Perioperative nurses often sustain musculoskeletal injuries from lifting and moving patients. This is a problem that poses even more risks in a society with an obesity epidemic.

Injuries among nurses and other staff can occur when too few people try to transfer a patient and from a facility’s lack of assistive technology to help with moving patients.

The Association of periOperative Registered Nurses offers guidelines and tools to help surgery centers with improving patient handling and make it safer.

When building a new ASC or renovating operating rooms, architects could design them with assistive patient handling devices in mind.

Nearly half of occupational injuries among perioperative nurses are musculoskeletal, often related to lifting and moving patients, according to the Association of periOperative Registered Nurses (AORN).

Root causes of these patient handling injuries include too few staff members required to transfer a patient, lagging technology that could make patient transfers safer, and poor planning.1 In one survey of 116 OR nurses from eight hospitals, two-thirds reported suffering from musculoskeletal problems, says Mary Ogg, MSN, RN, CNOR, senior perioperative practice specialist for AORN. The same survey also showed that about 53% of respondents reported pain in the lumbar region and 38% experienced pain in the cervical region. Also, OR nurses’ musculoskeletal problems are one of the most common causes of long-term absence from work.2

Since AORN developed its first safe patient handling guidance statement 15 years ago, the challenges in moving patients have only grown bigger. Obesity among patients is one of the chief challenges. The percentage of adults who are obese is around 40% in the United States.3

“Safe patient handling is more important today than it was 10 to 15 years ago because none of our patients are getting any smaller,” Ogg says. “That same patient who might have weighed 170 pounds 20 years ago now might weigh 270 pounds. When we had a 200-pound patient then, we thought the person was huge; today, we think that’s a smaller patient.”

AORN’s most recent safe handling and movement guideline offers suggestions for how ORs can improve staff and patient safety during transfers.4

The guideline calls for creating a culture of safety, including incorporating ergonomic design principles to provide a safe environment. ORs should select, install, incorporate, and maintain safe patient handling technology in the perioperative setting.

Also, be sure to educate and train staff on safe patient handling techniques and equipment use. To ensure continuous safety, establish a comprehensive quality assurance and performance improvement program to evaluate safe handling practices. Without assistive technology, it is unsafe for staff to handle patients who are morbidly obese, Ogg says. There are more modern solutions, such as hovercraft-like machines, to more old school devices, such as ceiling lifts attached to a sling and boom-mounted lifts. ORs also can use beds that can be modified with automatic lifting and other table functions.

“There are a few things out there to help,” Ogg observes. “Many nurses think they only need these devices to move bariatric patients, but, in reality, we should use them for all patients.”

When ASCs are built, they could be designed with assistive patient handling devices in mind, Ogg says. “This is especially helpful in outpatient ambulatory surgery centers because you tend to not have a lot of staff for moving patients,” she notes. “It’s great to have these assistive technologies available to make it easier for everyone so they don’t experience a neck or back or shoulder injury.”

Despite the benefits of technological solutions and other safe patient handling measures, not enough surgery centers and ORs have adopted them, Ogg laments. “We have a long way to go; the OR is the last frontier for getting these in place,” she says. “Hospitals may have this technology in place [on nursing floors], but they haven’t gained too much popularity in ORs yet.”


  1. Association of periOperative Registered Nurses. Advances in OR safe patient handling on the horizon. Published Sept. 11, 2019. Available at: http://bit.ly/2q461Cn. Accessed Oct. 28, 2019.
  2. Nützi M, Koch P, Baur H, Elfering A. Work-family conflict, task interruptions, and influence at work predict musculoskeletal pain in operating room nurses. Saf Health Work 2015;6:329-337.
  3. National Center for Health Statistics. Obesity and overweight. Available at: http://bit.ly/2BLB2Ol. Accessed Oct. 28, 2019.
  4. Association of periOperative Registered Nurses. Safe patient handling and movement. Available at: http://bit.ly/31QgQ8j. Accessed Oct. 28, 2019.