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Identifying Risk Factors of Falls among B.C.’s Healthcare Workers*
RS2008-DG05
Final Report Date: March 2010
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For more information about this project, please contact Hasanat Alamgir or Dave Keen
*In partnership with the Saskatchewan WCB and the Workplace Health, Safety & Compensation Commission of Newfoundland and Labrador (WHSCC)
Issue
This study examined data on workplace falls among healthcare workers in a large B.C. health region, to identify the factors leading to fall related injuries and report the associated compensation costs and days lost from work. Monitoring workplace falls in healthcare is critical to understanding the size of the problem, characterizing trends, estimating the economic burden, improving knowledge among health professionals, policy makers and the workers, and designing, implementing and evaluating appropriate interventions.
Key findings
- Rates of health care worker falls and resulting compensation costs and days lost increased over the three years included in the study.
- The risk of experiencing a fall was significantly higher for workers in Long-Term Care, Facility Support Services, Community Health, and Maintenance, and for females and older workers.
- The activities that most commonly contribute to falls are walking or running, reaching for things and pushing/pulling medical equipment. Key contributing factors are the floor (slipperiness, uneven surfaces and floor mats), the outdoor environment and temperature (slippery/icy conditions).
- Based on the findings, the researchers recommend making fall prevention for health care workers a priority, with attention to the groups of workers at higher risk and the contributing factors identified in the study.
Objectives
- To identify the factors that lead to fall related injuries in health care workplaces
- To report associated compensation costs and days lost from work
Methods
The study examined data on health care worker falls and injuries for a three year period (2004–2007). These data were obtained from the Workplace Health Indicator Tracking and Evaluation (WHITE™) Database, a web-based surveillance system to facilitate the analysis of workplace incidents and injuries and identify priorities for prevention. The WHITE™ accident data were linked with workers’ compensation and payroll data to enable an analysis of compensation costs and days lost. All data used in this project were anonymous, to protect the privacy of individuals.
Data analysis included an examination of worker demographics, occupation, location of accidents, time and seasonal patterns, contributing environmental factors, compensation costs, time lost, and trends in compensation costs and days lost.
Results
- Rates of health care worker falls, compensation costs and days lost increased within this health region over the three years included in the study.
- The risk of experiencing a fall was significantly higher for workers in Long-Term Care, Facility Support Services, Community Health, and Maintenance, and for females and older workers.
- Activities that contribute to falls include walking or running followed by reaching for things and pushing/pulling medical equipment.
- Key contributing factors are the floor (slipperiness, uneven surfaces and floor mats), the environment and temperature (outdoor, slippery/icy conditions).
- The majority of the fall incidents resulted in injury to the upper extremity, which includes the chest, shoulders, arms and hands. The next most commonly affected major body part was the lower extremity, which includes the buttocks and lower limbs, and the next most common area was the head and neck.
- The median number of days lost for falls resulting in time loss workers’ compensation claim was approximately 14.8 days , with a median compensation cost of approximately $800. For Care Aides, the median number days lost for time-loss falls was 27.
Conclusions
The researchers conclude that the risk of falls for health care workers in this health region is increasing over time, and that fall prevention initiatives should be a priority. Specific recommendations include:
- Occupation-specific interventions that take into account the diversity of tasks performed, distribution of workload over the day, week, month and season and changing work environments
- A job task analysis to obtain detailed information on how the tasks are performed and suggest alterations
- Policy and prevention strategies that target Facility Support Services workers and Community Health workers (these workers were found to have a higher risk of falls)
- Examining and improving compliance with general housekeeping procedures for floors and drainage in dish-room, where most of the Facility Support Services worker falls occurred
- Hazard perception training and an appropriate footwear policy for Community Health workers, who experience most of their falls outside clients’ homes
- Evaluation of current housekeeping procedures, in light of facility-wide concerns about lack of proper signage (caution signs) and slow and inadequate cleanup
- Promotional campaigns to improve reporting of near miss fall incidents so that hazards can be pro-actively identified
Future directions
Areas identified for future research include:
- Survey or focus group research to explore the individual causes of slips and falls and plan effective interventions
- More detailed research on the occupational groups and departments with higher rates of falls
- Qualitative research to complement this quantitative study and gain valuable insights from workers and employers
Publications and presentations
Drebit S, Shajari S, Alamgir H, Yu S, Keen D. Occupational and Environmental Risk Factors for Falls among Workers in the Healthcare Sector. Journal of Ergonomics (in press).
Shajari, Salomeh. Presentation. Study of Fall Incidents Among Healthcare Workers. Northwest Occupational Health Conference, October 2008.
Drebit, Sharla. Poster Presentation. Work Related Falls in Healthcare – Who’s at Risk? BCEOHRN Annual General Meeting. November 20, 2009.
Drebit, Sharla. Poster Presentation. Work Related Falls in Healthcare – Who’s at Risk? BC Health Authorities Health & Wellness Conference. September 14 – 15, 2009.