Background Information.

Ergonomics is the study of how people work and how to design the workplace so that people can easily
adapt to it and be more productive. Furthermore, a healthy workplace can help foster a culture of
innovation and creativity (Sabir et al,2019). Ergonomics looks at the worker, workplace and design of the
work to figure out how well a person fits their job(Jaffar et al,2011).

Globally, about 6% of the healthcare workers have received training on ergonomics and according to
estimate made by ILO (2018) about 330 million accidents annually occur globally, 160 million workers
are also estimated to suffer from work-related diseases that lead to a death of 2 million workers and loss
of 4% of world's annual GDP. The global burden of diseases that could be attributed to occupational risk
factors was about 0.9 million daily adjusted life years (DALY's) or 2.5 of global DALY's in 2010.

In USA, ergonomic injuries in a healthcare set-up has reduced to 33% of all worker injury and illnesses
according to (Bureau of labor statistics,2010).In Africa, mostly in developing countries like south
Africa,one year later implementing ergonomics program in healthcare facilities, injuries dropped by 25%
and the cost of workers compensation was down by more than 45%, workplace health and safety laws in
South Africa have a strong connection to ergonomics (Baril et. al, 2014). Healthcare facility was the only
sector that had a decrease in the total number of cases in 2021, decreasing 183,200 cases to 623,00 in
2021. This was driven by a decrease in cases of work-related injuries and illnesses in a healthcare set-up
(U.S Dept. of labor statistics) which has also led to 48% decrease in absenteeism through the
implementation of ergonomic improvements.

In Kenya, out of 329 approved hospital workers, only 60% are active, this is according to the National
council of occupational safety and health (NACOSH 2021) and there are only 75 healthcare institutions
that indulge in occupational safety and health training and awareness creation. Healthcare institutions in
Kenya are increasingly realizing that workplace ergonomics is clearly the most critical element in
ensuring employee performance, (Murray 2018).And according to (El-zeiny,2013) improved workplace
ergonomics accounts for 40% of the employee performance.

1.2 Problem Statement.

Institutions may not see ergonomics as an important part of their strategy, corporate goal, planning and
control cycles but rather as an outside factors, in terms of health and safety, the current trend is to
reduce command control legislation while increasing support to voluntary initiatives on their own (Dul et
al, 2012).

It is therefore a general knowledge that employee barrier can affect work and generate stress which can
make employee more prone to error,poor work performance while doing their work. Environmental
barriers also may affect employee's work and institutional barrier's is also among the barriers affecting
employee's performance, like lack of proper workstations and lack of proper tools that can promote
occupational safety and health.
1.3 Justification.

Ergonomics leads to healthy and pain-free workers who are more likely to be engaged and productive. It
also help make the work comfortable for the individual worker.Kisii teaching and referral hospital is a
good site because it has different workers working in different sections in the hospital.

1.4. Research Question.

Barriers to practice of ergonomics on support staffs in Kisii teaching and referral hospital?

1.5 Research Objectives.

1.5.1.Broad objectives.

To determine barriers to ergonomic practices.

1.5.2. Specific Objectives.

1.To assess employee's barriers to ergonomic practices.

2.To identify environmental barriers to ergonomic practices.

3.To assess the Institution barriers to ergonomic practice.

CHAPTER 2: LITERATURE REVIEW.

Barriers to ergonomic practice includes employee barrier like lack of resources, lack of knowledge and
lack of training,and the effects on ergonomic practices.There are environmental barriers like awkward
posture, stationary position stationary position, forceful motion and reputation. There are also
Institutional barrier's which are budget constraints, limited access to ergonomic assessments and
resources and inadequate staffing levels leading to increased workloads and ergonomic risks.

2.1.0 Employee Barriers.

These barriers include lack of resources, knowledge and physical training and lack of motivation.

2.1.1Lack of resources.

According to Rebertson and O'Neill (2019) found that inadequate ergonomic resources,such as poorly
designed workstations or insufficient equipment, can lead to discomfort, musculoskeletal disorders and
decreased productivity among employees.Lack of resources not only affects physical wellbeing but also
mental focus and efficiency. When employee's are uncomfortable or in pain due to poor ergonomic
conditions,their ability to concentrate and perform tasks effectively is compromised, ultimately
impacting overall performance and productivity levels negatively.

2.1.2 Lack of knowledge.

Lack of knowledge among support staffs can hinder ergonomic practices by leading to improper
ergonomic workstation set-ups and equipment usage, increasing the risk of musculoskeletal disorders
among employees.(Smith et al.,2020) found that inadequate training among support staff resulted in
suboptimal ergonomic interventions and increased musculoskeletal disorders. Additionally, limited
knowledge among support staffs on proper ergonomics principles contributes to higher rates of
workplace injuries and decreased productivity.(Jone & Johnson, 2021)

2.1.3.Physical limitations.

This can impede ergonomic practices by y restricting their ability to properly adjust workstations and
equipments to meet ergonomic standards, potentially leading to discomfort and injury. According to
study by Brow et al.(2023), support staff with physical limitations may struggle to implement ergonomic
recommendations effectively, resulting in increased musculoskeletal strain and decreased
productivity.Furthermore, Creen et al.(2022) suggests that accommodating physical limitations can lead
ergonomic risks and hinder overall workplace safety and efficiency.

2.1.4. Lack of motivation.

It hinders implementation of ergonomic practices,as it may lead to reduced adherence to safety,

2.2.1 Noise.

Excessive noise in hospital can interfere with communication, leading to miscommunication and
potential errors, which increases stress and fatigue among workers.(Jawadi & Chein,2023). Additionally,
constant exposure to high noise levels can lead to physiological and psychological effects such as
headache and increased anxiety which may hinder staffs ability to maintain proper ergonomic practices.
(Implementation science, 2023).

2.2.2. Uncomfortable temperatures

When the temperature is too high, it can lead to heat stress, causing fatigue and reducing concentration
which is critical in a healthcare environment where precision and attention to detail are paramount.Also
excessively cold temperatures can result in discomfort and distraction, impacting the ability to perform
tasks efficiently and safety primex.(2021), the CDC recommends specific temperature ranges for
different areas to balance comfort and efficiency of the water.Flexispot.(2021); the variability in
individual comfort levels adds a layer of complexity.

2.2.3. Inadequate lighting.

This affects visual comfort, increasing the risk of errors and also contributing to physical strain, poor
lighting cause eye strain, headaches and fatigue leading to decreased productivity and increased error
rates. (Mohezar et al;2020) Additionally, insufficient light levels can make it challenging to maintain
proper ergonomic postures, as workers may need to lean forward or position themselves uncomfortably
to see their tasks clearly. Canadian Center for Occupational Health and Safety (CCOHS) (2023).

2.3.0. Lack of ergonomic policies.

2.3.1. Budget constraints.

Often results in healthcare facilities prioritizing spending on essential medical equipment over
ergonomic tools for support staff. According to recent studies by Park et al; (2020), healthcare
organizations facing financial pressures tend to allocate funds towards patient care rather than investing
in ergonomic equipment for staff, thereby increasing the risk of musculoskeletal injuries among support
staff.

Budget limitations can also restrict the allocation of resources for ergonomic training program for
support staff.Research by Lipscomb et al;(2021) highlights that healthcare institutions with tighter
budgets are less likely to provide comprehensive ergonomic training to their employees leading to a lack
of awareness about proper ergonomic practices and an increased incidence of work related
musculoskeletal disorders.

2.3.2. Limited access to ergonomic assessment.