Nurses’ perceptions of how job environment and culture influence patient handling

This article is two of a two part series examining the people and environment associated with patient handling. The approach used was that of an occupational injury investigation of a job class, which incorporates defining in the task, environment, tools, and worker health status. Hence, the objective of this study was to evaluate nurses’ perceptions of how healthcare organization, environment, and culture influence a patient transfer. For this purpose, a postal survey was designed to collect data from Alabama nurses who had been registered in the state for at least one year. The potential participant pool included 1000 nurses randomly selected from the 49,000 registered. The return rate of 10% was expected based on nursing literature. One hundred and one surveys were returned with 86 being complete. Results showed nurses perceive bathroom transfers as being most difficult with 3 of the 4 significant transfers being associated with this location. Further, nurses reported they spend approximately 20% of their time performing patient handling tasks. Responses on job culture suggests in patient handling situations most nurses will place a patient’s safety above their own, which is expected given the core concepts of healthcare, but represents a shift from other industries involving manual material handling. Further, over 40% of nurses stated sprains, strains and sore backs are just part of the job. Significant factors shown to influence patient handling were the patient’s size and weight and understaffing. Reasons given for not using patient handling equipment were an emergency did not allow for time, equipment was unavailable, or the size, shape and/or congestion of space did not allow for use. Overall, responses suggest nurses are well educated regarding patient handling as it is a large part of the everyday job. However, job demands and culture often influence nurses to place patient safety ahead of their own. This suggests patient handling remains a problem that still needs to be addressed to find a proper balance between patient and provider safety before significant long-term advances are realized.

Significance to healthcare

Nurses constitute the largest proportion of the healthcare industry’s workforce. Understanding job factors that impact the health and subsequent working life of this employee group is essential in order to sustain the contributions of nurses as the demands on the healthcare system increase with an aging population.