Skill extraction from nursing care service using sliding sheet

Back pain has been a serious problem for novice nurses who care for bedridden patients. To avoid back pain, placing a slippery sliding sheet beneath a patient has been suggested so that nurses can pull it when repositioning the patient rather than lifting the patient. However, inappropriate use of the sheet may not reduce lumbar pain. Therefore, it is important to identify skills required for novice nurses to perform bed care movements using a sliding sheet. This study firstly performed interview to obtain useful knowledge from expert nurses who are skilled in using a sliding sheet. Next, a simulation study was then conducted to determine specific bed care movements that would minimize lumbar joint moment associated with lumbar pain. The simulated and expert movements were compared to validate whether expert movements decreases lumbar joint moment. Finally, a novice participant was taught these expert movements, and the educational effect of using these skills was validated. Our results showed that the experts used characteristic movements, keeping the upper arm and trunk stabilized and utilizing a shift in body weight, when performing bed care movements with the sliding sheet. Additionally, the expert movements and simulated movements were shown to be similar. This result confirmed that expert movements could contribute to reducing lumbar joint moments. Moreover, a novice participant could decrease lumbar moment using skills derived from effective education.