¹Occupational Medicine Linköpings University hospital, Region Östergötland, Linköping University, Linköping, Sweden
²School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
³Region Örebro, Faculty of Medicine and Health, University Health Care Research Center, Örebro, Sweden

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Introduction: Work-related musculoskeletal disorders (WMSDs) are among the most common occupational injuries in healthcare, with patient handling and movement (PHM) being a primary cause. To prevent WMSDs among healthcare workers (HCWs) and enhance safety in PHM, it is recommended for employers to establish clear risk assessment practises and implement appropriate multifactorial workplace interventions. The aim of this paper is to present the development, the content and launching of the Swedish national evidence-based guideline promoting safe PHM for a better work environment in hospitals, home nursing, ambulance care, and dental services.

Methods: The guide was developed through a comprehensive review of existing research, legislation, and best practices in WMSD prevention. Using a participatory approach, the guide engaged occupational health specialists, safety representatives, healthcare professionals, and policymakers. Grounded in work environment legislation and work health promotion, it follows a structured five-step framework:

1. initiation and establishment,
2. investigation and risk analysis,
3. risk assessment and intervention planning,
4. implementation of actions, and
5. follow-up and evaluation.

This framework enables systematic risk identification, tailored interventions, and a proactive safety culture. A key component is workplace training, equipping HCWs and managers with the skills and resources needed for sustainable safe handling practices.

Results: The Swedish version of the guide was published and launched in 2022 at a national seminar and the English version was published in 2024. Along with the guide, a quick guide for safe PHM was developed, which can be used as support in HCWs daily work. Early adopters of the guide at healthcare workplaces reported, through discussions, usefulness of the guide for promotion of routines for safe PHM and increased use of equipment when performing PHM. Actively implementing this guide in the workplace has the potential to result in the development of effective procedures and working methods for PHM.

Discussion: The Safe PHM Guide highlights the importance of integrating scientific research into workplace policy. By embedding preventive strategies within work environment management, it shifts the focus from reactive injury management to proactive, long-term prevention. The participatory development process and dialogues with stakeholders has been key in securing engagement and ensuring interventions are practical and adaptable. The guide offers practical and strategic guidance for PHM, aiming to prevent harm to both HCWs and care recipients.

Conclusion: This national evidence-based guide provides a scalable approach to preventing WMSDs in healthcare. By integrating research, policy, and clinical practice, it establishes a sustainable framework for risk assessment, intervention, and continuous improvement. Through collaborative implementation, systematic monitoring, and workplace training, the guide has potential to support safer healthcare environments, promote worker well-being, and enhances patient care.