Presentation
MDD27 - Understanding the Relationship Between Nurses' Perceived Subjective Effort and Objective Neuromuscular Effort of Prefilled Syringes With Varying Injection Variables
SessionPoster Session 2
DescriptionWork-related musculoskeletal disorders (WRMSDs) are a pervasive and significant health concern across all work domains, particularly within the nursing and nursing assistant population (Bureau of Labor Statistics, 2022). These injuries often cumulate as small trauma to the neuromuscular system and exacerbate as the individuals age. Previous literature evaluating the WRMSDs, reveal that nearly 50% of this population has reported non-fatal injuries in the neck, shoulders, and hands due to routine duties such as repetitive mixing and drawing fluid, manually pushing and administering of injections using syringes (S Ziam et. al 2023, W Thinkhamrop et. al, 2017; TSBS Magnago et. al, 2010). These tasks often require prolonged and repetitive use of pinch and grip hand forces with continuous low-level loadings without sufficient rest leading to fatigue, affecting levels of force exertion particularly during injection administration. To accommodate for required levels of forceful exertions and performance, nurses often compromise on safe interaction practices leading to non-ergonomic hand movements. These effects cumulatively contribute to the development of these WRMSDs.
Studies evaluating combination products, especially syringes, have established that differences in characteristics of drug formulation (such as viscosity and volume) affects forces required to dispense the medication (CJ Rini et. al, 2022; A Allmendinger et. al, 2015). However, during current mechanical testing of syringes (e.g., design verification), the break loose and extrusion forces are evaluated against a constant force (RP Watt et. al, 2019; GD Chitnis et. al 2019). This is a notable gap since users vary widely in their physical capabilities and no single force can accurately represent the intended end-user population. Additionally, this mechanical testing is often performed at a specific speed that may not completely reflect real-world administration either. Therefore, this research aims bridge the gap between end-user design needs and mechanical testing methodologies to design and develop pre-filled syringes that effectively address users’ minimal force requirements, to mitigate the risk of MSDs in the hands.
The aim of this research is to investigate the relationship between the perception of subjective effort and objective neuromuscular outcomes when interacting with pre-filled syringes of different viscosities (1 cP - 70 cP) and, volumes (1 mL - 2 mL). 60 registered nurses (40% Males) between the ages of 25 – 65 were recruited for this study. All volunteers were board certified nurses and currently in practice with an average (SD) of 12.47 (8.34) years of experience. Before starting the experiment, all participants underwent hand grip strength testing to determine their maximum grip strength. This measurement was further used to categorize the participants’ data into population percentiles for comparing trends between different strength percentiles. All volunteers performed 12 injections with the order of the injections randomized.
Some highlights of this study included:
1) Increase in viscosity is correlated with increased neuromuscular effort as evidenced by the area under the mean force-duration curve
2) Approximately 90% of participants utilized a syringe grip to administer the medication despite differences in viscosity and volume, suggesting that participants will adhere to their standard practices and past experiences without altering their grips to accommodate for more challenging injections
3) Subjective ratings of fatigue and force perceptions were moderately correlated across injections
Studies evaluating combination products, especially syringes, have established that differences in characteristics of drug formulation (such as viscosity and volume) affects forces required to dispense the medication (CJ Rini et. al, 2022; A Allmendinger et. al, 2015). However, during current mechanical testing of syringes (e.g., design verification), the break loose and extrusion forces are evaluated against a constant force (RP Watt et. al, 2019; GD Chitnis et. al 2019). This is a notable gap since users vary widely in their physical capabilities and no single force can accurately represent the intended end-user population. Additionally, this mechanical testing is often performed at a specific speed that may not completely reflect real-world administration either. Therefore, this research aims bridge the gap between end-user design needs and mechanical testing methodologies to design and develop pre-filled syringes that effectively address users’ minimal force requirements, to mitigate the risk of MSDs in the hands.
The aim of this research is to investigate the relationship between the perception of subjective effort and objective neuromuscular outcomes when interacting with pre-filled syringes of different viscosities (1 cP - 70 cP) and, volumes (1 mL - 2 mL). 60 registered nurses (40% Males) between the ages of 25 – 65 were recruited for this study. All volunteers were board certified nurses and currently in practice with an average (SD) of 12.47 (8.34) years of experience. Before starting the experiment, all participants underwent hand grip strength testing to determine their maximum grip strength. This measurement was further used to categorize the participants’ data into population percentiles for comparing trends between different strength percentiles. All volunteers performed 12 injections with the order of the injections randomized.
Some highlights of this study included:
1) Increase in viscosity is correlated with increased neuromuscular effort as evidenced by the area under the mean force-duration curve
2) Approximately 90% of participants utilized a syringe grip to administer the medication despite differences in viscosity and volume, suggesting that participants will adhere to their standard practices and past experiences without altering their grips to accommodate for more challenging injections
3) Subjective ratings of fatigue and force perceptions were moderately correlated across injections
Event Type
Poster Presentation
TimeTuesday, April 14:45pm - 6:15pm EDT
LocationFrontenac Foyer