Associations of self estimated workloads with musculoskeletal symptoms among hospital nurses.
(73/1913)
OBJECTIVES: To investigate the prevalence of neck, shoulder, and arm pain (NSAP) as well as low back pain (LBP) among hospital nurses, and to examine the association of work tasks and self estimated risk factors with NSAP and LBP. METHODS: A cross sectional study was carried out in a national university hospital in Japan. Full time registered nurses in the wards (n = 314) were selected for analysis. The questionnaire was composed of items on demographic conditions, severity of workloads in actual tasks, self estimated risk factors for fatigue, and musculoskeletal pain in the previous month. Rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated by the Cox's proportional hazards model to study the association of pain with variables related to work and demographic conditions. RESULTS: The prevalences of low back, shoulder, neck, and arm pain in the previous month were 54.7%, 42.8%, 31.3%, and 18.6%, respectively. The prevalence of musculoskeletal symptoms among hospital nurses was higher than in previous studies. In the Cox's models for LBP and NSAP, there were no significant associations between musculoskeletal pain and the items related to work and demographic conditions. The RRs for LBP tended to be relatively higher for "accepting emergency patients" and some actual tasks. Some items of self estimated risk factors for fatigue tended to have relatively higher RRs for LBP and NSAP. CONCLUSIONS: It was suggested that musculoskeletal pain among hospital nurses may have associations with some actual tasks and items related to work postures, work control, and work organisation. Further studies, however, are necessary, as clear evidence of this potential association was not shown in the study. (+info)
Physical work load between 1970 and 1993--did it change?
(74/1913)
OBJECTIVES: This study investigates changes in self-reported and expert-evaluated physical work loads between 1970 and 1993 in relation to calendar year, birth cohort, and gender in an urban and suburban population sample (232 men and 252 women) born between 1935 and 1952. METHODS: A self-administered questionnaire was answered in 1993 concerning different aspects of physical work loads between 1970 and 1993. With the use of a classification matrix, the objective physical work load on different body regions was also assessed. RESULTS: Between 1970 and 1993 the fraction of subjects in blue-collar occupations and the physical work loads decreased among the men, but they both increased among the women. Physical work loads were, in general, higher among the men than among the women at younger ages (below 30 years), but less so at higher ages. Expert evaluations of the musculoskeletal load showed a pattern similar to that of self-reported work loads. CONCLUSIONS: The gender difference in work load development with age may have implications for the development of musculoskeletal disorders. (+info)
The ethnic minority linkworker: a key member of the primary health care team?
(75/1913)
We present an evaluation of the role of a link-worker trained in health promotion and aspects of chronic disease management. A shift in workload occurred from the practice nurse to link-worker, and there were improvements in asthma and diabetes care. A link-worker can be successfully trained to do traditional nursing tasks, which permits a change of role for the practice nurse and can have a beneficial effect on the processes of chronic disease management. (+info)
A detailed analysis of theatre training activity in a UK teaching hospital.
(76/1913)
We examined the placement of anaesthetists in our department over a 2 yr period. Data were collected from an in-theatre system to provide details of caseload and supervision for 34,856 operations. There was wide variation between anaesthetic sub-specialties with overall supervision levels of 35% of cases for senior house officers (SHOs) and 32% for specialist registrars (SpRs). The consultant data showed the size and areas of teaching reserve in the department. We then examined individual logbooks in order to validate our data, and departmental rotas to put these data into perspective with previous attempts to quantify trainee supervision. Supervision data derived from the rota allocations showed that 86% of SHO lists and 62% of SpR lists were scheduled to be supervised. This study has described our training activity and facilitated departmental changes, as well as highlighting the need for great care in interpreting trainee supervision data acquired from different sources, particularly when comparisons are being made. (+info)
Sick but yet at work. An empirical study of sickness presenteeism.
(77/1913)
STUDY OBJECTIVE: The study is an empirical investigation of sickness presenteeism in relation to occupation, irreplaceability, ill health, sickness absenteeism, personal income, and slimmed down organisation. DESIGN: Cross sectional design. SETTING: Swedish workforce. PARTICIPANTS: The study group comprised a stratified subsample of 3801 employed persons working at the time of the survey, interviewed by telephone in conjunction with Statistics Sweden's labour market surveys of August and September 1997. The response rate was 87 per cent. MAIN RESULTS: A third of the persons in the total material reported that they had gone to work two or more times during the preceding year despite the feeling that, in the light of their perceived state of health, they should have taken sick leave. The highest presenteeism is largely to be found in the care and welfare and education sectors (nursing and midwifery professionals, registered nurses, nursing home aides, compulsory school teachers and preschool/primary educationalists. All these groups work in sectors that have faced personnel cutbacks during the 1990s). The risk ratio (odds ratio (OR)) for sickness presenteeism in the group that has to re-do work remaining after a period of absence through sickness is 2.29 (95% CI 1.79, 2.93). High proportions of persons with upper back/neck pain and fatigue/slightly depressed are among those with high presenteeism (p< 0.001). Occupational groups with high sickness presenteeism show high sickness absenteeism (rho = 0. 38; p<.01) and the hypothesis on level of pay and sickness presenteeism is also supported (rho = -0.22; p<0.01). CONCLUSIONS: Members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by study results. The categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most common combination is low monthly income, high sickness absenteeism and high sickness presenteeism. (+info)
New aspects of image distribution and workflow in radiology.
(78/1913)
The progressive use of digital image-generating devices and digital communication technology in clinical and practice environments implies changes in radiological workflow and asks for adequate quality assurance in the whole process of radiology report preparation. This improvement potential has to be rigorously reinvestigated with regard to up-to-date procedures and the full exploitation of supporting technologies like linguistic analysis, help desk and trouble ticket systems, competitive allocation algorithms, time-and-event monitoring, and intelligent agents. These approaches are to be evaluated in combination with business process analysis and shall help to reduce turnaround times for radiology reports while maintaining or even increasing quality-assurance levels. (+info)
Radiology workflow and patient volume: effect of picture archiving and communication systems on technologists and radiologists.
(79/1913)
This study was performed to evaluate the changes in workflow and efficiency in various clinical settings in the radiology department after the introduction of a picture archiving and communication system (PACS). Time and motion data were collected when conventional image management was used, and again after the introduction of a PACS. Changes in the elapsed time from examination request until the image dispatch to the radiologist, and from dispatch until report dictation, were evaluated. The relationship between patient volume and throughput was evaluated. The time from examination request until dispatch was significantly longer after the introduction of PACS for examinations taken on patients from the emergency department (ED) (pre-PACS, 20 minutes; post-PACS, 25 minutes; P < .0001), and for examinations taken on patients in the medical intensive care unit (MICU) (pre-PACS, 34 minutes; post-PACS, 42 minutes; P < .0001). The interval from image dispatch until report dictation shortened significantly after the introduction of PACS in the ED (pre-PACS, 38 minutes; post-PACS, 23 minutes; P < .0001) and in the outpatient department (OPD) (pre-PACS, 38 minutes; post-PACS, 20 minutes; P < .0001). Simple least squares regression showed a significant relationship between daily patient volume and the daily median time until report dictation (F = 43.42, P < .001). PACS slowed technologists by prolonging the quality-control procedure. Radiologist workflow was shortened or not affected. Efficiency is dependent on patient volume, and workflow improvements are due to a shift from batch to on-line reading that is enabled by the ability of PACS to route enough examinations to keep radiologists fully occupied. (+info)
A comparison of certain practice characteristics of dental anesthesiologists in Canada and the United States.
(80/1913)
An existing database was used to compare aspects of dental anesthesiology practice of dental anesthesiologists in Canada (n = 32) and the United States (n = 123). Data focusing on percutaneous injuries were obtained through a mailed questionnaire that was returned anonymously. Respondents provided information on the treatment of patients under deep sedation or general anesthesia only. Eighty-one percent of Canadians and 61% of Americans returned the questionnaire. The vast majority (84%) of injuries reported were due to sharps associated with general dentistry compared with those associated with anesthesiology. Canadians were more likely to be operator-anesthetists (P < .01) and to experience a percutaneous injury (P < .01) than US practitioners. American practitioners were more likely to have a greater proportion of the caseload under the age of 20 (P < .02). No other significant differences were observed. These results illustrate a number of unique attributes of the practice of dental anesthesiology in these 2 countries. (+info)