Use of Patient Abdominal Compression Device Reduces Staff Musculoskeletal Pain Associated With Supporting Colonoscopy: Results From a Randomized Controlled Trial

Seth Crockett, Evan S Dellon, Larissa Biggers, Donna A Ernst, Seth Crockett, Evan S Dellon, Larissa Biggers, Donna A Ernst

Abstract

Work-related musculoskeletal disorders occur frequently among the endoscopy staff, and patient-handling duties involved with colonoscopy-applying manual pressure and repositioning patients-are particularly physically demanding. This study explored whether the use of a lower abdominal compression device (ColoWrap), previously shown to reduce the need for manual pressure and patient repositioning, would diminish the frequency of staff-reported musculoskeletal pain. A randomized, blinded, sham-controlled clinical trial was performed at the University of North Carolina Hospitals. Three hundred fifty patients had either ColoWrap or a sham device applied before colonoscopy. The primary outcome was the frequency of staff-reported musculoskeletal pain after assisting with colonoscopy. In the intention-to-treat analysis, which included procedures in which ColoWrap was removed, there was no statistical difference in the frequency of staff-reported pain in the control versus ColoWrap arm (4.6% vs. 3.4% of procedures, p = .59). However, when ColoWrap was used as directed (e.g., remained in place for the duration of the procedure), the frequency of staff-reported musculoskeletal pain was significantly reduced (4.6% vs. 0.7% of procedures, p = 0.04). Use of ColoWrap as directed was also found to be independently associated with reduced odds of staff-reported pain relative to the sham arm (OR = 0.12; 95% CI [0.02, 0.95]). When used as directed, ColoWrap reduced the frequency of musculoskeletal pain experienced related to assisting with colonoscopy and may reduce the risk of musculoskeletal disorders and injuries among the endoscopy staff.

Trial registration: ClinicalTrials.gov NCT02025504.

Conflict of interest statement

Conflicts of interest: Biggers—Employee of ColoWrap; Crockett—Research funding from ColoWrap (this study only), Boston Scientific, and Exact Sciences; and Dellon—Research funding from Meritage Pharma, and Miraca Life Sciences. Dr Ernst reports no conflicts of interest.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Gastroenterology Nurses and Associates.

Figures

BOX 1.
BOX 1.
A Perspective From the Field: Manual Abdominal Pressure During Colonoscopy
FIGURE 1.
FIGURE 1.
ColoWrap device (ColoWrap, LLC).
FIGURE 2.
FIGURE 2.
ColoWrap device in situ.
FIGURE 3.
FIGURE 3.
Number of musculoskeletal pain reports by anatomical site.

References

    1. Biggers L. (2018). Endoscopy staff injury: A serious problem hidden in plain sight. International Journal of Safe Patient Handling & Mobility, 8(4), 167–168.
    1. Boutron I., Moher D., Altman D. G., Schulz K. F., Ravaud P., Group C. (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration. Annals of Internal Medicine, 148(4), 295–309. doi:10.7326/0003-4819-148-4-200802190-00008
    1. Centers for Disease Control and Prevention. (2013). Safe patient handling and mobility (SPHM). Atlanta, GA: National Institute for Occupational Safety and Health.
    1. Charney W., Schirmer J. (2007). Nursing injury rates and negative patient outcomes—Connecting the dots. AAOHN Journal, 55(11), 470–475.
    1. Crockett S. D., Cirri H. O., Kelapure R., Galanko J. A., Martin C. F., Dellon E. S. (2016). Use of an abdominal compression device in colonoscopy: A randomized, sham-controlled trial. Clinical Gastroenterology and Hepatology, 14(6), 850–857.e3. doi:10.1016/j.cgh.2015.12.039
    1. Dressner M. A. (2017, June). Hospital workers: An assessment of occupational injuries and illnesses. Monthly labor review. Washington, DC: U.S. Bureau of Labor and Statistics.
    1. Drysdale S. (2011). The incidence of upper extremity injuries in Canadian endoscopy nurses. Gastroenterology Nursing, 34(1), 26–33. doi:10.1097/SGA.0b013e31820b5ce5
    1. Drysdale S. A. (2007). The incidence of upper extremity injuries in endoscopy nurses. Gastroenterology Nursing, 30(3), 187–192. doi:10.1097/01.SGA.0000278167.90187.c7
    1. Drysdale S. A. (2013). The incidence of upper extremity injuries in endoscopy nurses working in the United States. Gastroenterology Nursing, 36(5), 329–338. doi:10.1097/SGA.0b013e3182a6e05d
    1. Drysdale S. A. (2014). The incidence of neck and back injuries in endoscopy nurses working in the United States of America. Gastroenterology Nursing, 37(2), 187–188. doi:10.1097/SGA.0000000000000039
    1. Hamade N. M., Nutalapati V. M., Chalhoub J. M., Chandrasekar V. T. M., Dasari C. M., Kennedy K. M., Sharma P. M. (2019). Use of abdominal compression device in colonoscopy significantly decreases cecal intubation time as compared to conventional colonoscopy: A systematic review and meta-analysis. American Journal of Gastroenterology, 114(2019 ACG Annual Meeting Abstracts), S314–S315.
    1. Koppelaar E., Knibbe J. J., Miedema H. S., Burdorf A. (2009). Determinants of implementation of primary preventive interventions on patient handling in healthcare: A systematic review. Occupational and Environmental Medicine, 66(6), 353–360. doi:10.1136/oem.2008.042481
    1. Nahrgang J. D., Morgeson F. P., Hofmann D. A. (2011). Safety at work: A meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. Journal of Applied Psychology, 96(1), 71–94. doi:10.1037/a0021484
    1. Occupational Safety and Health Administration (OSHA). (2011). Safe patient handling programs: Effectiveness and cost savings. Washington, DC: Author.
    1. Occupational Safety and Health Administration (OSHA). (2013). Worker safety in your hospital. Retrieved from
    1. Schulz K. F., Altman D. G., Moher D., Group C. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine, 152(11), 726–732. doi:10.7326/0003-4819-152-11-201006010-00232
    1. Sorour A., El-Maksoud M. (2012, July–September). Relationship between musculoskeletal disorders, job demands, and burnout among emergency nurses. Advanced Emergency Nursing Journal, 34, 272–282.
    1. Spence Laschinger H. K., Leiter M. P. (2006). The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/engagement. Journal of Nursing Administration, 36(5), 259–267.
    1. Tveito T. H., Sembajwe G., Boden L. I., Dennerlein J. T., Wagner G. R., Kenwood C., Sorensen G. (2014). Impact of organizational policies and practices on workplace injuries in a hospital setting. Journal of Occupational and Environmental Medicine, 56(8), 802–808. doi:10.1097/JOM.0000000000000189
    1. Vahey D. C., Aiken L. H., Sloane D. M., Clarke S. P., Vargas D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42 (2, Suppl.), II57–II66. doi:10.1097/01.mlr.0000109126.50398.5a
    1. Xhaja X., Church J. (2014). The use of ancillary techniques to aid colonoscope insertion. Surgical Endoscopy, 28(6), 1936–1939. doi:10.1007/s00464-014-3418-9

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다