¹Occupational Medicine Linköpings University hospital, Region Östergötland, Linköping University, Linköping, Sweden
²Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping, Sweden
³Linköpings Universitet, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping, Sweden
⁴Örebro University, Faculty of Medicine and Health, University Health Care Research Center, Örebro, Sweden

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Introduction: Research indicates a concerning lack of safety for both healthcare workers (HCWs) and patients in many healthcare settings, with multiple risk factors contributing to incidents and injuries. Key factors of work-related musculoskeletal disorders (WMSDs) among HCWs include physical and mental strain, staffing shortages, limited influence over work conditions and poor safety climate. One critical risk factor is the improper use of equipment during patient handling and movement (PHM). Notably, WMSDs arising from PHM rank among the most prevalent injuries. This study aimed to analyse HCWs’ perceptions of working conditions and safety climate in relation to PHM, and to identify areas for intervention to improve the work environment.

Methods: This multicentre cross-sectional study included HCWs from 17 hospital care units and 27 nursing homes. A digital questionnaire captured data on safety climate (using NOSACQ-50, scored 1–4, with >3.30 indicating a good safety climate), 14 PHM-specific questions (covering equipment use, safety practices, PHM education, risk assessment, and collaboration), and the Structured Multidisciplinary Work Environment Survey (SMET), which addresses physical, environmental, and psychosocial demands. Additional questions explored needs for work-environment improvements. Problems related to mental and/or physical workload in current work was reported.

Results: A total of 1214 HCWs (510 in hospital care units, 704 in nursing homes) completed the questionnaire (64% response rate). Most HCWs were assistant nurses (70%) or registered nurses (18%).The mean (SD) NOSACQ-50 scores across seven dimensions ranged from 3.1 (0.6) to 3.6 (0.4). SMET findings showed frequent reports of lifting and uncomfortable working positions (44% and 37%, respectively), while 65% indicated minimal problems with employer support. Most HCWs (82%) performed PHM at least daily, while 26% reported doing so 6–20 times or more per day. HCWs at hospital care units performed PHM less often with a colleague compared to HCWs at nursing homes (68% vs. 81%). Overall, 78% conducted PHM without equipment up to four days a week, and 22% did so daily. About 40% reported no regular PHM training. Common suggestions for improvement included training, communication and collaboration, adequate staffing, better equipment (including ceiling lifts), clear guidelines, and larger facilities. In total, 76% of the HCWs reported problems related to mental and/or physical workload in present work.

Discussion: NOSACQ-50 scores indicates that there is room for improvement of safety and risk awareness among HCWs. PHM remains a common and challenging task, with many HCWs reporting insufficient training and a high incidence of lifting-related strain. SMET data provided a multifactorial perspective on the work environment, highlighting how physical and psychosocial factors intersect to affect HCWs’ safety and health.

Conclusion: Work-related health problems remain a significant concern among HCWs, particularly for nurses and nurse assistants in hospital care units and nursing homes. HCWs reported the need for training on safe PHM, access to better equipment as well as the presence of clear guidelines outlining routines for safe PHM.