Ergonomic Hazards: How to Keep Periop RNs Safe


Your Practice: Avoid Ergonomic Hazards

New to the periop setting and eager to help? Or an expert periop RN providing safe patient care in a fast-paced setting? Either way, we share your passion.

But don’t let your enthusiasm put you at risk for musculoskeletal injury.

Guidelines author Emily Jones helps you steer clear of ergonomic hazards to keep you safe. Prevent work-related injuries with this sneak peek at the latest evidence every periop nurse needs to know.

Did you know?

A periop nurse can sustain an injury just by holding a patient’s leg for one minute. That means a routine preop skin antisepsis procedure could leave you with a musculoskeletal injury. That is unless you know how to do it safely.

Periop nursing comes with unique physical demands. As your partner in periop safety, AORN is here to remind you how easily an injury can happen.

Common Periop Nurse Musculoskeletal Injuries

  • Muscle & tendon sprains, strains & tears
  • Nerve damage
  • Spine/disc injuries & back pain
  • Joint & cartilage damage

“More than 60% of perioperative nurses experience lower back musculoskeletal injuries,” says Emily Jones, MSN, RN, CNOR, NPD-BC.1 She’s a senior perioperative practice specialist and the lead author of the Guideline for Safe Patient Handling and Mobility [previously Movement] (SPHM).

Guideline Sneak Peek

Jones is adding finishing touches and updates to the 2024 SPHM guideline. Proposed updates are open for public commenting. You can get a sneak peek and provide feedback through Sept. 25. The final updated guideline is slated for publication in January 2024.

Q&A with Guidelines Author to Help You Stay Safe

Periop Today asked Jones how nurses can stay safe in the periop setting and avoid musculoskeletal injury.

Periop Today: What should RNs new to the periop setting know to protect themselves from injury?

Jones: Start by making sure you know what can lead to an ergonomic injury. For example, prolonged standing when scrubbed in at the sterile field can lead to pain in the lower back and lower extremities.

Moving patients can also contribute to injury. When moving patients, use assistive technologies to help prevent staff injuries and keep patients safe. These might include air-assisted transfer devices or mechanical lift devices. Also, speak up if these tools aren’t readily available, or if you need training on their use.

Studies show that not having the necessary SPHM equipment is a predictor of back injury. (Andersen et al 2019) Other research suggests periop staff are more likely to use the SPHM equipment and practice safe patient handling techniques when these tools are available and accessible. (Galinsky et al 2021)

Periop Today: What are the most common ergonomic hazards in the OR and when are they most likely to occur?

Jones: Risk for injury increases with tasks requiring twisting, pushing, awkward statistic postures, and repetitive motions. The hazard can increase when these tasks include heavy loads, increased frequencies, or longer durations.

Researchers found that just five patient transfers a day was associated with almost eight times the risk of back injury. This was especially true when assistive devices were not available. (Andersen et al 2019)

“The most common work-related musculoskeletal injuries among perioperative nurses are lower back problems related to patient handling tasks, followed by knee and shoulder disorders.”
(Clari et al 2021)

Periop Today: What ergonomic tools should periop RNs use to help stay safe?

Jones: The SPHM guideline includes seven ergonomic tools for periop teams. Using the tools, staff can decide what’s best for each patient and methods to decrease injury.

Example: When transferring the supine patient to and from the OR bed, Ergonomic Tool #1 suggests you use assistive technology, e.g., an air-assisted lateral transfer device or mechanical lift.

Periop Today: How can periop RNs promote safe ergonomic practices at work?

Jones: AORN recommends that periop departments establish a formal SPHM program. Research shows that having a formal SPHM program results in a 56% decrease in risk of injury to healthcare workers. (Teeple et al 2017)

Periop RNs with specific interest in ergonomic safety can become peer leaders. Ask your leadership how to participate in SPHM technology evaluation, perform ergonomic analyses, or assist with staff education.

Learn how to prevent occupational injuries while providing safe patient care and share this information.



  • Be sure to review the draft SPHM guideline update now open for public commenting through Sept. 25, 2023.
  • Watch for important updates in “Guideline First Look” in the January issue of AORN Journal.
  • Look for the 2024 SPHM guideline updates when it publishes electronically in eGuidelines Plus. Also find it in print edition of the AORN Guidelines for Perioperative Practice next in January.

1 Based on evidence in a 2021 systematic review (Clari et al 2021) on the prevalence of musculoskeletal disorders among perioperative nurses.

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