Minimising back injury when showering patients with lower levels of functional mobility

More than half of residents in elderly and home care need substantial and daily assistance with washing and/or showering, which can place a great deal of load on a caregivers body 

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Each year, more than 200,000 caregivers in U.S. hospitals experience musculoskeletal injuries,  and  a leading cause is poor workplace ergonomics.1 While hospitals and long-term care facilities have reduced their injury rates over time, caregivers still face significantly higher rates of injury than in private industry as a whole.2,3 

Hygiene care potentially produces a great deal of static load on a caregivers body  when they are  showering or washing  a resident  as they are often leaning in over the  resident for a longer period of time, without being able to support their own weight, as both hands are needed to carry out the hygiene procedure. 

With 61% of residents in elderly and home care needing substantial and daily assistance with washing and/or showering,4   the impact of interventions aimed at reducing caregivers’ static load during hygiene routines can be profound. 

What can be done to help? 

All working postures lasting more than one minute in a position of more than 30-45 degrees flexion, rotation and / or latero-flexion should be avoided.2 Such postures lasting more than four minutes at a time – as hygiene care often requires – demand urgent preventative action.2,3,4

Using ergonomically supportive hygiene equipment, such as high-low showering chairs or trolleys, has been proven to help reduce static load on the caregiver.4  The correct equipment enables the caregiver to come close to the resident and also adjust the height to fit their needs and the specific task they are carrying out. 

It has also been shown that using adequate equipment can stimulate mobility in residents without taking more time.4 This means nursing procedures can be improved at the same time as improving the health and quality of life for the resident, all with the introduction of the correct showering chair or trolley. 


For more information, download a study summary on prevention programs for Hygiene Care which elaborates on different washing techniques and equipment to help minimise static load.

Download study


1- An evaluation of a ‘‘best practices’’ musculoskeletal injury prevention program in nursing homes, J W Collins et al., Injury Prevention 2004;10:206–211. doi: 10.1136/ip.2004.005595 
2- ISO/TR, Ergonomics – Manual handling of people in the healthcare sector: ISO/TR 12296. Gevena 2012 
3- Hignett SM, Fray M, Battevi N et al. International consensus on manual handling of people in the healthcare Sector: Technical Report ISO/TR 12296. International Journal of Industrial Ergonomics 2014; 44(1): 191-195 
4- Knibbe JJ, Knibbe NE, Vijtde monitoring fysieke belasting in verpleeg – en verzorgingshuizen, thuiszorg en kraamzorg 2015 in opdracht van A+O WT (Fifth National Monitoring Physical Load in Nursing Homes, Home Care and Maternity Care 2015, Commissioned by A+O WT). The Hague, 2015