Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: A systematic review

Background: Musculoskeletal injuries and musculoskeletal pain are prevalent among nurses compared to many other occupational groups. Objective: To identify interventions that may be effective at reducing the prevalence and impact of musculoskeletal injuries and pain in registered nurses. Design: Systematic review. Data sources: Seven databases were systematically searched, including MEDLINE, CINAHL, EMBASE, PsycInfo, Academic Search Complete, Health Source Nursing, and the Cochrane Database of Systematic Reviews. Review methods: Peer-reviewed journal articles reporting interventions designed to reduce the occurrence of musculoskeletal injuries and pain among registered nurses, published between January 2004 and June 2016, were eligible for inclusion. Randomised and non-randomised controlled trials, as well as studies implementing before-after designs were included. Studies investigating interventions in samples predominately comprised of nursing aides or non-nursing personnel were excluded. Relevant articles were collected and critically analysed using the Effective Public Health Practice Project methodology. Two reviewers independently extracted data and performed quality appraisals for each study. A narrative synthesis of study findings was performed. Results: Twenty studies met criteria for inclusion in the review. Types of interventions reported included: patient lift systems (N = 8), patient handling training (N = 3), multi-component interventions (N = 7), cognitive behavioural therapy (N = 1), and unstable shoes (N = 1). Only two studies received a 'strong' quality rating according to quality assessment criteria. One of these found no evidence for the effectiveness of patient handling training; the other found preliminary support for unstable shoes reducing self-reported pain and disability among nurses. Overall, evidence for each intervention type was limited. Conclusions: There is an absence of high quality published studies investigating interventions to protect nurses from musculoskeletal injuries and pain. Further research (including randomised controlled trials) is needed to identify interventions that may reduce the high rates of injury and pain among nurses.