"Negative" changes in the health care system may lead to musculoskeletal pain in nurses, according to a new survey study. Researchers from the University of Maryland School of Nursing asked more than 1,000 RNs about the occurrence of neck, shoulder, and back disorders over the previous year, as well as changes in their health care institutions that resulted from the implementation of managed care systems.
Musculoskeletal disorder was defined as the occurrence of at least moderately intense pain, numbness, tingling, aching, stiffness, or burning in the specified body part in the past year that lasted one week or more or occurred at least once a month. "Negative" workplace changes included increases in "floating" among units, RN vacancies, RN layoffs, patient acuity, patient-to-nurse ratios, and unlicensed personnel providing care; also included were decreases in the number of advanced practice nurses and nurse executives and in lengths of stay.
After adjusting for age, body mass index, family responsibilities, and the physical and psychological demands of the job, the authors found a positive association between negative changes at work and musculoskeletal injuries reported by nurses.
The authors note that exclusively self-reported data should be interpreted with caution. They are conducting a longitudinal study to measure more precisely the prevalence of musculoskeletal disorders among nurses and their temporal associations with changes in the health care system. Says lead author Jane Lipscomb, "Nurses' health and safety need to be primary considerations when making changes within a health care organization. An investment in nurses' work environment (and that of all health care personnel) is an investment in high-quality care."-Fran Mennick, BSN, RN
Lipscomb J, et al. Am J Public Health 2004;94: 1431-5.