GTRI_B-1

Preventing Slips, Trips and Falls in the Health Care Industry

GTRI_B-2

Defining the Problem

Breakdown of Hospital Employee Injuries by Type

Source: BLS 2009

GTRI_B-3

Top Causes of Healthcare Worker Slips, Trips, and Falls

HousekeepingMaintenance/ Environment Equipment

Floor contaminants Poor drainageStepstools and ladders

Tripping hazardsStairs and handrails

Flooring surfaces

Surface irregularities

Mats

Inadequate lighting

Weather conditions

GTRI_B-4

Housekeeping

Causes• Contaminants:

• Water, grease, oil, fluid, food

• Tripping Hazards:

• Hoses, cords, medical tubing, materials, debris

Solutions• Housekeeping / Organization procedures:

• Keep floors clean and dry

• Keep walkways clear

• Develop mopping procedures

• 5S

• Use mats where appropriate

• Wear slip resistant shoes

• Use cord organizers, covers, cable ties

• Position cones and barricades around hazardous areas

GTRI_B-5

Maintenance/ Environment

Causes• Drainage issues:

• Misaligned pipes

• Clogged drains

• Downspouts pointing into walkways

• Surface irregularities (indoor and outdoor):

• Warped/ buckled carpets

• Curled mats

• Damaged flooring

• Holes/ cracks

• Stairs/ handrails:

• Damage

• Improper or inadequate installation

• Poor marking

• Inadequate lighting

• Weather:

• Rain

• Ice

• Snow

GTRI_B-6

Maintenance/ Environment

Solutions• Drainage issues:

• Inspect and maintain pipes and drains

• Reroute downspouts to non-pedestrian areas

• Surface irregularities (indoor and outdoor):

• Replace/ re-stretch warped or buckled carpet

• Replace curled/ torn mats and secure edges to the floor

• Fill/ patch/ cover any indoor and outdoor holes, cracks, gaps, etc.

• Stairs/ handrails:

• Repair any damaged stairs and handrails

• Verify slip resistance of stair treads

• Keep the surfaces clean and dry

• Add additional handrails

• Create visual cues for elevation changes

• Inadequate lighting:

• Install additional light fixtures and/ or brighter bulbs

• Replace dead bulbs

• Use fixtures that emit light from all sides

• Weather:

• Promptly remove ice and snow from walking areas

• Distribute winter weather warnings

• Place labeled bins with ice-melt chemicals

• Utilize additional matts

• Slip-resistant footwear for outdoor workers

GTRI_B-7

Equipment

Causes• Improper use of stepstools and ladders

• Flooring surfaces:

• Selection

• Condition

• Mats:

• Incorrect type

• Inadequate size/ length

• Poor placement

Solutions• Stepstools and ladders:

• Train employees on proper selection and use

• Provide adequate equipment

• Place damaged equipment out of service

• Flooring surfaces:

• Measure surface friction for high traffic areas

• Apply friction coatings or install new flooring

• Maintain floors per manufacturers instruction

• Mats:

• Select appropriate mat for application

• Ensure adequate length and size

• Place additional mats during severe weather

• Secure mats from moving

GTRI_B-8

Put it all together

- Review your injuries and incidents

- Perform a baseline hazard survey

- Set goals

- Train your employees

- Develop and implement housekeeping procedures

- Perform routine inspections

- Address any physical hazards

- Review your injuries and incidents

- Review your inspection reports

- Compare with your goals

- Determine the root cause of any gaps between performance and expectations

- Implement a plan to bridge the gaps

Plan

Act

Check

Do

Develop a program

GTRI_B-9

It does workWorker’s compensation slip, trip and fall injury rates over time

Source: Bell et al. 2008

GTRI_B-10

Resources/ References• NIOSH Slip, Trip, and Fall Prevention for Healthcare Workers

• http://www.cdc.gov/niosh/docs/2011-123/pdfs/2011-123.pdf

• OSHA Healthcare Slips, Trips, and Falls eTool

• https://www.osha.gov/SLTC/etools/hospital/hazards/slips/slips.html

• Bell et. Al - Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees.

• http://www.ncbi.nlm.nih.gov/pubmed/18932056

GTRI_B-11

Questions?