Publication: PREVALENCE, ASSOCIATED FACTORS AND RISK MANAGEMENT PRACTICES OF WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG REGISTERED NURSES IN HOSPITALS IN SARAWAK.
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
International Medical University
Abstract
Background:
Studies have shown that work-related musculoskeletal disorders (WRMSD) among
nurses result in absenteeism, lost productivity, higher medical bills, higher workers'
compensation costs and decreased quality of life. Previous research has reported high
prevalence rates of WRMSDs among nurses in Malaysia, ranging from 58.8% to 97.3%,
depending on the body region and assessment method. However, there is a lack of
comprehensive information on how their workplace manages the risks of WRMSDs
among RNs. Apart from this, there is limited research on WRMSDs among nurses in
Sarawak, a state in East Malaysia.
Objective:
This study aimed to determine the prevalence, associated factors, and risk management
practices of work-related musculoskeletal disorders among registered nurses in hospitals
in Sarawak.
Methodology:
A quantitative cross-sectional was applied to this study. Data was collected using an
online self-reporting survey distributed through purposive and snowball sampling. Data
was collected from 204 registered nurses and was analysed using IMU IBM SPSS
Version 28.0.
Results:
The results showed that 95.1% (n=194) of the registered nurses (RNs) reported
experiencing work-related musculoskeletal disorders (WRMSDs) in at least one body part
throughout the last 12 months. The most common areas affected were the lower back
(90.2%, n=184), neck (89.7%, n=179) and shoulders (87.7%, n=183). Associated factors
identified from the Chi-Square Test were type of institution (p=0.021; OR=8.636; 95%
CI: 1.073-69.481), lifting bed-bound patients(p=0.030; OR=0.228; 95% CI: 0.063-
0.829), pulling heavy equipment(p=0.023; OR=0.023; 95% CI: 0.059-0.809), using
drawsheets(p=0.017; OR=4.967; 95% CI: 1.342-18.377), and perceived staffing
shortages(p=0.017; OR=4.967; 95% CI: 1.342-18.377). The investigator performed
additional analysis to investigate predictors of WRMSDs through Multiple Logistic
Regression. The identified predictor was perceived staffing shortages (p=0.048;
AOR=0.190; CI=0.037 – 0.984). Under Risk Assessment (Qualitative), most RNs
reported being assessed on their competency in patient assessment (65.7%, n=134) and
equipment handling (85.8%, n=175). In this study, the risk control practices focused on
substitution, engineering, and administrative control. Under substitution control, most
RNs reported recruiting healthcare assistants (64.3%, n=148) and engaging media to
recruit RNs (57.6%, n=204) to combat the shortage of RNs. Under engineering control,
the three most common equipment used for patient handling were drawsheets (37.1%,
n=153), remote assisted beds (33.3%, n=137), and slide sheets (20.9%, n=86). Under
administrative control, only some RNs (48.5%, n=99) reported they attended training on
manual handling. Most registered nurses had to care for six or more patients in the
morning (72.1%, n=147), afternoon (72.1%, n=147) and night (100%, n=204) shifts.
Conclusions:
The findings of this study highlight the high prevalence of WRMSDs (95.1%, n=194)
among RNs in Sarawak, suggesting that employers should implement risk management
strategies for WRMSDs in this population. Hospital management should prioritise hiring
more RNs, especially in public hospitals, as part of WRMSD prevention guidelines. This
would decrease the frequency of lifting and pushing/pulling heavy equipment by the RNs.
Additionally, improving access to assistive devices like remote assisted beds, roller
boards, hoists, and slide sheets, refraining from using drawsheets and providing training
should be considered in WRMSD prevention guidelines. Because risk assessment is
required under Malaysia's Occupational Safety and Health (Amendment) Act 2022
beginning in June 2023, it is timely for the hospital to manage risk related to WRMSDs
through the risk management process.
Keywords: Work-Related Musculoskeletal Disorders, Registered Nurses, Prevalence,
Associated Factors, Risk Management Practices, Sarawak.
Description
Keywords
Musculoskeletal Diseases, Prevalence, Nurses, Risk Management