Health education intervention of safe patient handling on musculoskeletal disorder among nurses

The protocol of the intervention has been published in International Journal of Public health and Clinical Science (https://doi.org/10.32827/ijphcs.6.1.222) This study is the cluster pre-test and post-test with control group quasi experimental study design on safe patient handling among government elderly care homes nurses in West Coast Malaysia. Quasi experimental has been done due to managerial and logistic problems. This was single blinding intervention.The intervention involve health education based on health belief model theory to change the behaviour toward safe patient handling. The intervention groups were care home in Cheng Melaka, Cheras Selangor, Ulu Kinta Perak, Kuala Kubu Bharu Selangor. Control groups were Johor Bharu, Kangar Perlis, Taiping Perak and Bedong Kedah. There were 226 or nurses involved in this intervention study. after assess for eligibility, 115 nurses were in intervention groups and 111 nurses were in control groups. The intervention development was divided into 4 elements: 1) Organisation commitment Researcher had explained Headquarters of Social Welfare Department regarding the intervention and benefits of the intervention towards organisation, nurses and elderly. The committee of the intervention program had been developed for each care home that involve in the intervention. Work through survey had been done for assessment and the equipment of safe patient handling had been provided according to the finding. Guideline and questionnaire developed and being validated. The content of guideline presented during meeting with headquarters 2) Unit based peer leader Supervisor had assigned 2 peer leaders in each ward and the peer leader was important to encourage the colleague to implement the intervention that had been planned by management 3) Implementation of intervention (education phase) Questionnaire was distributed to all care homes that involve in the study to get information at baseline before the intervention was given to nurses.The health education was given within 2 months period (January until March 2018) and followed by monitoring of the implementation of 6 months duration (April until October 2018).Each nurses involved in one day training of 3 hours lecture using power point and 5 hours practical session using video. The content of three hours lecture were introduction on musculoskeletal disorder including statistic of MSD among nurses world wide and in Malaysia, pathophysiology of MSD and symptoms of MSD, explained the tasks and the risks that contribute to MSD, benefit of safe patient handling towards nurses and patient, consequences if the the nurses still practice manual handling. Emphasized on correct body posture or body mechanic while transfering the patient. Explained the principal of safe patient handling, important the elderly assessment using algorithm. Other than that the practical session on technique of safe patient handling was also has been done. The hands on session was done on 10 transferring activities. The use of algorithm for assessment was applied during this session. There were about 12 to 15 respondents attended the course training and every respondent had their opportunity to practice the techniques. The transferring activities were: 1) Transferring the patient from bed to chair or toilet using transfer board and gait belt (1 carer) 2) Transferring the patient from bed to chair or toilet using gait belt only (1 carer) 3) Re-position patient on the chair using slide sheet & pillow (1 care) 4) Transferring the patient from chair to bed using transfer board (2 carer) 5)Transferring the patient from chair to bed using mechanical lifting aid 6) Transferring patient from bed to chair using mechanical lifting aid 7) Transferring patient from floor to bed using mechanical lifting aid 8) Transferring elderly from bed to trolley using slide sheet and transfer board (2 carer) 9) Re-position the elderly on bed using slide sheet (2 carer) 10) Technique make a bed while patient on the bed (2 carer) Prior to intervention done, guideline, pamphlet and poster of safe patient handling has been developed. The training was given by researcher herself. There were 8 session of training and it was held in Care Cheras Selangor as center of excellent for elderly in Malaysia. 4) Maintenance and monitoring phase Committee and supervisor need to do continuous monitoring in the ward and peer leader play important role to encourage the colleague to implement the intervention. Standardized log book has been developed. The peer leader filled up the name of elderly and equipment used in log book. The supervisor need to review the log book for monitoring. After 6 month post intervention the nurses re evaluate by answering the same questionnaire to look into improvement of musculoskeletal disorder symptoms, knowledge and practice of safe patient handling