Presentation on theme: "Elimination of Sonographer Musculoskeletal Injury in a Hospital Based Cardio-Vascular Ultrasound Lab Following Implementation of Ergonomic Guidelines Edward."— Presentation transcript:
Elimination of Sonographer Musculoskeletal Injury in a Hospital Based Cardio-Vascular Ultrasound Lab Following Implementation of Ergonomic Guidelines Edward Euler, RDCS Valerie Meadows, RDCS Memorial Medical Center, Springfield, IL
Disclaimers/Conflicts: Euler – None to report Meadows – None to report (though both authors have purchased and used the products and processes discussed)
Background: SDMS Society of Diagnostic Medical Sonography. Sonography Benchmark Survey. 2000. “More than 80% of sonographers are scanning in pain and 20% of these professionals eventually experience a career-ending injury.” JCAHO Preventing Occupational Injury among Diagnostic Medical Sonographers. JCAHO, Environment of Care News, March 2006, 9:3 OSHA Preventing Work Related Musculoskeletal Diseases in Sonographers, CDC/National Institute for Occupational Safety and Health, Pub No. 2006-148, Sept 2006 IAC-Echo/IAC-Vascular 2010 ICAEL Standards for Accreditation in Adult Echocardiography Testing, 2.1.1 ICAVL Standards for Accreditation in Non-Invasive vascular testing, 3.1.1 Local Experience: > $24,000 Employee Health Expenses FY2004 0.5 FTE Productivity Loss FY2004
Sources for Guidelines Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography: Consensus Conference on Work-Related Musculoskeletal Disorders in Sonography Journal of Diagnostic Medical Sonography, September/October 2003; 19: 281-282. Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography Journal of Diagnostic Medical Sonography, September/October 2003; 19: 283-286. Marylou Muir, Paul Hrynkow, Robert Chase, Dianne Boyce, and Daria Mclean The Nature, Cause, and Extent of Occupational Musculoskeletal Injuries among Sonographers: Recommendations for Treatment and Prevention Journal of Diagnostic Medical Sonography, September/October 2004; 20: 317-325.
Ergonomic Guidelines : Policies and Procedures for Prevention of Work Related Musculoskeletal Disorders in Sonographers: Provide adequate work space Position monitor / keyboard Proper use of adjustable exam chairs / tables Vary postures throughout day / sit or stand Alternate the scanning hand / vary the grip used Minimize awkward / extreme postures Increase tissue tolerances through exercise and adequate rest Schedule different types of exams in a work day Limit the number of portable exams Consider a maximum number or exams per day Annual training and reassessment
Actions/Interventions: Required: a)Annual Computer Based Learning (CBL) Module on Ergonomics and Injury Prevention b)Sonographer Reporting of on the job injury or persistent pain with scanning to Employee Health Services c)Adherence to ICAEL/ICAVL Standards and Guidelines Lab Culture Shift: a)Topic Included in Dept Meetings b)Literature Reviews during QI/Case Reviews c)Occupational Therapy assessments d)Guest Speakers (National and Local) Recommended:
Objective of Study: 10 Year Review of: Incidence of injury Cost of treatments Productive Time lost due to Sonographer MSK injury Impact of interventions
Methods: Review of Employee Health records: Type of Injury Cost of Treatment Hours of limited work or unavailable for work Review of Payroll records: Total of Productive Hours worked Echo and Vascular Cost centers (including callback and overtime) Department Records (Cardiology PACS, Siemens/Syngo): Annual Procedure Volumes Exclusions: Non – MSK injuries (cuts, falls) Temporary/Agency Employees Incidence, Cost, Lost hours, Hours worked and Procedure Volumes were compared to Timeline of Actions/Interventions.
Characteristics of Results: 60% of injuries reported from female sonographers 60% of injuries reported from sonographers > 20 years in the field 100% of injuries reported from single hand scanners (scan with only left or only right hands) Decrease in incidence despite conversion to inpatient scanning at bedside (Echo = 100%, Vasc = 50%.)
Study Limitations: Individual Sonographers not evaluated a)Compliance to Ergonomic recommendations not measured b)Limited Long term follow-up Cardiac and Vascular Ultrasound only Reviews only Reported Injuries Statistical Significance of Variability not evaluated.
Conclusions: Shared Accountability (Sonographer Compliance to Guidelines and Organizational Support with Tools) with Required Annual Re-Education contributes to Laboratory Culture of Awareness and Prevention. Implementation of Ergonomic Guidelines eliminates Sonographer MSK Injury decreasing organizational cost and lost productive hours.