title: Musculoskeletal injuries among hospital patient care staff before and after implementation of patient         lift and transfer equipment.
abstract: OBJECTIVE
  Using an observational research design and robust surveillance data, we evaluated rates of         musculoskeletal (MS) injuries, days away from work, and restricted work days among patient care staff at a medical         center and community hospital in the United States over 13 years, during which time a "minimal manual lift"         policy and mechanical lift equipment were implemented.
  
  
  METHODS
  Workers' compensation claims data were linked to         human resources data to define outcomes of interest and person-time at risk to calculate rates. Poisson and negative         binomial regression with lagging were used to compare outcome rates in different windows of time surrounding the         intervention. Patterns of MS injuries associated with patient-handling were contrasted to patterns of other MS injuries         that would not be affected by the use of mechanical lift equipment.
  
  
  RESULTS
  At the medical center, no change in the         patient-handling MS injury rate followed the intervention. A 44% decrease was observed at the community hospital. At         both hospitals, the rate of days away declined immediately - before it was reasonable for the intervention to         have been adopted.
  
  
  CONCLUSIONS
  Institutional-level changes at the time of the intervention likely influenced observed         results with findings only partially consistent with an intervention effect. Observational studies can be useful in         assessing effectiveness of safety interventions in complex work environments. Such studies should consider the process         of intervention implementation, the time needed for intervention adoption, and the dynamic nature of work         environments.
authors.affiliation: Department of Community and Family Medicine, Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27705, USA. ashley.schoenfisch@duke.edu
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Schoenfisch
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Pompeii
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Myers
authors.forename: John M
authors.initials: JM
authors.lastname: Dement
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000009:adverse effects*; D009140:Musculoskeletal Diseases / Q000209:etiology* / Q000517:prevention & control*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D014942:Workers' Compensation / Q000706:statistics & numerical data; D055815:Young Adult