Perceptions of hospital manual handling policy and impact on nursing team involvement in promoting patients’ mobility

Authors

  • Rosie Kneafsey PhD, RGN, PGCE,

    Senior Lecturer in Nursing, Corresponding author
    1. Coventry University, Coventry, UK
    • Correspondence: Rosie Kneafsey, Senior Lecturer in Adult Nursing, Faculty of Health and Life Science, Nursing and Midwifery, Coventry University, Richard Crossman Building (room 315), Coventry, CV1 5SP, UK. Telephone: +44 02476 795 909.

      E-mail: aa9398@coventry.ac.uk

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  • Collette Clifford RGN, PhD, MSc,

    Professor
    1. School of Health and Population Science, College of Medical and Dental Science, University of Birmingham, Birmingham, UK
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  • Sheila Greenfield PhD, MA, BSc

    Professor
    1. School of Health and Population Science, College of Medical and Dental Science, University of Birmingham, Birmingham, UK
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Abstract

Aims and objectives

To report the findings gained from interviews with hospital nurses and care assistants, regarding the impact of hospital manual handling policies on their role in maintaining and promoting patients’ mobility.

Background

Older hospitalised adults often experience deteriorations in mobility, which are often partially caused by protective or custodial care practice and environments that promote patient dependency. Hospital-induced mobility loss may be conceptualised as a problematic source of iatrogenic patient harm, worthy of attention from a patient safety standpoint. Preventative rehabilitation nursing interventions have the potential to prevent mobility loss.

Design

Grounded theory study.

Methods

Data were collected in three clinical settings: general rehabilitation, spinal injuries and stroke rehabilitation. Semi-structured interviews with 39 rehabilitation staff were completed.

Results

Perceptions of hospital manual handling policy were described via four subcategories: policy as stimulus to improved practice; policy as divorced from reality; policy as threat; and policy as hindrance to rehabilitation.

Conclusions

Hospital manual handling policy was perceived negatively by some nursing team members both as a threat and as a barrier to patients’ rehabilitation. Risk aversion, divided teamwork practices and overuse of patient handling equipment were matters of concern.

Relevance to clinical practice

Perceptions of hospital manual handling policy should be openly discussed by nursing managers and direct care providers. It is important to recognise that beliefs about and perceptions of policy will often impact later on staff practices and behaviours. Unintended consequences arising from dominant interpretations of manual handling policy must be acknowledged and risks identified. It is important that practitioners balance risk assessment and prevention of falls with patients’ needs for mobilisation.

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