Prevention Slips and Falls in the Healthcare Environment

1. Prevention Slips and Falls in the Healthcare Environment

2. Objectives Understand the importance of slips and falls Identify causes and contributing factors that lead to slip, trip, and fall accidents Describe elements of a slip and fall prevention program

3. Significance of Slips and Falls Over 540,000 slips and falls each year requiring hospitalization Slips and falls account for over 300,000 disabling injuries each year One in three serious bone breaks for seniors result in death, within one year of the accident. It is the second leading cause of accidental death and disability after automobile accidents. Slip and fall accidents account for 30% of all reported injuries. Statistic Sources: National Safety Council, Occupational Safety and Health Administration (OSHA), ADA, Architectural and Transportation Barriers Compliance Board,National Center for Injury Prevention and Control, Workers� Compensation Board, CMHC, American Society of Testing and Materials (ASTM), Canadian Injury Prevention Foundation, Health Canada, B.C. Injury Research and Prevention Unit, Smart Risk, International Sanitary Supply Assoc. (ISSA).

4. Anatomy of a Slip and Fall Slips and falls are usually caused by a combination of factors, not just a single cause Multiple factors include floor surface, shoe tread, and items on floors or stairs

5. Same Level Falls Most inside falls are caused by slipperiness related to: Faulty housekeeping Dirt, grease, or contamination on floors Defects Slippery floor dressing or finish Inappropriate floor surface or material Surface wear Uneven or damaged surface

6. Falls from Stairs Slips and fall from stairs can be caused by: Faulty housekeeping Objects, water, or grease on stairs or landings Defects No handrail Handrail at improper height Improper tread or riser dimensions Tread surface or materials

7. Other Major Causes Footwear traction Poor lighting Environment

8. Slips and Falls Prevention What can we do to prevent slips and falls? Hazard Assessments/Inspections Housekeeping Floor Mats Floor surface materials Floor surface treatments Footwear

9. Slips and Falls Prevention Process

10. Potential Dangerous Spots High loss areas�i.e. kitchens, bathrooms Transition Areas Unexpected changes in environment Distractions Contaminants Lighting and temperature Ramps

11. Measuring Housekeeping Hold first supervisors accountable for cleanliness in their departments Floor hazards must be periodically sampled and recorded with information given to managers (Unannounced inspections) Floor cleaning protocols must be tailored to the environment and floor material Congratulate best performing employees and departments Measure hazards or cleanliness as these are much more reliable indicators (as opposed to loss data)

12. Floor Mats Benefits Use at entrances and high contamination areas Traps moisture and debris Scrapes and adsorbs moisture, snow, and sand from footwear Reduces floor maintenance costs by protecting the floor finish

13. Floor Mats Need mats that both abrade and adsorb Mats need to be sufficient running length and width Snow � 10 to 12 walking steps Rain � 8 to 10 walking steps Dry � 6 to 8 walking steps Quick exchange of mats when dirty Should be a contrasting color to floor and affixed to prevent creation of an additional fall hazard

14. Floor Treatments Abrasive floor coatings Grit Size (Lower # = Larger Grit Size) 8 � 16 Ramps 16 � 30 General purpose

15. Abrasive Floor Coatings Grit Type (and Hardness) Silicone Carbide Al. Oxide Quartz 9.5 9.0 7.0 Bonding Material Epoxy resin Adhesive sheets Paint Cost/Durability High---------------------------------------------------------------Low

16. Floor Treatments Chemical Etching Ceramic tile, quarry tile, concrete Higher coefficient of friction (COF) When wet than dry When more heavily etched Waxes, polishes Limitations of COR data offered by manufacturers Durability an issue

17. Other Floor Surface Materials Carpeting Inherently slip resistant Aesthetically pleasing Some carpets are �spill resistant� Modular carpet squares allow quick replacement in areas which can become soiled easily

18. When Choosing Flooring What kinds of spills are likely? What are the sanitary requirements? Is noise a concern? Will the area have heavy traffic? Is it a normally wet environment? What equipment must the floor hold? How will the floor be cleaned? Are aesthetic effects a concern?

19. �Slip Resistant� Footwear Polyurethane microcellular sole material offers best slip resistance Some manufacturers have experience with slip testing of footwear Choose footwear appropriate to the environmental conditions Use may be hard to enforce

20. Prevention of Slips and Falls Prevention needs to address all: Knowledge of problem areas Selection of floor surface materials Maintenance and housekeeping Prompt removal of contaminants Footwear Selection and use of floor mats Training and Accountability!

21. Summary Slips and falls are a BIG problem Slips and fall accidents due to: Poor housekeeping Lack of traction Defects Lighting Ineffective slip and fall safety process/strategy