ICU护士工作相关肌肉骨骼疾患患病现状与工效学负荷评估  

Assessment of ergonomic load on the prevalence of work-related musculoskeletal disorders in ICU nurses

作　　者：郑双峰[1] 袁媛[1] 罗丽坤 汤婷[1] 李映兰[2] 蒋昕 颜萍 ZHENG Shuangfeng;YUAN Yuan;LUO Likun;TANG Ting;LI Yinglan;JIANG Xin;YAN Ping(不详;The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054 [2]中南大学湘雅护理学院,湖南长沙410013 [3]新疆医科大学护理学院,新疆乌鲁木齐830017

出　　处：《中国职业医学》2023年第2期155-158,164,共5页China Occupational Medicine

基　　金：中国卫生人才培养项目护理研究子项目(2019-HLYJ-017);新疆医科大学博士(后)科研启动项目(2019-20)。

摘　　要：目的了解重症加强护理病房(ICU)护士工作相关肌肉骨骼疾患(WMSDs)的患病情况,评估其相关工效学负荷和总接触水平。方法采用方便抽样方法,选择某市2所三级甲等综合医院272名ICU护士为研究对象,采用《中国肌肉骨骼疾患问卷》调查其WMSDs患病情况;采用《快速接触检查表》(QEC)评估其在不同临床护理操作时背部、肩/臂部、手/腕部及颈部工效学负荷。结果ICU护士WMSDs年患病率为75.7%;不同部位WMSDs年患病率从高到低依次为腰部、颈部、肩/臂部、背部、膝部、臀/腿部、手/腕部、踝/足部和肘部(54.8%vs 43.4%vs 40.8%vs 36.0%vs 21.3%vs 19.9%vs18.8%vs 18.4%vs 8.1%,P<0.01)。在6项临床护理操作中,ICU护士在协助患者翻身操作时的背部(动态)、肩/臂部、手/腕部和颈部的QEC评分最高(P值均<0.05)。协助患者翻身、搬运患者、替患者擦浴、替卧床患者更换床单时,其背部(动态)、肩/臂部均处于高负荷水平,而其手/腕部和颈部均处于中等负荷水平;ICU护士在护理气管切开患者和行气管插管患者口腔护理时,其身体背部(静态)、肩/臂部、手/腕部和颈部均处于中等负荷水平。协助患者翻身、搬运患者、气管插管患者口腔护理、替卧床患者更换床单、替患者擦浴和护理气管切开患者的总接触水平依次为77.8%、66.5%、63.6%、60.2%、58.5%和57.4%;其中,协助患者翻身的风险等级为4级风险,其他临床护理操作项目的风险等级均为3级风险。结论ICU护士WMSDs患病率较高;其在进行临床护理操作时背部、肩/臂部、手/腕部及颈部的工效学负荷水平和总接触水平均较高。Objective To investigate the prevalence of work-related musculoskeletal disorders(WMSDs)among intensive care unit(ICU)nurses,assess its relationship with ergonomic load and overall exposure levels.Methods A total of 272 ICU nurses from two tertiary hospitals in a city were selected as the research subjects using convenient sampling method.The Chinese Musculoskeletal Disorder Questionnaire was used to investigate the prevalence of WMSDs among the ICU nurses.The Quick Exposure Check(QEC)was used to assess the ergonomic load on the back,shoulder/arm,hand/wrist,and neck during different clinical nursing operations.Results The annual prevalence of WMSDs was 75.7%among ICU nurses.The annual prevalence of WMSDs in different body parts,from high to low,was as follows:lower back,neck,shoulder/arm,back,knee,hip/leg,hand/wrist,ankle/foot,and elbow(54.8%vs 43.4%vs 40.8%vs 36.0%vs 21.3%vs 19.9%vs18.8%vs 18.4%vs 8.1%,P<0.01).ICU nurses had the highest QEC scores on the back(dynamic),shoulder/arm,hand/wrist,and neck with assisting patient turning(all P<0.05)among the six clinical nursing items.During the operation of patient turning,patient lifting,patient bathing,and bed sheet changing for bedridden patients,the back(dynamic)and shoulder/arm were at a high load level,while the hand/wrist and neck were at a mild load level.When nurses were providing tracheostomy care and oral care for intubated patients,their back(static),shoulder/arm,hand/wrist,and neck were at a mild load level.The overall exposure rate for assisting patient turning,patient lifting,oral care for intubated patients,bed sheet changing for bedridden patients,patient bathing,and tracheostomy care were 77.8%,66.5%,63.6%,60.2%,58.5%,and 57.4%,respectively.The risk for assisting patient turning was classified as level four,while the risk for other clinical nursing items was level three.Conclusion The prevalence of WMSDs in ICU nurses is high.Both ergonomic load level and total exposure rate of back,shoulder/arm,hand/wrist and neck were high during clinical nursing o

关 键 词：工作相关肌肉骨骼疾患 ICU 患病率 工效学 负荷 评估 护士 

分 类 号：R135.99[医药卫生—劳动卫生]