Sonography work in healthcare

Healthcare professionals undertaking diagnostic imaging work using ultrasound equipment have a high prevalence of musculoskeletal disorders (MSD).

There is a substantial amount of published information on MSD risk management specific to sonography. However, it is not clear how this information translates into practice in the UK.

A report titled 'Risk management of musculoskeletal disorders (MSDs) in sonography work' has been produced. It examines MSD risk management performance across a range of sonography operations at UK NHS Trusts. It is aimed at healthcare professionals involved with sonography work, their professional bodies, and Trusts / Boards that employ sonographers and operate services. It is also aimed at manufacturers of sonography equipment and training providers.

HSE has a specific web page on moving and handling in health and social care that provides further information on how to prevent work-related musculoskeletal disorders (MSDs) in your workplace.

Summary of initiative

The work examined MSD risks to sonography workers within the healthcare sector. Reference is made to stress where this could exacerbate MSD risks, although wider work-related stress issues were outside the scope of this work. The focus was on establishing custom and practice with respect to management of MSD risks. The intention was to assess uptake and implementation of a range of risk reduction and control measures for sonography.

Visits to 14 NHS trusts in the UK were undertaken to examine how effectively MSD risks were managed. Overall, performance was found to be much less effective than it should be. This is cause for concern because of the high levels of MSD associated with sonography professionals and the extensive industry specific guidance.

Summary of findings

Risk assessments generally weren't suitable and sufficient as they did not address the cause of MSD risks.
Despite widespread awareness of the MSD risks to sonographers, action to tackle the problems tended to be superficial.
Risk reduction and controls were generally not comprehensive enough to control the risk.
Workload was generally high in sonography. Work organisational / psychosocial factors were seldom sufficiently assessed and controlled.
In most cases training did not adequately address MSD risks, and how to conduct best practice scanning.
Occupational Health provision, whilst generally good, tended not to be used proactively for sonographers.
Health monitoring was rare, even for individuals with established MSD problems.
Manufacturers and education providers have a key role in developing improved systems in sonography work. Both should take account of and facilitate fundamental changes to current scanning practice.
Generally the arrangements for sonography work are less than optimal. This may adversely affect the sonographer's health and performance.

Further information on the findings of this inspection project can be found in the full report.

Improving standards

Trusts should adopt the seven stage approach described in HSG60 'Upper limb disorders in the workplace'. The evidence strongly suggests that action is needed most in risk assessment and control. NHS Trusts should provide the necessary resources to help all departments tackle their MSD risks effectively.

Efforts should be coordinated wherever sonography takes place. Work organisation should be a central target. Increased control of work by sonographers should be considered, and efforts made to balance workloads to enable rest breaks to be taken. Changes to the physical environment like the introduction of slave monitors can be effective.

Fundamental changes in sonography practice, such as scanning with both hands and making effective use of voice activated systems, should be considered as a priority. There is a clear role for equipment manufacturers and education providers to develop / facilitate improvements to sonography systems of work, supported by feedback from users.

Further information

This section provides useful links to guidance, research and information on reducing musculoskeletal disorders at the workplace.