Long-Term Effects of Structured Microbreak Interventions on Musculoskeletal Health, Psychological Wellbeing, and Patient Safety Among Operating Room Nurses: A Multicenter Longitudinal Cohort Study

Wenhui Gao,1 Guangmei Fan,1 Dandan Liu,2 Guangrui Fan3 1Department of Anesthesiology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, People’s Republic of China; 2Department of Media and Communication Studies, Faculty of Arts and Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia; 3School of Computer Science and Technology, Taiyuan University of Science and Technology, Taiyuan, Shanxi, People’s Republic of ChinaCorrespondence: Guangmei Fan, School of Computer Science and Technology, Taiyuan University of Science and Technology, 66 Waliu Road, Taiyuan, Shanxi, People’s Republic of China, Email [email protected]: Operating room (OR) nurses frequently experience work-related musculoskeletal disorders (MSDs) and psychological strain due to prolonged static postures, repetitive movements, and high-stress conditions. While short-term benefits of microbreak interventions have been demonstrated, evidence on their long-term effectiveness and impact on patient safety remains limited. This study aimed to evaluate the sustained effects of structured microbreaks on MSD outcomes, psychological wellbeing, and patient safety, and to explore organizational factors influencing intervention adherence.Methods: A nonrandomized, controlled, multicenter mixed‑methods study, six-month follow‑up (N = 178 analyzed) was conducted in five hospitals in Shanxi Province, China. Ninety-one OR nurses received a structured microbreak intervention (2– 3-minute breaks every 30 minutes during procedures > 60 minutes, including ergonomic exercises and mindfulness practices), while 87 served as controls (analyzed cohorts after attrition). Quantitative data (Nordic Musculoskeletal Questionnaire, Perceived Stress Scale, Maslach Burnout Inventory, patient safety metrics) were collected at baseline and six months. Qualitative data were gathered through semi-structured focus groups and interviews with intervention participants.Results: Compared to controls, intervention nurses experienced significantly greater reductions in MSD prevalence (− 20.9 vs − 5.7 percentage points, p < 0.01) and pain intensity (p < 0.001), alongside marked improvements in perceived stress (− 4.4 vs − 0.6 points, p < 0.001) and burnout dimensions (emotional exhaustion: − 6.3 vs − 0.8 points, p < 0.001). Improvements in patient safety metrics were also observed, with larger reductions in medication errors (− 7.4% vs − 2.5%) and surgical site infections (− 5.2% vs − 1.6%), and increased patient satisfaction scores (+1.5 vs +0.5 points, p < 0.01). Qualitative findings highlighted leadership engagement, clear protocols, and cultural integration as key facilitators, while emergency cases and staff shortages posed barriers. Adaptive strategies, such as flexible scheduling, supported sustained implementation.Conclusion: Structured microbreaks yielded sustained improvements in MSD outcomes, psychological wellbeing, and patient safety, with organizational support and adaptability proving crucial for long-term success. Integrating microbreaks into routine OR workflows may enhance nurse health, reduce errors, and improve patient care quality, offering a strategic, resource-feasible intervention for high-stress healthcare settings. Findings support embedding microbreaks into standard operating procedures and orientation, using leadership role‑modeling, brief “buddy” coverage, and lightweight prompts to optimize fidelity at scale.Keywords: microbreaks, musculoskeletal disorders, occupational health, operating room nurses, patient safety, mixed-methods