1. GTRI_B-1 Preventing Slips, Trips and Falls in the Health Care Industry

2. GTRI_B-2 Defining the Problem Breakdown of Hospital Employee Injuries by Type Source: BLS 2009

3. GTRI_B-3 Top Causes of Healthcare Worker Slips, Trips, and Falls Housekeeping Maintenance/ EnvironmentEquipment Floor contaminantsPoor drainage Stepstools and ladders Tripping hazards Stairs and handrails Flooring surfaces Surface irregularities Mats Inadequate lighting Weather conditions

4. GTRI_B-4 Housekeeping Causes Contaminants: Water, grease, oil, fluid, food Tripping Hazards: Hoses, cords, medical tubing, materials, debrisSolutions 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-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

6. 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

7. GTRI_B-7 Equipment Causes Improper use of stepstools and ladders Flooring surfaces: Selection Condition Mats: Incorrect type Inadequate size/ length Poor placementSolutions 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-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

9. GTRI_B-9 It does work Worker’s compensation slip, trip and fall injury rates over time Source: Bell et al. 2008

10. 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 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 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

11. GTRI_B-11 Questions?