SGNA: Ergonomics in the GI Setting

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The following is a position statement from the Society of Gastroenterology Nurses and Associates regarding ergonomics in the gastroenterology setting. It's the most recent guideline on this topic for gastroenterology nurses.

Disclaimer 

The Society of Gastroenterology Nurses and Associates, Inc. (SGNA) assumes no responsibility for the practices or recommendations of any member or other practitioner, or for the policies and procedures of any practice setting. Nurses and associates function within the limitations of licensure, state nurse practice act, and/or institutional policy.

Definitions 

For the purpose of this document, SGNA has adopted the following definitions:

Administrative controls refers to management dictated work practices that reduce or prevent workers from ergonomic risk factors. They include procedures to reduce the duration, frequency or intensity of exposure to the hazard. Administrative control strategies include modifications of job rules and procedures, job rotation or modified of duties or length of shift and training workers to recognize ergonomic risk factors so they can adopt stress reduction technique while performing their work duties (Nelson & Baptiste, 2004).

Behavior or work-practice (training) controls refers to educating staff about causes of musculoskeletal injury, body mechanics, or joint protection principles such as techniques including manual patient lifting, training in proper use of lift equipment/devices, and the use of unit based peer leaders (Nelson & Baptiste, 2004).

Control methods refers to changes made to the environment, equipment, work processes and employees’ behavior to decrease the risk of musculoskeletal injury. They include training and administrative and engineering controls.

Engineering controls refers to changes made in the work environment, layout, tools, or equipment used on the job, or changing the ways a task is completed to reduce or prevent work-related musculoskeletal hazards (Nelson & Baptiste, 2004).

Ergonomics refers to the study of the physical and cognitive demands of a task in relation to an individual’s capacity (Shergill, McQuaid, & Remple, 2009).

Musculoskeletal Disorder (MSD) refers to a repetitive strain injury.

Background 

Nursing has one of the highest incidences of work-related musculoskeletal injuries. Musculoskeletal injuries result when the physical requirements of the job are greater than the physical capabilities of the worker (Odom-Forren, 2005). Multiple occupational activities in gastroenterology nursing can injure the muscles, nerves, tendons, ligaments, joints, cartilage and spinal discs (AORN, 2007). 

For example, injuries can occur when using forceps, maintaining awkward postures for certain procedures, and during patient handling tasks. Overuse injuries of the upper extremities include high pinch force, repetitive hand activities, awkward postures, vibration and contact stress (Shergill et al., 2009). 

Endoscopy procedures may involve one or more of these factors, especially during complex procedures that require the nurses and associates to use repetitive motions such as those used during ERCP.

Musculoskeletal disorder (MSD) not only affects the individual; the occurrence of these incidences can increase costs. Nursing personnel have the highest worker compensation claim rates of any occupation (ANA, 2010). The incidence rate for lost work-days related to back injuries was 90.1 per 10,000 workers in hospitals (ANA, 2010). 

Indirect costs attributed to muscular skeleton disorders include employee replacement cost, supervisor’s time, loss of productivity, liability costs and other operations costs (Odom-Forren, 2005, ANA, 2010).

Over the past decade, new technology and best practices have emerged to support evidence-based patient handling that is safer for both the caregiver and the patient. The American Nurses Association (2010) (through its “Handle With Care" program), the National Institutes of Occupational Safety and Health (NIOSH), and the Veteran’s Administration’s Patient Safety Center have been actively disseminating information to promote the implementation of these evidence-based practices (Nelson et al., 2007).

Ergonomics is the study of the physical and cognitive demands of a task in relation to an individual’s capacity to perform the task. In effect, ergonomics evaluates how jobs can best be altered so that people can perform them without being injured (Shergill et al., 2009).

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