Outcomes of safe patient handling and mobilization programs: A meta-analysis

Article type: Research Article

Authors: Teeple, Erin^{a; b; *} | Collins, Jamie E.^{c; d} | Shrestha, Swastina^c | Dennerlein, Jack T.^{e; f} | Losina, Elena^{c; d; g; h} | Katz, Jeffrey N.^{c; d; f; g; i}

Affiliations: [a] Department of Work Environment, University of Massachusetts, Lowell, MA, USA | [b] Liberty Mutual Research Institute for Safety, MA, USA | [c] Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA | [d] Harvard Medical School, Boston, MA, USA | [e] Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA | [f] Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA | [g] Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA, USA | [h] Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA | [i] Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA

Correspondence: [*] Address for correspondence: Erin Teeple, MD, MPH, Department of Work Environment, University of Massachusetts Lowell, Lowell, MA 01854, USA. Tel.: +1 508 732 7495; Fax: +1 508 435 3456; E-mail: [email protected].

Abstract: BACKGROUND:Variability in patient care settings and the range of patient handling tasks present challenges in developing and evaluating safe patient handling and mobilization (SPHM) programs. OBJECTIVE:We performed a systematic meta-analysis of SPHM program evaluations. METHODS:Systematic literature review identified published SPHM program evaluations. Injury Rate Ratios (IRR), pre- to post-intervention, were used to estimate intervention effects and to examine the influence of patient care level, program components, and follow-up time using meta-regression. RESULTS:27 articles reported evaluations from 44 sites. Combined effect estimate for all SPHM programs was 0.44 (95% CI 0.36, 0.54), reflecting substantial injury reductions after program implementation. While specific program components were not associated with greater effectiveness, longer follow-up duration was associated with greater injury rate reduction (p = 0.01) and intervention effects varied by level of care (p = 0.01), with the greatest effect in intensive care unit interventions (IRR 0.14; 95% CI 0.07, 0.30). CONCLUSIONS:SPHM programs appear to be highly effective in reducing injuries. More research is needed to identify the most effective interventions for different patient care levels.

Keywords: Healthcare, safety, hospital, safe patient handling

DOI: 10.3233/WOR-172608

Journal: Work, vol. 58, no. 2, pp. 173-184, 2017