Assessment of Musculoskeletal Disorder Risk with Hand and Syringe Use in Chemotherapy Nurses and Pharmacy Assistants

Abstract

The purpose of this thesis was to examine hand actions required of nurses and pharmacy assistants involved with chemotherapy drug administration over a work shift, and propose associated risk control strategies. There is a need to evaluate and redesign manual “pushing” and mixing of chemotherapy drugs to prevent musculoskeletal disorders and associated healthcare costs. Muscle activity of the forearm flexor and extensor muscles, and thumb forces, were measured from 5 lab nurses, 5 floor nurses and 5 pharmacy assistants who had their actions recorded throughout their shift. Lab nurses performed an average of 1.85 ± 0.48 hand efforts per min, floor nurses performed 1.62 ± 0.09 per min, while pharmacy assistants performed 5.29 ± 1.27 per min. Syringe use accounted for 17% of the pharmacy assistants’ shift and 12% each for the floor and lab nurses. The tasks of drawing fluid and manually pushing treatment represented 10% of the work day. The left forearm flexors generated the highest activity over the workday and across tasks while only resting for 6% of the workday. The high number of hand efforts, combined with prolonged durations, and lack of muscular rest show evidence of muscular overload over the course of the shift as well as illustrate that the pharmacy assistants are at higher risk for WMSD. The results may also help explain the documented injury statistics and complaints associated with the arm, hand and thumb and support the implementation of a chemotherapy robot to reduce the risk associated with tasks performed by the pharmacy assistants. Further, the findings of this thesis can act as a guide for future evaluation and research of workplaces with similar syringe and hand demands. The risk reducing strategies presented may also be applied to other jobs where hand and syringe use is repetitive and prolonged.