Manual Handling in Aged Care: Impact of Environment-related Interventions on Mobility

The manual handling of people (MHP) is known to be associated with high incidence of musculoskeletal disorders for aged care staff. Environment-related MHP interventions, such as appropriate seated heights to aid sit-to-stand transfers, can reduce staff injury while improving the patient\u27s mobility. Promoting patient mobility within the manual handling interaction is an endorsed MHP risk control intervention strategy. This article provides a narrative review of the types of MHP environmental controls that can improve mobility, as well as the extent to which these environmental controls are considered in MHP risk management and assessment tools. Although a range of possible environmental interventions exist, current tools only consider these in a limited manner. Development of an assessment tool that more comprehensively covers environmental strategies in MHP risk management could help reduce staff injury and improve resident mobility through auditing existing practices and guiding the design of new and refurbished aged care facilities

Optimizing aged care environments to promote resident functional mobility and reduce staff injury risk

Introduction: This study aimed to evaluate the suitability and usability of the Pro-Mobility patient/person handling assessment tool (ProMob) within residential aged care. Physiological changes associated with ageing influence an older person’s ability to perform functional mobility tasks such as transferring from furniture and walking. Strategies that improve capability and/or reduce the physical demands of the task have the potential to promote an older person’s mobility, independence and wellbeing. Environment-related strategies in Manual Handling of People (MHP), such as optimum seated heights, in part address this challenge, as they can promote resident functional mobility while also protecting staff from injury. The ProMob tool was developed to address this issue through systematic evaluation of these environmental factors.Methods: The participants in this study were seven (7) residential aged care facilities (RACFs) operated by a not-for-profit aged care organization. A qualified assessor evaluated MHP risk management with the ProMob tool at each RACF through collection of data for a random sample of residents (n = 67) regarding their living environments and available mobility information. Data was transferred to an SPSS-22 statistical software database for analysis which involved descriptive statistics and cross tabulations.Results: Application of the ProMob tool provided effective quantification of the nature and extent of environment-related MHP interventions that may influence resident mobility. Areas for improvement with MHP risk management were identified, with variation evident across RACF’s within the same organisation, which was not consistent with levels of care (e.g., lack of clear space to facilitate mobility). Low level care facilities were observed to have fewer adaptive environmental features that could potentially slow decline in independence.Discussion: Features of the aged care environment can be used to facilitate the functional mobility of aged care residents, and simultaneously reduce injury risk for staff in MHP interactions. The ProMob tool can be used for auditing care facilities, planning re-development, and continual improvement in provision of care and management of staff injury risk exposure

A review of medical error taxonomies: a human factors perspective

Although a large number of medical error taxonomies have been published, there is little evidence to suggest that these taxonomies have been systematically compared. This paper describes a study comparing 26 medical error taxonomies using a human factors perspective. The taxonomies were examined to determine if they classified systemic factors of medical errors and if they utilized theoretical error concepts in their classifications. Scope of classification was also examined. It was found that two-thirds of the taxonomies classified systemic factors of medical errors and only a third utilized theoretical error concepts. Medical error taxonomies based on theoretical error concepts were more likely to be generic in applicability and also more likely to classify systemic factors and psychological error mechanisms of medical errors. In addition to terminology, the medical error taxonomies also varied in terms of domain-specificity, granularity, and developmental process. Different medical error taxonomies provide different information; how these differences affect medical error management needs to be investigated

Older Worker-Orientated Human Resource Practices, Wellbeing and Leave Intentions: A Conservation of Resources Approach for Ageing Workforces

At a time where there are ageing populations, global shortages of skilled labour, and migration pathways impacted by the COVID-19 pandemic, retaining older workers presents as a vital strategic initiative for organizations globally. This study examines the role of Human Resource Practices (HRPs), which are oriented towards accommodating the needs of an ageing workforce in mitigating psychological distress and turnover intentions. The study collected self-reported survey data from 300 Australian employees over the age of 45, over two time points. Using structural equation modelling, the study analyzed the extent to which Older Worker-oriented Human Resources Practices (OW-HRPs) translate into employee psychological health and retention within organizations, through the mediation of ageism and work–life conflict. The results support our hypothesis that OW-HRPs are associated with lower ageism, better work–life balance; and in combination these reduce psychological distress and help retain older workers in the workforce. We conclude that OW-HRPs can foster work environments conducive to older worker wellbeing, supporting the retention of talent and maintaining effectiveness, in the face of substantial labour supply challenges brought on by the COVID-19 pandemic and an ageing population

A systematic review of literature on occupational health and safety interventions for older workers

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents ‘A future research agenda for older worker health, safety and well-being interventions.’ This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design

Using the Functional Resonance Analysis Method (FRAM) in Aviation Safety: A Systematic Review

The functional resonance analysis method (FRAM) is a system-based method to understand highly complex sociotechnical systems. Besides learning from safety occurrences or undesirable states, FRAM can be used to understand how things go well in a system, by identifying gaps between “work as imagined” (WAI) and “work as done” (WAD). FRAM is increasingly used in many domains and can enhance our understanding of a complex system and proposes strategies to refine the work design. This systematic review identified 108 FRAM research papers from 2006–2019. Most of these papers were conducted by European researchers and employed qualitative methods such as document analysis, interviews, and focus groups with subject matter experts (SMEs) and observations to develop WAI and WAD. Despite being used in healthcare, construction, and maritime sectors among others, aviation was the most commonly explored domain in FRAM studies. The 26 FRAM studies in aviation explored many aspects of the aviation industry, including Air Traffic Control (ATC) systems, cockpit operation, ground handling, maintenance, and a range of past safety incidents, like runway incursions. This paper also characterises the FRAM studies focused on aviation in terms of the common methods and steps used to build FRAM and the available software tools to build FRAM nets. Current FRAM illustrates its advantages in capturing the dynamic and nonlinear nature of complex systems and facilitates our understanding and continual improvement of complex systems. However, there are some critical issues in FRAM use and interpretation, such as the consistency of methods and complexity and reliability of data collection methods, which should be considered by researchers and FRAM users in industry

How error classification systems can impact on incident reporting and analysis

Backgrounds: Incident reporting systems often play a critical role in how high-risk organizations such as aviation, healthcare, and nuclear power generation understand and therefore manage incidents. Integral to the effectiveness of incident reporting systems are reliable and useful error classification systems. Results: In this paper, we dis-cuss how error classification systems can influence the information that is extracted from medical error reports, particularly information pertaining systemic factors of patient safety incidents. We also explain the importance of terminology in designing a reliable and easy to use error classification system

The influence of personality on responses to stressors: an examination of the Grossarth-Maticek personality inventory

Grossarth-Maticek and colleagues presented longitudinal evidence for personality Typebeing related to disease. Type 1s (cancer prone) and Type 2s (CHD prone) were proposedto be dependent on others, in contrast to the autonomous Type 4s, who had a lowermortality rate at follow-up. Stress was the mechanism proposed to account for the effectsof personality on disease, yet this claim has not been systematically investigated. Fourstudies compared responses of Type 1, 2 and 4 individuals to stress and non-stress tasks.Types 1 and 2 showed increased salivary cortisol responses to an uncontrollable mathsstress task (relative to control) compared to Type 4s, and scored higher on perceivedstress, state-anxiety, and measures of negative mood, consistent with the implications ofthe Grossarth-Maticek hypothesis. No significant differences were evident between theTypes in response to progressive muscle relaxation, suggesting stress is necessary forType differences to emerge. Further, Types 1 and 2 responded differently to differentstressors (maths vs. exam), arguing against criticisms that Types 1 and 2 areindistinguishable.The relation between Grossarth-Maticek Type subscales was further clarified throughtheir correlations with each other (controlling for mood, stress and social desirability),and with the Lifestyle Defense Mechanisms (LDM) inventory, a psychometric refinementof the Grossarth-Maticek scales. A prospective study examining mortality rates in asample exposed to environmental noise stressors revealed no prediction of death or causeof death by Grossarth-Maticek Type. This may have been due to the relative youth of thesample, short (7 year) follow-up period, and consequently low death rate.The current research is the first to show different responses to different stressors betweenTypes 1 and 2, and revealed converging evidence for the claim that stress is themechanism for Type effects on disease. Additionally, theoretical issues in conceptions ofstress, and models of the relation between the Types, stress and disease were considered.This project suggests that after a history of criticisms, the Grossarth-Maticek typologyshould be re-considered for its public health implications, and along with the LDMinventory, should be considered for further investigation of the relation betweenpersonality variables and disease