Welcome to this session on how to prevent slips, trips, and falls for healthcare workers. This session is for all employees.

Slips, trips, and falls are among the most common causes of injury on the job and at home. Everyone slips, trips, or falls on occasion. We tend to shrug off these accidents as just clumsy embarrassments. But they can result in serious and painful injuries.

We all need to recognize slip, trip, and fall hazards on the job and take proper precautions to prevent these accidents so that we can protect ourselves and our coworkers as well as our patients and visitors to our facility.

Session Objectives

The main objective of this session is to help you avoid slip, trip, and fall hazards and prevent accidents. By the time this session is over, you will be able to:

• Recognize slips, trips, and falls as a serious safety problem;
• Identify slip, trip, and fall hazards on the job;
• Avoid and eliminate slip, trip, and fall hazards;
• Use stairs and ladders safely to avoid falls; and
• Minimize injuries if you do fall.

What You Need to Know

During the session, we’ll discuss:

• Frequency and types of slip, trip, and fall injuries;
• Common causes of slips, trips, and falls;
• How to prevent slips, trips, and falls;
• How to prevent falls on stairs and from ladders; and
• What to do if you fall.

Injury Statistics

Let’s begin by looking at some statistics about workplace slips, trips, and falls in hospitals.

• According to the U.S. Bureau of Labor Statistics, the incidence rate of lost-workday injuries from slips, trips, and falls on the same level in hospitals was 38.2 per 10,000 employees, which was 90% greater than the average rate for all other private industries combined (20.1 per 10,000 employees).
• Slips, trips, and falls as a whole are the second most common cause of lost-workday injuries in hospitals.
• Patients and visitors are also at risk of slips, trips, and falls in our facility unless we take proper precautions to protect them.

 

Types of Injuries

Usually slips, trips, and falls are minor and don’t result in injury. But sometimes these accidents are serious. As we said earlier, some are permanently disabling. And injuries can occur whether you fall from a height, like a ladder, or just slip or trip on ground level. Injuries resulting from slips, trips, or falls include:

• Back or spine injuries that can cause paralysis in the most serious cases;
• Head injuries that can include brain damage in the most serious cases;
• Muscle strains;
• Sprains and torn ligaments;
• Broken bones; or
• Even death—remember someone dies in a fall on the job practically every day.

Think about a slip, trip, or fall you or a coworker has had. What kind of injury resulted?

Common Causes of Slips, Trips, and Falls

Common workplace hazards that lead to slips, trips, and falls include:

• Not keeping work areas neat and orderly, not picking things off the floor, and so on;
• Poor visibility caused by inadequate lighting or burned out lights in halls, stairwells, and outside;
• Not watching where you’re going or carrying something you can’t see over; • Running or walking too fast; and
• Spills and wet floors.

Common Causes of Slips, Trips, and Falls (cont.)

Other common hazards include:

• Clutter on stairs or in walkways;
• Open drawers in offices, kitchens, labs, supply rooms, and other places;
• Uneven, defective flooring, worn stairs, or worn spots in carpets that nobody has bothered to report or fix;
• Failure to use handrails when going up or down the stairs;
• Lack of caution on ladders; and
• Wearing shoes that are not appropriate for the workplace or the job.

Take a moment to consider all the slip, trip, and fall hazards in your work area or anywhere else in the facility.

Eliminate Trip Hazards

You don’t have to fall from a great height to get injured. Many fall injuries occur on level ground when people trip over unexpected objects in their path. Here are some important ways to help eliminate trip hazards:

• Keep your work area neat and tidy. Put things away after use;
• Pick up items from the floor, even if you didn’t put them there;
• Step over or around obstructions, not on them;
• Walk slowly and change directions slowly, especially when carrying a load;
• Watch for changes in floor level—such as a few steps or a ramp up or down; and
• If lighting is inadequate or bulbs are burned out, report the problem to maintenance right away. Outside, use a flashlight at night if you need more light coming to or going from the facility.

Eliminate Trip Hazards (cont.)

Here are some additional tips for eliminating trip hazards:

• Don’t leave boxes, bags, tools, or other materials on the floor;
• Don’t block walkways with carts, wheelchairs, or other equipment;
• Don’t leave cords or power cables in walkways;
• Don’t place anything on stairs; and
• Don’t leave drawers open.

Can your think of any other steps you could take to eliminate trip hazards in your work area?

Watch Out for Slip Hazards

It’s easy to slip on wet or smooth surfaces, and down you go! To avoid slip hazards, be sure to remember these important tips.

• Clean up spills, drips, and leaks immediately, whether they are in halls, patient areas, laundry, food service areas, lab, pharmacy, or anywhere else you find them. If you can’t do it yourself, report the problem to housekeeping and ask them to take care of it right away.
• Put up signs or barriers to warn people when floors are wet, slippery, or otherwise hazardous.
• Also put mats down on wet days near entryways to help keep floors dry.
• Wear sensible shoes with nonskid soles, and wipe your feet when you come inside if they’re wet from outside.
• On wet or slippery surfaces, walk slowly and slide your feet.
• Finally, be sure to report icy spots outside right away so that they can be sanded.

What other steps could you take to eliminate slip hazards in your work area?

Keep Alert and Use Common Sense

Of course, one of the best ways to prevent slips and trips is to keep alert and use common sense.

• Always be alert to all the potential slip and trip hazards.
• Pay attention to where you’re going. Watch for potential hazards.
• Make wide turns at corners. If you try to take a sharp corner and plant your foot to cut and turn, that foot could be planted on a slippery surface and cause your feet to slide right out from under you.
• Adjust your stride according to the walking surface. Slow down on slippery surfaces, ramps, stairs, or in areas where there are obstructions in your path.
• And, when carrying objects, do not carry so many items that your forward vision is blocked. Make sure you can always see the floor in front of you, especially when traveling up and down stairs or ramps.

 

 

Slip, Trip, & Fall Hazards

Now it’s time to ask yourself if you understand what we’ve discussed so far about slip, trip, and fall hazards.

It’s important for your safety that you remember this information and act on it every day on the job.

Now let’s continue to the next section, where we’ll talk about avoiding falls on stairs and from ladders.

Be Careful on Stairs

Stairs can be dangerous, especially if you’re not taking precautions.

• Always be sure to hold onto the handrails going up or down. Even the most athletic person can trip on the stairs and fall. The handrail gives you that extra point of contact.
• Walk up and down stairs. Running or jumping just increases the possibility of falling.
• Inspect the steps for slippery surfaces, such as wet spots caused by spills. Check for damaged steps. Be careful on carpeted steps because they can also be slippery.
• Avoid putting objects on stairs. Many people have the habit of putting objects that they intend to take upstairs later on the bottom steps of the stairs. However, someone else unaware of the object could fall or trip over it.
• Finally, be especially careful when carrying objects while going up or down stairs. Try to leave one hand free for the handrail.

Think about a stair accident that you’ve had or heard about. How could this accident have been prevented?

Choose the Right Ladder For the Job

Preventing falls from ladders starts with choosing the right ladder for the job.

• For example, a step stool might be just what you need to safely get to an item on a shelf that is just out of reach.
• For getting to higher places, use a stepladder. You should have several different heights to choose from.
• If you need to go higher, don’t stretch or overreach. Instead, use a straight ladder of the right height.
• If you need to go even higher, use an extension ladder.

What are some of the jobs you perform that require you to use a ladder? What different kinds of ladders do you choose?

Ladder ‘Don’ts’

Here are some things you should never do when using a ladder:

• Don’t stand on the top two steps of a stepladder or the top three rungs of a straight or extension ladder;
• Don’t use a box or chair in place of a ladder;
• Don’t join two short ladders together to form a longer ladder; and
• Don’t place a ladder on boxes or barrels to gain height.

Think about any ladder accidents you had or heard about. What caused the accident? Was it one of these mistakes or some other kind of risky behavior?

 

Set Up Ladders Correctly

You must know how to set up the ladder correctly to prevent falls.

• Place a ladder on a firm, level surface, and check to make sure it’s stable. Use wide boards under a ladder if the ground is soft.
• Never set up a ladder in front of a door unless the door is locked or a guard is posted on the other side.
• Make sure the braces on stepladders are fully extended and locked in place.
• Position straight and extension ladders so that the bottom of the ladder is 1 foot from the wall for every 4 feet of height. An easy way to remember the 4-to-1 rule is to divide the number of rungs from the bottom of the ladder to the support point at the top by 4. For example, 12 rungs divided by 4 equals 3. Place the bottom of the ladder 3 feet from the wall. Also, regardless of the height of the ladder, always be sure it extends at least 3 feet above the landing level. And be sure extension ladder locks work properly.
• Never lean a ladder against a surface that isn’t strong enough to support your weight or an object that might move.
• And finally, be sure to secure straight and extension ladders at the top and bottom.

Climb and Descend Safely

Even if the ladder is set up correctly, you also have to climb and descend safely or else you could fall. Here are some safety tips to remember:

• Wear shoes with clean nonskid soles—not leather soles;
• Allow only one person on a ladder at a time;
• Face the ladder when climbing up or down, holding the side rails with both hands;
• Carry tools up or down on a belt, shoulder strap, or with a rope or hoist; and
• Hoist up materials once you are firmly fixed atop the ladder.

Climb and Descend Safely (cont.)

Here are some more tips for climbing, descending, and working on ladders safely:

• Always maintain three points of contact with the ladder while ascending and descending―two hands and one foot or one hand and two feet.
• Work with one hand on the ladder, keeping tools and materials in a hanger or holder;
• Keep your body centered on the ladder as you work;
• Don’t overreach—get down and move the ladder instead;
• Move slowly and cautiously, and never move the ladder while you’re on it; and
• Never slide down a ladder.

Inspect Ladder Before Each Use

Ladders should be inspected before each use to make sure they are in good, safe condition. For example, check to make sure that:

• Joints between the steps and side rails are tight;
• Hardware and fittings are secure;
• Movable parts operate freely;
• Rope on extension ladders is in good condition;
• Safety feet and locks are in good condition; and
• Rungs and steps are free of grease and oil.

Do you always inspect a ladder before use? You should. It takes only a minute, and it could save you from suffering a painful injury.

What to Do if You’re Falling

If a fall occurs, you can minimize injury by falling correctly. Here’s what to do:

• Bend elbows and knees to absorb the shock of the fall;
• Roll with the fall;
• Protect your head by tucking toward a collarbone;
• Use your hands and the insides of your forearms to help break the fall; and
• Yell or exhale as you fall. The reason for this is that you’re better off in a fall if your body is relatively loose and relaxed. Yelling or exhaling helps accomplish this goal.

Think about a fall you’ve had. Did you use this technique to minimize injuries? If not, remember it so you can use it next time.

What to Do if You’re Injured

Sometimes, no matter how hard you try to prevent it, you will fall. If you are injured—no matter how minor you think it is—be sure to:

• Report the incident to your supervisor. Your supervisor must know about any employee injuries. They may have to be recorded. Your supervisor also needs to know so that any hazards that may have caused a slip, trip, or fall can be corrected. Don’t worry, you won’t be blamed or penalized for reporting an incident.
• Get medical attention. Falls can cause serious physical problems if injuries are untreated. With the proper treatment you can be back on your feet and free of pain much more quickly.
• And be sure to follow doctor’s orders. Take prescribed medications. Give injuries time to heal. Participate in recommended physical therapy.

You should always report workplace accidents—no matter how minor. If you’re not sure how to report an accident, ask your supervisor about the proper procedure.

Stair and Ladder Hazards

Do you understand the points we’ve made about using stairs and ladders safely to prevent falls? This information is important to your safety. Many falls and injuries at work and at home involve stairs and ladders. Now is a good time to go back and review anything that isn’t perfectly clear before we finish the session.

Key Points to Remember

Here are the main points to remember from this session on slips, trips, and falls:

• Keep walkways clean and clear;
• Clean up spills promptly, and pick up trip hazards from the floor;
• Make sure stairs and ladders are safe, and use them carefully;
• Walk slowly, watch where you’re going, and wear proper shoes; and
• Don’t carry loads that block your vision.

This concludes the How to Prevent Slips, Trips, and Falls for Healthcare Workers training session.