A direct observation instrument for assessment of nurses' patient transfer technique (DINO).

The aim of this project was to develop a direct observation instrument to assess the work technique of nursing personnel during patient transfers and to test the validity and reliability of the instrument. An expert group developed this instrument, called DINO (DIrect Nurse Observation instrument for assessment of work technique during patient transfers), which contains 16 items divided into three phases of a transfer: the preparation, performance and result phases. To quantify the assessments a scoring system was constructed, giving an overall score for each transfer, depending on the level of musculoskeletal health and safety. Four observers assessed 45 patient transfers at hospital wards and showed in an evaluation that the inter-observer reliability and criterion-related validity of DINO was satisfactory. The assessments with the DINO instrument are done directly when the transfer occurs, without costly equipment. Therefore, it has a wide range of applications. For example, when evaluating training in work technique or when identifying an unsafe work technique as a risk factor for musculoskeletal problems in epidemiological studies.