Understanding risks of workplace injury in labor and delivery

To understand nurse and other staff perceptions about care activities in labor and delivery (L&D) that were performed with high frequency, required high exertion, and had the greatest potential to cause injury and to determine what personal characteristics might be related to the caregiving tasks with potential for injury.

This exploratory study employed a mixed methods design using qualitative open-ended questions and quantitative surveys administered in three different times (n = 56, 58, and 58).

A 22-room L&D unit in a women's hospital with 8,500 annual deliveries.

Nurses and assistive staff.

High-risk tasks were classified in three categories. High-exertion tasks included (a) moving patients in labor, delivery, recovery (LDR) beds to other locations; (b) breaking delivery beds and applying stirrups; (c) assisting dependent patients with mobility in bed; and (d) pushing medical equipment and delivery carts. Awkward posture tasks during patient care included (a) listening for heart tones; (b) performing difficult vaginal exams; (c) keeping the fetal head off of the cord during cord prolapse; and (d) assisting with epidurals. Culture of safety tasks included (a) physician requests to conduct patient care tasks that put staff at risk for injury; (b) providers ignoring broken equipment in the environment; (c) responding to emergent/urgent situations without regard to self-posturing to prevent injury; and (d) holding patients' legs during delivery at the physician's direction. Several significant correlations were noted between demographic variables and high potential for risk items.

This study provides the first information about the caregiving tasks L&D nurses perceive to be risky for personal injury because of their high frequency and exertion or breaches in the culture of safety.