Loading presentation...

Present Remotely

Send the link below via email or IM


Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.


Self-Care Management Strategies:

No description

Anne Kang

on 17 November 2014

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Self-Care Management Strategies:

Self-Care Management
Lower Back Pain

Relevance to Professional Practice Setting
Variety of professional practice settings
Pediatric critical care
Despite low weight of population, extensive activity required over long periods of time
Public health - Elementary Schools Program
Many hours spent in vehicles or at a desk on the computer
Ability to remain active important during interactions with children
Details of the Activities
Identification of self-care issue relevant to professional practice setting

Completion of questionnaire prior to, during, and following main activity (also evaluation)

Modified version of Nordic Questionnaire
Identifies impact of lower back discomfort on both personal and professional functioning prior to self-care regimen
Highlights various elements of activities
Practical aspect of implementation
Efficacy - is it working?
Could this be used in a larger population?
Relation to Curriculum Theme
Addresses internal and external influences which may impact patient care
Body mechanics and workplace ergonomics are enormous contributors to external influences on the nurse and the care he/she provides


Capstone Project Goal:
What is a self-care management plan nurses can implement addressing lower back pain in relation to body mechanics and ergonomics?
Self-Care Regimen
Highlights of Evaluative Process
Based on responses of questionnaire, both participants deemed activity implemented to have been beneficial

Cost-effective, simple and time-efficient series of exercises that can be implemented and provide positive outcomes

From the brief period of implementation, the activity appears applicable to a wide variety of professional practice settings
Potential Implications
Implement this regimen to fellow new graduates to prevent serious low back pain in the future
Increase awareness of self-care, especially posture
Encourage proper body mechanics and ergonomics
Promote general physical activity and exercise to manage low back pain
Barrier: may be ineffective for those already suffering from lower back pain
Identification of key issue present in two quite different professional practice settings
Development of self-care plan which assisted our own personal practice
Lower back pain can be prevented and managed in high-injury disciplines such as nursing
High prevalence of lower back pain among healthcare professionals, especially nurses
Relationship with proper body mechanics and ergonomics
Patient care impacted directly & indirectly
(American Massage Therapy Association, 2011).
Supporting Literature
Context, Health and Healing
Impact on Nursing Context
Preventing lower back pain is important to our future in this profession
Identification of self-care management techniques can help us become active participants in our workplace
Initiating programs to prevent lower back injuries
Assisting others in developing self-care practices
Theory - Best Practice Guideline
Key Learning
Overview of Poster Presentation
Relation to curricular theme
Relevance to professional practice setting
Supporting literature
Details of the activities
Impact on nursing context
Self-care regimen
Highlights of evaluative process
Potential implications
Key learning

Literature retrieved pertaining to self-care issue identified

Adaptation of existing self-care techniques to specific professional practice issue
Self-care regimen of: 1. Review of body mechanics and ergonomics,
2. Back strengthening exercises
x3 weekly
three week period
outside of professional practice setting
Impact of implementation on self-care and nursing care provided

Identification of feasibility of implementing self-care regimen
(Taylor & Renpenning, 2011).
(RNAO, 2008).
Ergonomics training and exercise therapy on lower back pain and improved posture
Nurses with lower back pain and quality of patient care
Nurses (in hospital and office) and prevalence of lower back pain
Low back pain is very prevalent in nurses
Back pain can be managed through ergonomics training and non-specific back exercises aimed at improving posture and body mechanics
Proper body mechanics is the most effective method of preventing work-related lower back pain
Increased awareness in posture is one step towards promoting nurse self-care
Kasia Gingras Little
Anne (Young) Kang

Partial Crunches
On back, knees bent
Contract abdominal muscles until shoulders off the ground
Hold for one breath
8-12 repetitions
Pelvic Tilts
On back with knees bent
Pull belly button into spine
Feel back pressed into floor
Hold 10 seconds
8-12 repetitions
Press-Up Back Extensions
On stomach, push up from the floor
Alternatively, rest on elbows
Hold for 5 seconds
On back with knees bent
Heels pushed into floor
Flex glutes
Shoulders, hips, and knees should line up
Hold 6 seconds, rest 10 seconds
8-12 repetitions
Bird Dog
Start on hands and knees
Keeping abdominal muscles tight, extend one leg and opposite arm
Ensure hips remain square
Hold 5 seconds and switch limbs
8-12 repetitions/limb
Morning Breathing
Best done upon waking
From standing position with bent knees, bend from the waist
Return to standing position by straightening one vertebrae per breath
2 repetitions
Knee to Chest
Start on back, knees bent
Pull one knee up to chest
Hold 15-30 seconds, the switch legs
2-4 repetitions/leg
American Massage Therapy Association. (2011). Living well: Recharge your commitment, practice and passion.
Massage Therapy Journal.
.Retrieved from http://www.amtamassage.org/articles/3/MTJ/detail/2482.
Chen, H., Wang, H., Chen, C., & Hu, H. (2014). Effectiveness of a stretching exercise program on low back pain and exercise self-efficacy among nurses in Taiwan: A randomized clinical trial.
Pain Management Nursing, 15
(1), 283-291.
Cho, C., Hwang, Y., & Cherng, R. (2012). Musculoskeletal symptoms and associated risk factors among office workers with high workload computer use.
Journal of Manipulative and Physiological Therapeutics, 35
(7), 534-540.
Daraiseh, N., Cronin, S., Davis, L., Shell, R., & Karwowski, W. (201). Low back symptoms among hospital nurses, associations to individual factors and pain in multiple body regions.
International Journal of Industrial Ergonomics,
40, 19-24.
Hoy, D., March, L., Brooks, P., Woolf, A., Vos, T., & Buchbinder, R. (2010). Measuring the global burden of low back pain.
Best Practice & Research Clinical Rheumatology, 24
(2), 155-165.
Karahan, A, Kay, S., Abbsoglu, A., & Dogan, N. (2009). Low back pain: Prevalence and associated risk factors among hospital staff.
Journal Advanced Nursing,65
(3), 516-524.
Lovgren, M., GUstqavsson, P., Melin, B., & Rudman, A. (2014). Neck/shoulder and back pain in new graduate nurses: A growth mixture modeling analysis.
International Journal of Nursing Studies, 51
(4), 625-639.
Michigan Quality Improvement Consortium. (2012). Management of acute low back pain.
National Guideline Clearinghouse.
Retrieved from http://www.guideline.gov/content.aspx?id=37956.
Murray, E., Franche, ., Ibrahim, S., Smith, P., Carnide, N., CotP., Gibson, J., Guzman, J., Keohoorn, M., & Mustard, C. (2013). Pain-related work interference is a key factor in a worker/workplace model of work absence duration due to musculoskeletal conditions in Canadian nurses.
Journal of Occupational Rehabilitation, 23
(4), 585-596.
Registered Nurses' Association of Ontario (RNAO). (2008). Healthy work environments best practice guidelines: Workplace and well-being of the nurse. Retrieved from http://rnao.ca/sites/rnao-ca/files/Workplace_Health_Safety_and_Well-being_of_the_Nurse.pdf.
Szeto, G., Wong, T., Law, R., Lee, E., Lau, T., So, B., & Law, S. (2013). The impact of a multifaceted ergonomic intervention program on promoting occupational health in community nurses.
Applied Ergonomics, 44
, 414-422.
Taylor, S., & Renpenning, K. (2011).
Self-care, nursing theory, and evidence-based practice
. New York, NY: Springer.
(American Massage Therapy Association, 2011).
Image: http://www.presentermedia.com/files/animsp/00007000/7109/ab_crunch_elbow_switch_sm_wm.gif
(American Massage Therapy Association, 2011).
Image: http://bretcontreras.com/anterior-pelvic-tilt-and-lumbosacral-pain-as-it-relates-to-the-hip-thrust-and-glute-bridge/
(American Massage Therapy Association, 2011).
(American Massage Therapy Association, 2011).
Image: http://www.iposture.com/exercise_bridge-simple.php
(American Massage Therapy Association, 2011).
(American Massage Therapy Association, 2011).
Image: http://www.webmd.com/fitness-exercise/knee-to-chest-exercise
(American Massage Therapy Association, 2011).
Image: http://exercise.about.com/od/abs/ss/abmoves1_3.htm

Image: http://nursing-care.org/highresolution/l_132.jpg

Image: http://www.presentermedia.com/files/clipart/00004000/4239/business_binder_pc_md_wm.jpg

Image: http://www.presentermedia.com/files/clipart/00004000/4344/nurse_charting_pc_sm_wm.jpg

Image: http://www.presentermedia.com/files/clipart/00002000/2338/stick_figure_reading_pc_sm_wm.jpg
Personal and empirical ways of knowing: identification that these activities could lead to lower back pain, and that pain could cause an interruption in care provided
Image: http://gre2us.com/wp-content/uploads/2013/11/animated-checklist-clipart-presentermedia-580x253.jpg

Image: Pediatric patients: https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcRVlojrDWRkvqXpGtF3ypcbjF4ozChu_1bFhPIfaeXr4q-rtOwb
Image: Computer: http://www.presentermedia.com/files/clipart/00002000/2441/typing_at_desk_pc_sm_wm.jpg

Image: http://www.presentermedia.com/files/clipart/00012000/12284/woman_nurse_jumping_celebration_sm_wm.jpg



Image: http://sr.photos2.fotosearch.com/bthumb/CSP/CSP625/k6258288.jpg
Questionnaire Handout
Image: http://www.presentermedia.com/files/clipart/00010000/10747/patient_surrounded_by_medical_team_md_wm.jpg

Image: http://obrazovnokreativnicentar.com/media.obrazovnokreativnicentar.com/public_html/2014/08/ocenjivanje01.gif
Image: http://thumbs.gograph.com/gg58255058.jpg
Image: http://sr.photos2.fotosearch.com/bthumb/CSP/CSP311/k3114674.jpg
Image: http://2.bp.blogspot.com/-U_k2nS6bLnY/T1n1U-a5MbI/AAAAAAAAc88/recycvp2-qw/s1600/Platic+Men+clipart+(5).jpg
Longitudinal study, 1153 nursing students from Sweden
50% reported lower back pain during education into post-grad practice
25-27% reported pain 1 year later
21% reported pain 2 years later who had previously reported no pain
Qualitative study, 263 nurses from U.S.
1 month prevalence rate for MSK symptoms highest for lower back 74%
1 year prevalence rate for functionally limiting symptoms highest for lower back 29%
1 year prevalence rate for severe symptoms most frequently reported for back 49%
Qualitative study, 203 office workers in Taiwan
86% employed full-time, 58% had work involving computers for 7+ hours a day
Top identified MSK symptoms: shoulder 77%, neck 76%, lower back 64%
Cross-sectional survey, 1600 hospital staff in 6 Turkish hospitals
Highest prevalence of low back pain in nurses 77.1%
Reported low back pain affected their work (54%), decreased their performance (48%), limited their movement (21%) and caused difficulty doing their job properly (6%)
Global burden of disease study
Low back pain is the most frequent occupational problem in high-income countries, 2-5% lead to permanent debilitation
Low back pain is the most frequent activity-limiting complaint and second leading cause of sick-leave
Cross-sectional survey, 941 Canadian nurses
Pain severity and pain-related work interference mediate impact of factors on work absence i.e. physical demands, back problems
Average number of work days lost per worker in 1 year was 8-10 days across all occupations from 1999-2009
Nurses' average was 19.2 days
Longitudinal study, 50 community nurses in Hong Kong
1 year follow up: significant reduction in physical and psychosocial risk factors, improved functional outcomes, and significant reduction of self-reported MSK symptoms
Follow up the year following showed no different from previous results = effective program
Non-pharmacologic recommendations:
Stay active, continue ordinary activity as pain permits, avoid bed rest
Injury prevention with proper body mechanics and safe back exercises
Stretching exercises
RCT, 127 nurses with low back pain for 6+ months
Follow up at 2, 4, 6 months showed significant lower pain scores
81% moderate to high pain relief
78% moderate to high satisfaction with program
Do you believe lower back pain issues may arise in your desired future area of practice?
Do you believe implementing these activities in your daily routine would be possible?
In the future, if a lower back pain program became available to you, would you categorize this as a priority in your self-care?
Full transcript