Erin Teeple1,2, Jamie E Collins3,4, Swastina Shrestha3, Jack T Dennerlein5,6, Elena Losina3,4,7,8, Jeffrey N Katz3,4,6,7,9. 1. Department of Work Environment, University of Massachusetts, Lowell, MA, USA. 2. Liberty Mutual Research Institute for Safety, MA, USA. 3. Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA. 4. Harvard Medical School, Boston, MA, USA. 5. Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA. 6. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 7. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA. 8. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. 9. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: Variability in patient care settings and the range of patient handling tasks present challenges in developing and evaluating safe patient handling and mobilization (SPHM) programs. OBJECTIVE: We performed a systematic meta-analysis of SPHM program evaluations. METHODS: Systematic literature review identified published SPHM program evaluations. Injury Rate Ratios (IRR), pre- to post-intervention, were used to estimate intervention effects and to examine the influence of patient care level, program components, and follow-up time using meta-regression. RESULTS: 27 articles reported evaluations from 44 sites. Combined effect estimate for all SPHM programs was 0.44 (95% CI 0.36, 0.54), reflecting substantial injury reductions after program implementation. While specific program components were not associated with greater effectiveness, longer follow-up duration was associated with greater injury rate reduction (p = 0.01) and intervention effects varied by level of care (p = 0.01), with the greatest effect in intensive care unit interventions (IRR 0.14; 95% CI 0.07, 0.30). CONCLUSIONS: SPHM programs appear to be highly effective in reducing injuries. More research is needed to identify the most effective interventions for different patient care levels.
BACKGROUND: Variability in patient care settings and the range of patient handling tasks present challenges in developing and evaluating safe patient handling and mobilization (SPHM) programs. OBJECTIVE: We performed a systematic meta-analysis of SPHM program evaluations. METHODS: Systematic literature review identified published SPHM program evaluations. Injury Rate Ratios (IRR), pre- to post-intervention, were used to estimate intervention effects and to examine the influence of patient care level, program components, and follow-up time using meta-regression. RESULTS: 27 articles reported evaluations from 44 sites. Combined effect estimate for all SPHM programs was 0.44 (95% CI 0.36, 0.54), reflecting substantial injury reductions after program implementation. While specific program components were not associated with greater effectiveness, longer follow-up duration was associated with greater injury rate reduction (p = 0.01) and intervention effects varied by level of care (p = 0.01), with the greatest effect in intensive care unit interventions (IRR 0.14; 95% CI 0.07, 0.30). CONCLUSIONS: SPHM programs appear to be highly effective in reducing injuries. More research is needed to identify the most effective interventions for different patient care levels.
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