Floor surface, cleaning agents make a difference

Russell Kendzior, executive director of the National Floor Safety Institute (NFSI), offers this advice on how proper floor maintenance can reduce falls in health care facilities:

Consider the choice of floor surfaces, especially when remodeling.

The particular type of flooring can make a big difference in the risk of falls. Some flooring is more slippery or slip-resistant, and others can react differently when a liquid is spilled. Consult with flooring experts to find the best product for your budget. Insist that floor safety be made as big a priority as aesthetics.

Some problems with floor surfaces are hard to imagine until you do the research. High-gloss floors, for instance, look pretty but can be difficult for older patients. The glossy surface challenges their depth perception, leading to falls, so many nursing homes have switched to low-gloss flooring. Keep that in mind when choosing how floors are maintained also. The housekeeping department may think they’re doing a good job by making floors extra shiny, but not if you’re trying to prevent falls.

Select cleaning agents very carefully.

What you put on the floor makes a huge difference in reducing or increasing the risk of falls. Health care facilities usually focus on sanitizing the floors, but sanitizers are not cleaners, Kendzior says. Even worse, they often leave a slippery film behind.

Health care providers also focus on odor control, so they choose products that mask offensive smells, he says. The first thing that hits you when you walk in the door is a strong scent such as pine. But the effect on floor safety can be tremendous, he says. Pine oil cleaners can drop slip resistance by 40%.

Work closely with housekeeping and engineering to choose products that actually accomplish what you want — cleaning.

"In the past 50 years, the floor cleaning industry has convinced us that you can tell how clean a floor is by how it smells or how shiny it is. That’s an American perception that has been marketed down our throats for many years," he says. "The fact is that the smell of clean is no smell at all. And shiny doesn’t mean anything about how clean it is. Many shiny floors actually aren’t clean at all."

Develop a proactive auditing program for your floors.

Randomly test walkways and floors for slip resistance. The testing will reveal if certain areas are more prone to being slippery and, if so, you can focus on that area to determine why and how to lower the risk.

Kendzior recommends random auditing of floor surfaces throughout the facility on a monthly or quarterly basis. If someone slips and falls, bring in all the auditing statements to show there was no reason to expect a fall in this location.

"The plaintiff’s attorney will go to the nth degree to show that you didn’t care and didn’t do anything to prevent this injury, and auditing can be a tool to counter that," he says.

Such testing once required an engineering consultant and could be quite expensive, but the NFSI now offers an electronic tool that tests for you. The Universal Walkway Tester operates like a small robot and produces a visual reading on its display and a paper printout. Cost is $4,295, but can be rented for $500 per week. (For more information, see the NFSI web site at www.nfsi.org.)

When analyzing slip resistance, Kendzior says health care risk managers should shoot for a sweet spot of between 0.6 and 0.7 static coefficient of friction. Remember that a higher coefficient isn’t necessarily better. Anything above that level, like carpet, can be a tripping hazard.

Anything below can lead to slipping.