改善加護病房護理人員下背肌肉骨骼傷病認知正確率與風險率之專案

Enhancing Understanding Among Intensive Care Unit Nurses of Lower Back Musculoskeletal Disorders and Associated Risks

背景：職業肌肉骨骼傷病（work-related musculoskeletal disorders, WMSDs）是國內、外職業醫學領域中，最受大眾所關注的健康議題。在加護病房中，重症病人依賴程度高，需仰賴護理人員協助日常生活照護及復健，皆會增加護理人員WMSDs的風險，尤其低度風險者宜早介入以免惡化。經傷病篩檢發現，本單位加護病房護理人員下背肌肉骨骼傷病屬低度風險者之百分比高達56.4%，主要導因為護理人員對於下背WMSDs認知正確率不足。
目的：主要目標提升護理人員下背WMSDs認知正確率，次要目標為降低WMSDs低度風險者之百分比。
解決方案1.舉辦整合性人因危害課程，增加同仁對於WMSDs認識及預防。2.規劃「翻身五撇步」口訣、海報及教學影片，避免同仁因施力錯誤造成WMSDs。3.製作加護病房常見下背WMSDs高危險姿勢標示，避免人因性傷害的發生。
結果：護理人員下背WMSDs認知正確率由改善前73.8%提升至96.2%，而下背肌肉骨骼傷病低度風險者百分比由原本56.4%下降至25.5%。
結論：本專案依循勞動部WMSDs篩檢暨風險分級管理流程，推行多元改善措施，提升加護病房護理人員下背WMSDs認知正確率，同時也改善了人員WMSDs的發生風險。

Background & Problems: Work-related musculoskeletal disorders (WMSDs) have received the most attention worldwide of the various diseases addressed by the field of occupational medicine. In intensive care units (ICUs), patients with critical illness typically rely heavily on assistance provided by nurses to engage in daily life and rehabilitation activities. This dependence increases the risk of nurses experiencing WMSDs. An injury screening revealed that 56.4% of the nurses working in the ICU of the case hospital faced a mild risk of lower back musculoskeletal disorders and that the main contributor to this risk was lack of understanding among these nurses of lower-back-related WMSDs.
Purpose: This project was designed to enhance understanding of lower back WMSDs among the ICU nurses and to reduce the percentage of nurses facing a mild risk of contracting WMSDs.
Resolutions: 1. Organize integrated courses to introduce human-induced hazards and enhance nurses’understanding and prevention of WMSDs. 2. Design slogans, posters, and teaching videos to promote awareness of patient turning tips and procedures to prevent nurses from experiencing WMSDs due to incorrect force application. 3. Design illustrations highlighting risky postures commonly performed by nurses in ICUs that may cause lower back WMSDs to prevent the occurrence of human-induced injuries.
Results: The rate of correct understanding of lower back WMSDs in the target nurse population improved from 73.8% to 96.2%. In addition, the percentage of those assessed with a mild risk of contracting lower back musculoskeletal injuries decreased from 56.4% to 25.5%.
Conclusions: This project promoted multifaceted improvement measures based on the WMSD screening and risk classification and management processes stipulated by Taiwan’s Ministry of Labor to increase understanding of lower back WMSDs among ICU nurses and reduce the percentage of those facing a mild risk of contracting WMSDs.