透過排班最佳化降低醫事放射師整體肌肉骨骼不適風險：以新竹市某區域醫院為例

Reducing the Overall Risk of Musculoskeletal Discomforts among Medical Radiation Technologists through Schedule Optimization: A Regional Hospital in Hsinchu City as an Example

曾世瑋(Shih-Wei Tseng) ； 徐薏帆(Yi-Fan Hsu) ； 盧俊銘(Jun-Ming Lu) ； 徐世美(Shih-Mei Hsu) ； 趙慶勇(Ching-Yung Chao)

《中華放射線技術學雜誌》 46卷1期 (2022/03) Pp. 29-41

摘要

醫事放射師工作時需搬移病人作業，伴隨彎腰、高舉手臂、等重複性動作，造成肌肉骨骼不適，但外界對放射師的危害多聚焦於輻射暴露風險，易忽視肌肉骨骼不適之風險分析與改善。因此，本研究以新竹市某醫院放射線科為例，建構排班最佳化的模型，並利用此排班模式來降低醫事放射師肌肉骨骼不適的風險。本研究分為二個階段：（1）問卷調查：調查放射師連續工作多天之累積疲勞程度，藉以將主觀累積疲勞納入風險衡量，進行班表規劃，亦透過北歐肌肉骨骼不適問卷調查放射師目前之肌肉骨骼不適情形；（2）建立排班模式：以最小化放射師整體肌肉骨骼不適風險為目標式，並以法令規範、科內輪班規定等為限制式，使用Gurobi Optimizer 8.1.1版本搭配Python 3.7環境求解、產生班表。研究結果分為二部分：第一部分為問卷調查結果，前三名依序為：「工作量較大」、「輪班工作」、「睡眠不足」與「反覆操作動作」，透過排班最佳化應可改善輪班工作與反覆操作動作造成的疲勞感受，另外肌肉骨骼不適現況盛行率最高的身體部位前三名為：下背或腰（66.67%）、手或手腕（46.67%）及肩膀（46.67%）；第二部分為最佳化排班模式結果，基於主觀累積疲勞程度與各班別肌肉骨骼不適風險分數，求出最佳化班表。整體而言，本研究將醫事放射師的主觀累積疲勞、各班別的肌肉骨骼不適風險納入考量，建立最小化整體肌肉骨骼不適風險的排班模型，提供個案醫院在未來實行，將有助於縮短排班所需時間以及降低醫事放射師工作之肌肉骨骼不適風險。

關鍵字

主觀累積疲勞 ； 北歐肌肉骨骼傷害問卷（NMQ） ； 排班模型

並列摘要

Medical radiation technologists need to repeatedly operate instruments, move patients, Repetitive actions such as bending the torso, raising the arms, twisting the neck, standing for a long time, and squatting are involved and would cause musculoskeletal discomforts. However, the public focuses mainly on the risk of radiation exposure among medical radiation technologists. Risk analysis and improvement of musculoskeletal discomforts are somehow neglected. Therefore, this study takes the radiology department of a hospital in Hsinchu City as an example and aims to construct a mathematical model for schedule optimization to reduce the overall risk of musculoskeletal discomforts among medical radiation technologists. There are two stages in this study:(1)Questionnaire survey: Workplace fatigue questionnaire was used to investigate medical radiation technologists' cumulative fatigue level in multiple working days. By doing so, subjective cumulative fatigue can be included in risk assessment for schedule optimization. Meanwhile, medical radiation technologists were also asked about the possible causes of fatigue. In addition, the current musculoskeletal discomfort situation among medical radiation technologists was investigated through the Nordic Musculoskeletal Discomfort Questionnaire to understand the prevalence of discomfort in various body parts. (2)Constructing the scheduling model: By combining the subjective cumulative fatigue level from the questionnaire survey and the risk of musculoskeletal discomfort from on-site observation, the scheduling model was constructed to minimize the overall risk of musculoskeletal discomforts among medical radiation technologists. The research results are divided into two parts. The first part is the questionnaire survey results. The top three possible causes of fatigue are ＂heavy workload＂, ＂shift work＂, ＂lack of sleep＂ and ＂repetitive operations.＂ With schedule optimization, the fatigue caused by shift work and repetitive operations might be improved. In addition, the body parts with the highest prevalence of musculoskeletal discomforts are lower back or waist (66.67%), hands or wrists (46.67%), and shoulders (46.67%). The second part is the result of the scheduling model. Based on the subjective cumulative fatigue level and the musculoskeletal discomfort risk scores of each operation, the optimized schedule for the types. Overall, this study took the subjective cumulative fatigue of medical radiation technologists and the risk of musculoskeletal discomforts of each operation into account, and constructed a scheduling model that minimizes the overall risk of musculoskeletal discomforts for the implementation in the hospital. With the scheduling model, the overall risk of musculoskeletal discomforts among medical radiation technologists can be reduced.

並列關鍵字

subjective cumulative fatigue ； Nordic Musculoskeletal Questionnaire ； Scheduling Model