Paradoxical Impact of a Patient-Handling Intervention on Injury Rate Disparity Among Hospital Workers

Source avec lien : American Journal of Public Health, 109(4), Jul-05. 10.2105/AJPH.2018.304929

Les chercheurs ont testé l’efficacité d’une intervention complète de manipulation sécuritaire des patients pour les travailleurs de la santé à salaire élevé (infirmières) par rapport aux travailleurs de la santé à faible salaire (préposés aux soins des patients). Les résultats démontrent que même si l’intervention a changé la perception des deux groupes de travailleurs de la santé à l’égard de la manipulation sécuritaire des patients, on n’a observé de réduction des blessures que chez les travailleurs mieux rémunérés.

OBJECTIVES: To test whether a comprehensive safe patient-handling intervention, which successfully reduced overall injury rates among hospital workers in a prior study, was differentially effective for higher-wage workers (nurses) versus low-wage workers (patient care associates [PCAs]). METHODS: Data were from a cohort of nurses and PCAs at 2 large hospitals in Boston, Massachusetts. One hospital received the intervention in 2013; the other did not. Using longitudinal survey data from 2012 and 2014 plus longitudinal administrative injury and payroll data, we tested for socioeconomic differences in changes in self-reported safe patient-handling practices, and for socioeconomic differences in changes in injury rates using administrative data. RESULTS: After the intervention, improvements in self-reported patient-handling practices were equivalent for PCAs and for nurses. However, in administrative data, lifting and exertion injuries decreased among nurses (rate ratio [RR] = 0.64; 95% confidence interval [CI] = 0.41, 1.00) but not PCAs (RR = 1.10; 95% CI = 0.74,1.63; P for occupation × intervention interaction = 0.02). CONCLUSIONS: Although the population-level injury rate decreased after the intervention, most improvements were among higher-wage workers, widening the socioeconomic gap in injury and exemplifying the inequality paradox. Results have implications for public health intervention development, implementation, and analysis.

Consultez la page de l’article

Leave a Comment