Slips, Falls and Outdoor Hazards

Slips, trips, and falls (STFs) are a significant problem for healthcare workers and can result in serious injury and occupational injuries that cause time off from work. STFs are the second leading cause of serious injury among hospital workers, with overexertion being the first leading cause of nonfatal occupational injuries and illnesses according to the United States Bureau of Labor (BOL).

The most common injuries are back injuries, twisted ankles, and knee strains. However, depending on how a person falls, so are fractured wrists and muscle tears. Preventing slips and falls is a concern that should be addressed by every employer and an important issue for workers, visitors, and the public.

According to the U.S. Department of Labor, slips, trips and falls make up the majority of general industry accidents, which account for:

  • 15% of all accidental deaths per year, the second-leading cause behind motor vehicles
  • About 25% of all reported injury claims per fiscal year
  • More than 95 million lost work days per year — about 65% of all work days lost

What is causing these injuries? They may be due to multiple factors, including wet floors, low-profile equipment and cords, poor lighting, improper footwear, improper drainage, and adverse weather conditions.

Planning Ahead

Floor safety management plans should include comprehensive documents that identify problem areas as well as procedures to reduce exposure to slip, trip, and fall injuries. According to a 2010 report by the National Institute of Occupational Safety and Health (NIOSH), implementing a comprehensive STF prevention program could reduce workers’ compensation claims by 59%.

Planning and prevention starts with identifying hazards. Home healthcare settings are prime places for trip injuries in particular. Loose cords, wires, crowded work spaces, and standard home risks such as pets, stray objects, etc. all present significant exposures. Safety managers must also examine the outdoor setting of the home that their employees are going to for care visits. Is the area exposed to inclement weather conditions such as ice and snow? Are there uneven sidewalks or deep cracks that cause outdoor surfaces to be unsafe?

It’s not always possible for one designated safety manager to be aware of all the hazards that exist for STF accidents in the home healthcare industry. This is why it’s important to have multiple personnel involved in planning a prevention strategy; from nursing and risk management supervisors that do in-home assessments before employees are assigned, to insurance advisors, the entire staff plays an integral role in identifying problems areas that may not have been noticed during an initial walkthrough by a safety manager.

Maintaining Attentiveness

One of the leading causes of slippery floors is ineffective care and maintenance. Improper cleaning could cause problems, and even cleaning too much or using the wrong type or amount of cleaner could also create hazards. When training staff on how to maintain attentiveness the following points should be addressed:

  • Keep all walkways clean and clear
  • Clean up spills promptly and pick up trip exposures from the floor
  • Use stairs and stepstools carefully
  • Walk slowly, watch where you are going, and wear proper foot attire
  • Don’t carry equipment or loads that block your vision
  • When tending to a patient ensure there are no entanglement hazards present

The end goal with a STF training program is to ultimately avoid these types of injuries, or at least minimize injuries if a fall occurs. Of course, not all accidents are avoidable, which is why it’s imperative that all home healthcare organizations invest in a robust Workers’ Compensation program.

Wear Proper Shoes

The shoes we wear can play a big part in preventing falls and are a critical component of PPE. The slickness of the soles and the type of heels worn need to be evaluated to avoid slips, trips and falls. Shoelaces need to be tied correctly. Whenever a fall-related injury is investigated, the footwear needs to be evaluated to see if it contributed to the incident. Employees are expected to wear footwear appropriate for the duties of their work task. Nurses who assist patients in the shower can be provided positive-grip shoe covers so they do not slip or fall.

Pathways must be kept clear, particularly of low-profile equipment and cords that can be overlooked in patients’ rooms, hallways, operating rooms, or other care areas. Lighting must be adequate to visualize pathways, particularly stairways, when supplies or other items are being carried. Outside parking areas and entrances/exits must have proper lighting to aid personnel traversing the area.

Seasonal Safety Hazards

Walkways, ladders, and work platforms present seasonal slip-and-fall hazards due to snow, ice, and rain. It’s important to evaluate your equipment and employee needs before each new season begins. For example, devise a team of volunteers or employees to handle snow- and ice-removal emergencies, and stock up on salt and shovels before the winter season.

Be sure to consider:

  • Snow and ice. Clear snow and ice from emergency exits, outdoor staircases, walkways, and parking lots as soon as possible. Evaluate downspouts to ensure runoff does not form ice buildup on sidewalks or parking areas.
  • Rain. Keep floors dry and alert people to potentially slippery surfaces in the event of rain. Entryways and hallways become slippery when wet, but also consider potentially dangerous outdoor areas, such as ramps. Preplanning and vigilance can help prevent a majority of slips and falls.

For more on our Workers Compensation and General Liability Insurance compensation risk pool program contact Brian Wilkins at USI – 603-365-8137.