the implementation of occupational health programs, workers' compensation assessment reductions resulted in savings of more than half-a-million dollars annually. The databases were invaluable in affecting these changes.

Cost-Benefit Analysis↗
PubMed1998

On PMWs and two-stroke engines.

On Saturday, August 24, 1996, a 40-year-old man from Edmonton was riding a personal motorized watercraft (PMW, a Seadoo or Jet Ski type of machine) on Shuswap Lake, in south-central British Columbia. He was approximately 200 m offshore. The man motioned to his sister, who was riding another PMW, to follow him across the lake. She did so, but as the turned her head to check for other boat traffic, her brother suddenly slowed down and her machine rode right up on his back, crushing him against his handlebars. His sister, a nurse, held her brother's head above water until help arrived but, 48 minutes after the moment of impact, he was pronounced dead at the Shuswap Lake General Hospital. He had suffered a ruptured aorta.

Accident Prevention↗
PubMed1998

Causes of staff abuse in health care facilities. Implications for prevention.

Verbal and physical abuse of health care workers (HCWs) is prevalent and costly. A 3 month prospective study was conducted to characterize precipitating conditions and the perpetrators of abusive incidents reported by HCWs at a large inner city hospital. Sixty-six HCWs reporting 102 incidents were interviewed by a research nurse within 48 hours of the incident. Abusive incidents resulted from 55 different patients and 11 visitors. Verbal abuse accounted for 42 incidents (41%) and 60 (59%) involved physical abuse. Two thirds of the abuse occurred on psychiatric wards, 20% on inpatient wards, and 13% in other settings. Overall, twice as many abusive incidents were inflicted by males as females. Cognitive impairment accounted for 19% of the incidents and one abuser was intoxicated at the time. Rule enforcement precipitated abuse in 70% of incidents. Researchers concluded that reviewing rules that apply to patients, how HCWs are trained to enforce rules, how to respond when service requested cannot be provided promptly, and how HCWs can protect themselves when performing a service were important elements in the prevention of staff abuse.

Causality↗
PubMed1997

Repetitive strain injuries.

Repetitive strain injuries (RSI) present an increasingly common challenge to clinicians. They consist of variety of musculoskeletal disorders, generally related to tendons, muscles, or joints, as well as some common peripheral-nerve-entrapment and vascular syndromes. These disorders generally affect the back, neck, and upper limbs, although lower limbs may also be involved. Although RSI may occur as a result of sports and recreational activities, occupational RSIs, affecting the patient's livelihood, are particularly important. These injuries result from repetitive and forceful motions, awkward postures, and other work-related conditions and ergonomic hazards. Occupationally induced RSIs are generally costly, creating a strong incentive for physicians to become familiar with the symptoms, signs, and risk factors so that they can be diagnosed early and appropriate interventions facilitated.

Carpal Tunnel Syndrome↗
PubMed1997

The use of health indicators in environmental assessment.

Environmental assessment (EA) is required in Canadian federal and provincial jurisdictions as part of the process for decision-making on the acceptability of development projects. With increasing recognition of the relationship between environment and health, assessing "health" impact has growing importance. This paper presents the framework that is being developed by the World Health Organization (WHO) for addressing environmental health indicators, reports on the findings of a series of five regional workshops held in 1995-96 to examine the role of health professionals in environmental assessment in Canada, and presents a case study illustrating how human health has been addressed in a prominent EA conduct in northern Saskatchewan. Opportunities for future development of environmental health indicators are considered, with special reference to the potential use of medical data to address these challenges.

Canada↗