Effect of Safe Patient Handling and Mobility Coordinators on Work-Related Musculoskeletal Injuries, Proximal Mental Illness, and Patient-Related Safety Events in New York State Intensive Care Unit Registered Nurses in the Age of COVID-19: The Methods

Researchers continue to examine how COVID-19 has impacted the globe. In New York State (NYS), the initial epicenter of the pandemic in the United States, intensive care unit registered nurses (ICU-RNs) were among those who have been exposed to one of the longest and most severe public health crises in over a century. Most ergonomic studies that use administrative databases to evaluate effects of SPHM programs only capture information on work-related musculoskeletal injury (MSI) incidence rates, lost workdays associated with work-related MSIs, and a limited number of individual risk factors, such as age and sex; some studies based on self-report, capture information on perceived program effectiveness (eg, number of times SPHM technology was used) and self-efficacy concerning safe patient handling and mobility (SPHM) programs. Few studies, however, have employed both self-report and administrative databases, in which the latter will be used to corroborate self-reported items and the former will be used to obtain individual risk factors, temporal factors related to occupation, work practice/usability items, and mechanical and psychosocial exposures, in which these variables will be examined as potential confounders. Moreover, few longitudinal studies have evaluated the effect of SPHM coordinators on proximal mental illness, lost workdays associated with proximal mental illness, and psychosocial exposures in ICU-RNs, in addition to work-related MSI incidence rates; further, there are no studies that have used a longitudinal design to examine the influence of adherence, sustainability, and reliability (potential mediator variables) on SPHM coordinators and SPHM program effectiveness. In addition, while some SPHM programs have examined work-related MSIs and quality-of-care patient-related safety initiatives (prevention of pressure- and fall-related injuries), few have examined both in one study. The objective of this article is to present the methodology of a 1-year prospective cohort study designed to examine the impact of SPHM coordinators on ICU-RNs in NYS; its long-term goal is to strengthen NYS SPHM programs during the current pandemic and future public health crises. The theoretical rationale is that system-, organizational-level SPHM coordinators can improve potential mediators of SPHM programs, and reduce incident work-related MSIs, proximal mental illness, lost workdays, and psychosocial exposures in ICU-RNs, and patient-related safety events in ICU-RNs and patients. We hypothesize that the variation in the SPHM coordinator variable will substantially account for the variation in potential mediator variables, and that the variation in potential mediator variables will substantially account for the variation in SPHM program effectiveness. We further hypothesize that ICU-RNs and patients will have better health outcomes and fewer patient-related safety events with full-time than part-time SPHM coordinators, and that ICU-RNs and patients will have better health outcomes and fewer patient-related safety events with part-time SPHM coordinators than in facilities without SPHM coordinators; this will follow an exposure-response relation.

Latvala S, Masterman R, Rasul R, Dropkin J

Keywords: prospective cohort study, patient handling, incident work-related musculoskeletal injuries, proximal mental illness, patient-related fall and pressure injuries, health system costs