Upper extremity strain in caregivers during enteral tube feeding of semi-solid nutrients to children requiring constant medical care: a simulated experiment focusing on the impact of new injection devices compliant with Standard No. ISO 80369-3.

Abstract

Objectives. Healthcare facilities provide semi-solid nutrients to children requiring enteral tube feeding. The introduction of a new injection device (NEW) with a different syringe-to-tube connector geometry from a pre-existing device (PRE) results in increased workload, and an increase in nurses developing hand pain is a concern. A simulated experiment was conducted to determine the impact on upper extremity strain due to the difference between NEW and PRE. Methods. Twelve nurses performed two injection tasks for one portion of semi-solid nutrients into a dummy gastrostomy using the NEW and PRE. Surface electromyograms were measured on the upper extremity. Task time was divided into sucking and extruding manipulations. Task time and mean myoelectric potentials were calculated for each manipulation and statistically compared between the NEW and PRE. Forces required to manipulate the syringe for semi-solid nutrient injection were estimated using fluid dynamic models. Results. Task time was significantly longer with the NEW. Myoelectric potentials for sucking manipulation were significantly higher with the NEW. Sucking force with the NEW was approximately twice that of the PRE. Conclusion. Sucking with the NEW placed a high strain on the caregiver's hand/wrist. The NEW is less appropriate for enteral tube feeding of semi-solid nutrients.