Staying on your feet

In 2008/09, in the health and social care sector alone, there were more than 1,800 major injuries caused by slips, trips and falls in the workplace and over 3,500 that resulted in workers having to take more than three days off work.
    
Failing to manage risks effectively can shatter lives, leaving employees and their families to pick up the pieces and businesses paying a heavy price. Slips, trips and falls in this sector cost British society around £50 million every year. Although, over the last 10 years there has been a sustained reduction in the number of fatalities caused as a result of falls from height in the workplace, it still remains the most common cause of fatal injury, with slips and trips the most common cause of major injury.
    
Peter Brown, HSE’s head of Division for Work, Environment, Radiation and Gas, said: “Making improvements doesn’t need to cost the earth and we are encouraging people to visit the Shattered Lives website, where they will be able to get simple and cost effective solutions to help manage slips, trips and falls hazards in their workplace.”
    
As part of the campaign HSE has developed two e-learning tools to identify risks and manage hazards in the workplace. STEP deals with slips and trips and WAIT with work at height. To use these tools visit www.hse.gov.uk/shatteredlives
    
Taking sensible measures to keep workplaces safe, protects staff and helps to give patients a good level of service. The cost of incidents may affect the delivery of high quality patient care and viability of the business. For example:

• patients being seriously injured through falls leads to additional medical costs and an increased stay in hospital, with implications for waiting lists and service delivery
• staff sickness absence due to slips, trips and falls at work, and other associated costs, such as staff replacement costs, will have a detrimental effect on budgets
• people may experience hardship as a result of loss of wages, as well as pain and suffering.

These incidents can be cut dramatically through planning and positive management during refurbishment and new build, together with good housekeeping. Employees should be consulted at an early stage, as they will have useful experience of areas where problems arise.

Causes of slips
The main causes of slips and trips incidents in healthcare are: slippery/wet surfaces caused by water and other fluids; slippery surfaces caused by dry or dusty floors; contamination, such as plastic, lint or talcum powder; obstructions, both temporary and permanent; uneven surfaces and changes of level, such as unmarked ramps. Other factors include poor levels of lighting and external glare; human factors such as employees rushing; running or carrying heavy/cumbersome items; the wearing of unsuitable footwear or the use of improper cleaning regimes.

In order to reduce slips trips and falls, it is recommended that you:

• Follow the free practical guidance offered by the e-learning tools, STEP and WAIT, at www.hse.gov.uk/shatteredlives
• Depending on the degree of risk and the size of business, develop a policy document but crucially ensure practical arrangements are in place, such as quickly cleaning up spillages and better still preventing spillage of water, oils, cardboard, waste etc onto the floor in the first place
• Remove any obstructions
• Avoid creating trailing cables
• Store goods safely
• Keep workstations clear of obstacles
• Make sure flooring materials are level and secure
• Mark slopes and changes of levels
• Ensure you have adequate lighting
• Wear sensible footwear
• Think about visitors to your workplace, what do they need to know? Do you need to do more to protect them?

Winchester and Eastleigh NHS Trust
After monitoring health and safety records, bosses for Winchester and Eastleigh NHS Trust recognised they had problems with slips and trips on wet hospital floors. Between 2002-2004 the Trust had to tackle in the region of 100 slips and trips from staff, all of which could be blamed on floors left wet after cleaning.
    
The Trust’s safety adviser had attended an HSE slips, trips and falls workshop in 2004, which reinforced the belief that more could and should be done. This prompted the Trust to look again at the areas where falls were occurring to identify trends. Around the same time the Trust was unfortunate enough to have a member of staff fall in a ward area after the floor had been mopped.
    
An inspector from the Health and Safety Executive recommended that changing the way mopping was done could reduce the risk of slips and trips. He suggested using a dry mopping system using micro fibre, would limit the amount of fluid on the floor.
    
Micro fibre mops are designed to pick up dirt and cling to it. Rather than saturating the mops, the mops are placed into a bucket and left to soak up the water and cleaning fluid. This reduces the amount of residue that is left on the floor during and after mopping. The staff were also advised to mop and dry the floor in sections before moving onto the next part of the ward, to provide safe access around the area.
    
Dean Bailey, safety advisor for Winchester and Eastleigh NHS Trust, said: “At first the housekeeping staff were reluctant to change to a system that they believed would take much longer. However, once we started to see a decrease in the number of people slipping and how easy it was to implement, they were more than happy with the new way of working.”
    
The Trust purchased 11 systems and trialed them for four weeks. The results were so dramatic they bought another six so they could roll the method out across all wards. Since the Trust implemented the system in April 2005 it has received one report of a slip/trip to date as a result of wet floors, which was reportable under RIDDOR, and an 85 per cent reduction in falls from the 100 reported in the previous two years.
    
Dean Bailey said: “Using HSE’s online risk assessment tools and having HSE on board was fundamental in reducing the slips and trips within our organisation. Without these tools and HSE support we wouldn’t have seen such dramatic results and made our wards safer for our members of staff and patients whilst maintaining our clean environments.”