Competency-based training for patient handling.

A technique-training approach has traditionally been used to address the problem of back pain associated with patient handling. This project aimed to investigate whether different levels of safety culture, based on competency-based training, resulted in different behaviour (physical and cognitive) for patient handling tasks. Sixteen healthcare organisations in the UK participated from the acute and primary healthcare sectors. Archival data for each organisation were benchmarked against the Royal College of Nursing competencies for manual handling. Behavioural data were collected on two patient handling tasks: (1) sitting-to-standing and (2) repositioning-in-sitting using observations (postural analysis) and interviews (verbal protocol analysis). The data were analysed for each organisation and then grouped by task and method into larger data sets. These data sets were triangulated using the key decision-making points (from the interview data) as the framework. The results showed that in organisations with a more positive safety culture the nursing staff demonstrated more complex decision-making about the patient handling tasks and had lower levels of associated postural risk.