Preventing Slips, Trips and Falls in the Health Care Industry by GTRI
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Preventing Slips, Trips and Falls in the Health Care Industry by GTRI
- 1. GTRI_B-‹#› Preventing Slips, Trips and Falls in the Health Care Industry
- 2. GTRI_B-‹#› Defining the Problem Breakdown of Hospital Employee Injuries by Type Source: BLS 2009
- 3. GTRI_B-‹#› Top Causes of Healthcare Worker Slips, Trips, and Falls Housekeeping Maintenance/ Environment Equipment Floor contaminants Poor drainage Stepstools and ladders Tripping hazards Stairs and handrails Flooring surfaces Surface irregularities Mats Inadequate lighting Weather conditions
- 4. GTRI_B-‹#› 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
- 5. GTRI_B-‹#› 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
- 6. GTRI_B-‹#› 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
- 7. GTRI_B-‹#› 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
- 8. GTRI_B-‹#› 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
- 9. GTRI_B-‹#› It does work Worker’s compensation slip, trip and fall injury rates over time Source: Bell et al. 2008
- 10. GTRI_B-‹#› 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/s lips.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
Notes de l'éditeur
- Slips, trips and falls is the second leading injury type in the healthcare industry in terms of frequency. The rate for slip, trip and fall loss time injuries is almost double what we see in the rest of private industry.
- This chart is a breakdown of hospital employee injuries by injury type. You can see that the biggest piece of this pie is allocated to overexertion, primarily related to patient handling. The second largest piece is slips, trips, and falls; and contact (generally infectious or communicable diseases) makes up the next largest piece. If you think of this in the context of the type of work in healthcare, this makes sense right? There’s a lot of moving of patients, a lot of moving around in general, and naturally, the patients are going to be sick, so there’s going to be an exposure. A lot of effort is put forth towards the contact exposures, or infection control-- and rightfully so. It’s not only a staff exposure, but a patient exposure. Slips, trips and falls are the same story. Patients are going to be exposed to the same hazards as your staff. And like infectious diseases, we can largely prevent slip, trip and fall incidents from occurring.
- Historically, conditions that cause slips, trips, and falls in the healthcare industry can be separated into four groups: Housekeeping Maintenance Environment And equipment We’re going to go through causes and solutions for each one of these areas.
- Housekeeping issues are fairly obvious, and in a healthcare setting can generally be divided into two areas: floor contaminants and tripping hazards. These are things like fluids on the floor, hoses, cords, or other materials in walkways. Some questions to ask concerning your facility are: Does your facility have written housekeeping procedures? Methods for barricading areas that have a hazard? Do you have procedures for reporting hazards? Does your facility implement 5S? 5S is one of the organizational principles of lean manufacturing, which is primarily focused in waste reduction. Essentially it boils down to everything having a place, and everything put in its place. You also want to use mats where appropriate, perhaps provide slip resistant shoes for employees frequently working in wet areas.
- Maintenance and environment issues could be things like: drainage issues that cause water to collect along walking paths surface irregularities or damage damaged or improperly installed stairs and handrails lighting issues or weather issues.
- For drainage issues, make sure you’re inspecting your pipes and drains to address any clogging issues. Look at any of your downspouts and see if they’re routed into walkways. Inspection can also reveal issues with surface irregulaties, stairs and handrails, and inadequate lighting. Looking at this from a management perspective-- do you have a process for inspecting and reporting these issues. If issues are reported or found, do you have a good process for ensuring the hazards are abated? Lastly, with regard to severe weather do you have a plan for addressing it. This could be things like additional mats for rain, winter weather warnings, special housekeeping procedures, or slip resistant shoe wear for employees working outdoors in hazardous conditions.
- Lastly, equipment usage and selection causes a large number of injuries in healthcare. Make sure that your ladders are in good condition, that there’s an adequate amount, and that employees are trained to use them. Flooring surface selection and maintenance is also important. Marble floors look nice, but they have a very low surface friction so they are probably not an ideal choice for areas like kitchens, bathrooms, and entryways. Also look at flooring surface transitions, making sure that there’s not a drastic change from something like a carpeted surface to a slick surface. And of course, make sure your floors are properly maintained. And lastly, while we discussed that mats can solve some of these issues they can also create some. If you putting down mats in wet areas, try to select ones with a beveled edge so that they don’t create a trip hazards. At your entryways, make sure the mats are long enough. And where you have heavy foot traffic, consider taping down the corners to prevent them from folding up.
- Knowledge of the hazards alone is obviously not enough. In order to effectively reduce these injuries, an effective management program is needed. This chart follows Dr. Deming’s plan-do-check-act continuous improvement methodology. The process can be general described as: PLAN: Finding out what’s causing the injuries, and create goals DO: Creating programs and to address the hazards and actually fixing them CHECK: Checking your results to see how if you’re meeting your goals ACT: Fine tuning your program to meet your goals if you missed them, or so you can create newer loftier ones. From here you would proceed back to the planning phase.
- This illustration shows that with properly directed efforts, you will make an impact. The graphic is a comparison of a group of facility’s slip, trip, and fall worker’s comp rates before, during, and after they implemented a program to address these injuries. (Study conducted by NIOSH) Comparing the before and after groups, we can see that the injuries were more than cut in half.
- Additional references in the lesson plan.