title: Understanding risks of workplace injury in labor and delivery.
abstract: OBJECTIVE
  To understand nurse and other staff perceptions about care activities in labor and delivery (L&D) that were performed with high frequency, required high exertion, and had the greatest potential to cause injury and to determine what personal characteristics might be related to the caregiving tasks with potential for injury.
  
  
  METHODS
  This exploratory study employed a mixed methods design using qualitative open-ended questions and quantitative surveys administered in three different times (n = 56, 58, and 58).
  
  
  METHODS
  A 22-room L&D unit in a women's hospital with 8,500 annual deliveries.
  
  
  METHODS
  Nurses and assistive staff.
  
  
  RESULTS
  High-risk tasks were classified in three categories. High-exertion tasks included (a) moving patients in labor, delivery, recovery (LDR) beds to other locations; (b) breaking delivery beds and applying stirrups; (c) assisting dependent patients with mobility in bed; and (d) pushing medical equipment and delivery carts. Awkward posture tasks during patient care included (a) listening for heart tones; (b) performing difficult vaginal exams; (c) keeping the fetal head off of the cord during cord prolapse; and (d) assisting with epidurals. Culture of safety tasks included (a) physician requests to conduct patient care tasks that put staff at risk for injury; (b) providers ignoring broken equipment in the environment; (c) responding to emergent/urgent situations without regard to self-posturing to prevent injury; and (d) holding patients' legs during delivery at the physician's direction. Several significant correlations were noted between demographic variables and high potential for risk items.
  
  
  CONCLUSIONS
  This study provides the first information about the caregiving tasks L&D nurses perceive to be risky for personal injury because of their high frequency and exertion or breaches in the culture of safety.
authors.affiliation: professor in the School of Nursing, San Diego State University and a research consultant for the Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA.
authors.forename: Jaynelle F
authors.initials: JF
authors.lastname: Stichler
authors.affiliation: physical therapist in the Sharp Memorial Sports Medicine Center and lead therapist for the Injury Prevention Program, Sharp Metropolitan Campus, San Diego, CA.
authors.forename: Judd L
authors.initials: JL
authors.lastname: Feiler
authors.affiliation: the manager of the labor and delivery unit, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA.
authors.forename: Kimberlie
authors.initials: K
authors.lastname: Chase
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D032882:Comprehension; D036861:Delivery, Obstetric / Q000592:standards* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007743:Labor, Obstetric; D009773:Obstetric Nursing; D016272:Occupational Health; D060051:Occupational Injuries / Q000453:epidemiology* / Q000209:etiology; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult