PLIBEL and QEC for ergonomic risk assessment in operating room scrub nurses during coronary artery bypass grafting: a...

To identify and evaluate ergonomic risks among scrub nurses during coronary artery bypass grafting (CABG) using the Swedish Ergonomic Hazard Identification Method (PLIBEL) and the Quick Exposure Check (QEC). This pilot study was designed to test the feasibility of applying PLIBEL and QEC for ergonomic risk assessment in CABG scrub nurses and to generate preliminary risk profiles. Fifteen scrub nurses from a tertiary hospital in Baoding, China, were enrolled, with each nurse observed during three CABG procedures, resulting in a total of 45 observed operations. The CABG procedure was divided into 11 stages. Two trained observers performed on-site PLIBEL identification and QEC scoring. Video recordings were made during high-load stages, and Kinovea software was used as an auxiliary tool to support observer scoring. QEC scores across stages were compared using the Friedman test. A total of 311 adverse ergonomic factors were identified across the 11 stages. The postoperative finishing stage showed the highest risk, with the "surgical instrument cleaning and disposal" step contributing 36 factors. During intraoperative cooperation, thoracotomy, internal mammary artery harvesting, and vessel anastomosis each had 30-31 adverse factors. QEC scores revealed that static back load reached a high level in the vessel anastomosis cooperation and instrument counting stages, while the neck reached a high load in the vessel anastomosis cooperation, chest closure cooperation, and instrument cleaning stages. Friedman test showed significant stage differences for all body regions (back dynamic P = 0.02, others P < 0.001). The E-value ranged from 38.8% to 61.1%; five stages were high-risk (51%-70%), with the highest in vessel anastomosis cooperation (61.1%). In this small-scale, single-center pilot study, the combination of PLIBEL and QEC appears to be a feasible and useful approach for the preliminary identification of ergonomic risks for CABG scrub nurses. The vessel anastomosis cooperation stage had the highest overall risk, and the neck was the most loaded body region. Targeted interventions, including environmental optimization, workflow restructuring, and ergonomics training, are suggested for high-risk stages, although these recommendations require further evaluation in larger, multicenter studies.