Factors associated with safe patient handling behaviors among critical care nurses

Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment.

A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors.

More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort-reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior.

Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury.