title: Do assistive devices, training, and workload affect injury incidence? Prevention efforts by nursing homes and back injuries among nursing assistants.
abstract: OBJECTIVE
  This paper is a report of a study of association between workplace injuries experienced by nursing assistants in nursing homes in the United States and four factors that may affect injury rates: initial nursing assistant training, training at the current facility, lifting devices, and time to execute daily duties.
  
  
  BACKGROUND
  High injury rates among nursing personnel have been reported in multiple settings across countries. The existing literature is divided on the effectiveness of training and assistive devices in reducing injury rates among nursing assistants.
  
  
  METHODS
  We examined associations between whether or not the nursing assistant has experienced an injury and four key factors: quality of initial injury prevention training, injury prevention training at current facility, lift availability and whether or not the nursing assistant has sufficient time to complete resident activities of daily living. We estimated a survey-weighted logit model using 2004 National Nursing Assistant Survey data.
  
  
  RESULTS
  The odds of an injury in the past year were lower among nursing assistants who reported always having a lift available when needed (41% lower odds), available facility training to reduce workplace injuries (39%), and sufficient time to complete resident activities of daily living (35%). Quality of initial training to prevent work injuries was not significantly associated with injury status.
  
  
  CONCLUSIONS
  Regions without widespread access to lifting devices may be able to reduce injury rates by increasing the availability of lifting devices. The potential for reductions in injury rates in the United States is greatest from improving training and ensuring adequate time for resident care, as most facilities currently have lifts available.
authors.affiliation: Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, USA. ldarcy@email.unc.edu
authors.forename: Laura P
authors.initials: LP
authors.lastname: D'Arcy
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Sasai
authors.forename: Sally C
authors.initials: SC
authors.lastname: Stearns
mesh_terms: D000203:Activities of Daily Living; D019567:Back Injuries / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D007318:Inservice Training / Q000706:statistics & numerical data*; D016015:Logistic Models; D017116:Low Back Pain / Q000453:epidemiology / Q000517:prevention & control; D055805:Moving and Lifting Patients / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D009728:Nursing Assistants / Q000193:education / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000458:organization & administration*; D060051:Occupational Injuries / Q000453:epidemiology* / Q000517:prevention & control; D011322:Primary Prevention / Q000193:education / Q000295:instrumentation; D018582:Sick Leave / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D000078329:Workforce; D016526:Workload; D017132:Workplace / Q000458:organization & administration