Every day, health care workers and patients are at risk for slip, trip and fall injuries. For health care workers, these injuries are the second-most common cause of lost workdays in hospitals and clinics. And they cost a lot more than just money. Lost production time, damage to an organization’s reputation, poor workplace morale and interrupted service are just some of the negative consequences of slip, trip and fall injuries.

The solution to avoiding these consequences is to either get rid of hazards altogether or control them. In addition to hallways and work areas, a patient’s room exposes workers to all sorts of fall hazards when medication is dispensed, food is served, and sinks, tubs and showers are used. Spills or liquids that are not cleaned, wet floors and misplaced clutter, such as a patient’s personal items and hospital equipment, can also contribute to fall incidents.

The good news is that slips, trips and falls are preventable. Understanding the hazards, applying solutions and implementing a comprehensive Slip, Trip, Fall Program are all actions that can help create a safer health care facility for employees and patients.

Understanding Fall Hazards

People only use 5% of their field of vision to look where they are walking. With this in mind, it is important to be aware of hazards that can lead to slip, trip and fall incidents – and remove them.

These fall hazards can be common within health care facilities:

• Contaminants on the floor – such as water, grease and other fluids – that make walking surfaces slippery.
• Drains and water pipes that are improperly aligned or clogged drains that cause liquid to spill onto walking surfaces.
• Irregularities of indoor walking surfaces – such as damaged, warped, buckled or uneven flooring – that can trigger an employee or patient to stumble.
• Clutter, loose cords, hoses, wires and medical tubing.
• Floor mats and runners improperly placed or used.

Creating a Slip, Trip, Fall Program

One of the problems with encountering a slip, trip and fall hazard is that employees do not consciously look for hazards. Hazards can also be unknowingly created when you’re in a hurry. In some cases an attitude of “it’s not in my job description to clean it up” can result in a co-worker becoming injured because of an ignored puddle on the floor or obstacle in the way.

This is where supervisors can play an important role in controlling the atmosphere of a workplace. For everyone’s safety, hazardous situations must be noted, reported and corrected immediately.

A lack of enforcement for situations that could result in a slip, trip or fall is one of the most common omissions causing falls.

Safety programs should include these measures to remove or control slip, trip and fall hazards:

• Train employees on the common hazards that can cause fall incidents.
• Provide a written procedure for reporting and cleaning / removing hazards.
• Require reporting of hazards to supervisors immediately.
• Charge everyone with the responsibility to remove hazards when they see them.
• Require or provide footwear that is appropriate for the work environment.
• Investigate every fall immediately – before conditions change or people forget what they saw. Be sure to find out what type of footwear was worn. This is an important element in determining what should be done to prevent a recurrence of the fall.
• Include a “safety attitudes and activities” section in employee performance reviews. After all, what gets measured gets done!

These additional guidelines should be included in formal policies and procedures for fall prevention:

• Implement a “walking surface” inspection program that concentrates on identifying and removing hazards on a regular basis.
• Straddle the spill by standing over it until the mess is cleaned up. This is a good practice to use in areas where wet conditions or spills are common.
• Keep floors clean and dry. Provide warning signs for wet floor areas. In addition to being a slip hazard, surfaces that are continually wet promote the growth of mold, fungi and bacteria that can cause infections.
• Keep absorbent materials, brooms, mops and containers located throughout the facility so that everyone can respond to spills appropriately and easily.
• Use prudent housekeeping procedures, such as cleaning only one side of a passageway at a time.
• Where wet processes are used, maintain drainage and provide false floors, platforms, mats or other dry standing places where practical, or provide appropriate waterproof footgear.
• Use no-skid waxes and surfaces coated with grit to create no-slip surfaces in slippery areas, such as toilet and shower areas.
• Keep all places of employment clean and orderly and in a sanitary condition. Eliminate cluttered or obstructed work areas.
• Keep aisles and passageways clear and in good repair, with no obstructions across or in aisles that could create a hazard. Provide floor plugs and/or strategically placed wall plugs for equipment so power cords do not run across pathways.
• Keep exits free from obstructions.
• Provide adequate lighting especially during night hours. Use flashlights or low-level lighting when entering patient rooms. Also ensure that good lighting is provided in hallways and stairwells.
• Use only properly maintained ladders to reach items. Do not use stools, chairs or boxes as substitutes for ladders.
• Use the handrails on stairs and maintain an unobstructed view of the stairs ahead.
• Eliminate uneven floor surfaces.
• Promote safe work in cramped working spaces. Avoid awkward positions and use equipment that makes lifts less awkward.
• Re-lay or stretch carpets that bulge or have become bunched to prevent tripping hazards.

Establishing a Safety Culture

Reducing injuries from slips, trips and falls is everyone’s responsibility. Helping employees understand that if we take responsibility for our own actions and follow protocols, we create an improved safety culture and safer facility for all co-workers and patients. A workforce that is healthy, injury-free and feels safe increases morale throughout the facility.