The health care industry contains some of the most hazardous occupations in the United States (Moeller, 2011). Workers in the health care industry have one of the highest rates of lost work days and, according to Moeller (2011), the highest number of workers’ compensation claims for back injuries is filed by nurses and nurses aids. Overexertion (usually caused by lifting heavy medical equipment or through moving and repositioning patients) is the leading cause of injury among health care workers, with slips, trips, and falls (STFs) the second leading cause (Centers for Disease Control and Prevention [CDC], 2010). STFs are also the second most common cause of lost work days in hospitals (CDC, 2010).
A recent study by Yeoh, Lockhart, and Wu (2013) analyzed Bureau of Labor Statistics data on nonfatal fall-related injuries in the workplace between 2008 and 2010. This study provided additional insight into STFs among health care workers. Key findings of the study concluded that workers in the nursing-related profession had the highest workplace injury rates due to falls; over 90% of injured workers were female, and more than 50% were between the ages of 45 and 64 years (Yeoh, Lockhart, & Wu, 2013). A higher percentage of falls in health care professions occurred at night as compared to other professions, and the most common resulting injuries were sprains and strains, mostly affecting the lower extremities (Yeoh, Lockhart, & Wu, 2013). One fourth of the health care workers who were injured because of a fall between 2008 and 2010 required 30 or more days to recover (Yeoh, Lockhart, & Wu, 2013).
The same data analyzed by Yeoh, Lockhart, and Wu (2013), as well as an earlier study by Bell et al. (as cited in CDC, 2010), are at the heart of an education campaign for health care workers developed by the CDC and the National Institute for Occupational Safety and Health (NIOSH). The program also guides health care facility administrators, and others responsible for safety in health care facilities, to implement prevention programs. Bell et al. (as cited in CDC, 2010) identified the top ten causes of STFs, with the top three being contaminants (i.e. water, grease, and other fluids) on the floor, improper drains and pipes that make floors and walkways wet and slippery, and walking surface irregularities (i.e. bunching or loose carpet, cracked or missing floor tiles, and uneven floors or walkways). Two other top causes of STFs are inadequate lighting and tripping hazards such as rugs, electrical cords, wires, and medical tubing (Bell et al. as cited in CDC, 2010). Identifying the leading causes of STFs among health care workers makes it easier to prevent workplace injuries. Safety guidelines for wet floors (i.e. reporting spills, placing warning signs, and effective clean up procedures) and routine safety checks for walking and tripping hazards can significantly reduce the risk for falls and related injuries (CDC, 2010).
Preventing falls, however, is only one of three important steps in addressing workplace injuries related to falls. The prevention strategies recommended by the CDC and NIOSH address the issue in the pre-event phase. William Haddon developed a matrix for analyzing accidents that divides then in to pre-event, event, and post-event stages and considers three factors in each phase: the people involved, the equipment they use or come in contact with, and the environment in which the people and equipment operate (Moeller, 2011). The matrix can be used as a tool for reducing the risk of injury, providing a framework to identify actions and strategies for each factor involved in the three phases of an accident (Moeller, 2011). In the pre-event stage, an example of a human factor is fall prevention training for staff members; an example of an equipment factor might be making sure that electrical cords are secured and that they do not cross walkways; an example of an environmental factor is ensuring adequate lighting in the work area. During the event-phase of a fall, a person might be trained in “safer ways to fall” techniques, such as rolling to prevent serious injury; if possible, equipment could be moved out of the way, and emergency call buttons can be available in the environment so that help can be summoned when needed. In the post-event stage, persons involved in a fall should receive immediate medical care as well as follow-up, even if injuries are minor or not immediately apparent; both equipment and the environment should be examined for damage and routine safety checks of the equipment and area should be conducted to prevent additional events and injuries.
The strategies that would be most effective in preventing fall-related injuries occur in the pre-event stage. Providing fall prevention training to all workers and keeping equipment and the work environment safe of STF hazards are the best ways to reduce the number of falls among health care workers (CDC, 2010).
Centers for Disease Control and Prevention [CDC]. (2010). Slip, trip, and fall prevention for healthcare workers [Publication Number 2011–123]. Washington, DC: Department of Health and Human Services, National Institute for Occupational Safety and Health.
Moeller, D. W. (2011). Environmental health (4th ed.). Cambridge, MA: Harvard University Press.
Yeoh, H., Lockhart, T., & Wu, X. (2013). Nonfatal occupational falls among U.S. health care workers, 2008-2010. Workplace Health & Safety, 61(1), 3-8. doi:10.3928/21650799-20121221-52