What makes a moving and handling people guideline work? : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Manawatū, New Zealand
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Date
2018
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Massey University
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Abstract
Moving and handling of people (MHP) is a major reason for developing musculoskeletal
disorders (MSD) in the healthcare sector worldwide. To reduce MSD from MHP, many national
and state level guidelines targeting MHP have been developed. However, little is known about
their impact on injury claims rates, how they are intended to work, if intended users are aware of
and use them, which parts of the guideline are being used, and how they are implemented.
Therefore, the overarching goal of this thesis was to contribute to understanding what makes a
MHP guideline work. It was addressed by examining the effects of introducing the New Zealand
Accident Compensation Corporation ‘Moving and Handling People: The New Zealand Guidelines’
(MHPG), using a mixed-methods approach in five sequential studies. An analysis of claims data
(Study 1) showed that MHP related claims rates declined before, but increased after the
introduction of the MHPG. A study of the MHPG programme theory (Study 2) showed that key
actors for implementation were MHP coordinators, H&S managers, and therapists. The
developers argued for implementing a multifaceted MHP programme where implementation of
organisational systems should create the foundation for implementing the core components. A
questionnaire analysis (Study 3) showed that a high proportion of MHP coordinators, H&S
managers, and therapists were aware of the MHPG, while a high proportion of therapists used it.
In contrast, fewer carers were aware of and used it. A second questionnaire analysis (Study 4)
showed that more key actors were familiar with and used the core components compared to the
organisational systems. A low proportion of actors experienced change after use. Case studies
(Study 5) showed that organisational motivation to implement a MHP programme was initiated
by MHP related staff injuries. The implementation process was gradual, changing MHP practices
during multiple steps, and dependent on a dedicated person to drive implementation.
This thesis shows that making a MHP guideline work requires a dedicated actor, with support
from management, to facilitate implementation and organisational changes needed. However,
many contextual factors affect implementation, ranging from national, e.g. legislation and
policies, to individual level, e.g. individuals conducting MHP.
Description
Appendix 2 was removed to comply with copyright, but it may be accessed via:
Lidegaard, M., Olsen, K.B., and Legg, S.J. (2019, April ). How was a national moving and handling
people guideline intended to work? The underlying programme theory. Evaluation and
Program Planning, 73, 163–75. https://doi.org/10.1016/j.evalprogplan.2019.01.002
Keywords
Health facilities, Risk management, New Zealand, Safety measures, Industrial accidents, Prevention, Medical personnel, Health and hygiene, Musculoskeletal system, Diseases, Accident Compensation Corporation (N.Z.)