Disabled elderly old man patient with walking stick fall on floor and caring young assistant at nursing home, Asian older senior man falling down on lying floor and woman nurse came to help support
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Occupational Health and Safety Administration regulations “should be considered the starting point for any facility health and safety program,” according to presenters at a Thursday webinar by business management consulting firm WTW. 

But “while sometimes the OSHA citations and the OSHA regulations track with the actual risks we have in our facilities, quite often, there’s a number of other risks that we need to address that aren’t truly covered under OSHA,” said Tom Lauber, senior casualty risk, control specialist risk control and claims advocacy practice at WTW.

The presenters shared four areas that operators should be especially mindful of.

1. Eliminate slip-and-fall hazards.

“Slip and fall hazards are the top hazard in your exposure, and we need to manage them and make sure that they are addressed to prevent them from becoming a costly injury and also injuring a resident,” said Michael David, MS, CSP, senior risk control consultant,

risk control and claims advocacy practice at WTW. “Not only are slip and fall exposures common for residents, but they’re also a common exposure for employees that may be working in our community and our facilities.”

Strategies for minimizing slips and falls, he said, include installing handrails along corridors to give residents something to hold onto if they begin to lose their balance, keeping walkways clear of potential tripping hazards, and using a hoist or other device to help residents out of bed.

Additionally, David said, providers should ensure that carpets are not loose or frayed. 

“Over time, as the carpet gets a lot of wear and tear, it becomes an exposure. It creates a potential safety hazard where not only employees can get their foot caught in it, but also residents can get their foot caught in it. They can get their canes or walking devices could get caught in that and could cause a potential trip hazard in the community,” he added.

A simple falls prevention strategy, he said, is to put up a “wet floor” sign.

“I have seen this … not only in senior living, but I’ve also seen it in retail where somebody has cleaned the floor, the floor surface is still wet, and people come walking right through and slip. Although material … has been removed and cleaned up, the floor surface is still slippery and it’s not dry yet,” David noted.

2. Address garden and courtyard area safety hazards.

David said residents face unexpected hazards when they spend time outdoors in garden and courtyard areas. Sometimes, there is a slight drop from the walkway onto flower beds or lawn edging.

Operators, he suggested, should build up mulch beds and landscaping around them to eliminate a potential rough edge where somebody could slip and fall.  

3. Pay attention to contractor, housekeeping actions.

When deliveries are made, they should not be left in areas where residents have to maneuver around them, David said.

Although he said that most communities he encounters are mindful of eliminating those types of hazards, contractors may not be as diligent, and it is up to the provider to be.

“Also, when it comes to no obstructed hallways, we want to make sure that, obviously, we’ve been talking about housekeeping, keeping things free of clutter but also, we want to make sure that we have adequate space around the doorways,” David said.

4. Consider a safety alert system.

It’s impossible for staff members to watch all residents at all times, so safety alert systems are very important, according to David.

“If we don’t have a safety alert system and a resident falls, it could be a significant amount of time before somebody can assist that person,” he said. “And obviously, that creates a potential hazard and can make things more difficult than treating the injury if you do not have the ability to respond to somebody falling right away.”