keys to preventing falls in senior living environments

Nano-Grip should be incorporated into every senior living facilities strategy to keep residents safe from the dangers of slipping on wet surfaces. This inexpensive, invisible treatment will make tubs, showers, and tile floor surfaces less slippery when they are wet than when dry. In addition to the the safety of their clients, senior facilities can ensure compliance with ADA requirements, and shield themselves from claims of legal negligence as well.

Preventing Falls Can be Within Your Power

September 19, 2013

by Lois A. Bowers, Senior Editor Long-Term Living Magazine

Three keys to preventing falls in senior living environments are staff members’ awareness of challenges facing residents, a belief that they can help address some of

those issues, and their taking action based on that belief, says Lynn Beattie, vice president of injury prevention at the National Council on Aging.

“Everyone has a role to play and a contribution to make in fall prevention, as long as they have some education,” she says. “Within their sphere of influence, they can make a difference.”

Vision is a major risk factor associated with falls, says Beattie, who leads the national Falls Free Initiative and is involved with many projects related to falls prevention.

“As we age…you have less light entering the eye, and so it’s harder to see in darkened areas, it’s harder to see contrasting edges, it’s harder to see slips and spills, it’s harder to see the brick or sidewalk that might be sticking up. So just by aging alone, an increased risk [exists] around vision,” she says. “And vision is part of your balance system. It’s also is how you interact with the environment, which may be unsafe. So it’s all integrated.”

If a resident falls, he or she should be examined so that any related health needs can be addressed, Beattie says. Ongoing assessments—including a fall risk assessment—and subsequent monitoring may prevent falls from occurring in the first place, she adds. And preventing falls in the first place can reduce costs in the healthcare system, according to Jeff Todd, JD, chief operating officer of Prevent Blindness America.

$20 BILLION IN COSTS

The organization issued a report, “The Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States,” in June. According to the research, which was conducted by the University of Chicago, annual nursing home costs related to vision impairment or blindness in those aged at least 65 years totaled about $16.8 billion; these costs are borne by the government, private insurers and individuals. Vision loss-related skilled nursing facility care, calculated separately from nursing home care, was estimated as $3.4 billion.

“So we’re talking close to $20 billion that relates to long-term care of folks who are visually impaired or blind,” Todd says. “Certainly this emphasizes the…importance of prevention and why we need to detect the problems early that can not only reduce the costs involved in long-term care but also increase quality of life and independent living for people who are able to get their vision issues diagnosed early and treated before they lose significant vision.”

Todd says that falls figure prominently in the cost estimates. “We know that repeated falls are a significant predictor of nursing home admission,” he adds. “As people age and we see falls increase, there’s a direct correlation between the number of people who are going into long-term care. There’s also a pretty strong correlation to the role that vision plays in that.”

About one-fourth of people with vision impairment who are aged more than 85 years had reported a fall in the past three months, Todd says. The Los Angeles Latino Eye Study, he adds, “showed that those individuals with impaired central vision, through macular degeneration and other conditions, are almost three times higher to experience falls with injuries than those with

one and a half times at greater risk for falls with injury.”

A DOZEN MORE TIPS

Senior living communities can take several additional steps to prevent vision-related falls in their facilities and reduce costs locally and generally within the healthcare system, according to Todd and Beattie:

• Establish a culture where employees feel empowered to take action to help prevent falls within the scope of their positions.
•  Custodial staff must address spills in a timely manner, and everyone can ensure that equipment and supplies that might pose tripping hazards are stowed in their proper places, out of the way.
•  Design rooms, hallways and other areas with a natural, obstacle-free flow and features—such as grab bars in bathrooms and other areas—to assist residents with movement.
•  Provide non-skid floor surfacing wherever fall risk exists —such as entrance doorways that are subject to outside precipitation; bathroom flooring surfaces around tubs, showers, and toilets; and in food service areas.
•  Minimize the rearrangement of furniture and other movable objects.
•  Clearly delineate potentially challenging areas—steps, for instance—with contrasting edges and lighting.
•  Encourage routine eye care.
•  Facilitate easy access to eyeglasses for residents who wear them—and make sure they wear them. See that the glasses don’t get wrapped up in bedding or some other aspect of the living quarters, and make sure the lenses are clean. If possible, mark the glasses with some kind of identification so they can be returned to the owner if misplaced.
•  For residents who wear eyeglasses, encourage the use of single-vision lenses to avoid depth perception issues related to progressive lenses meant to accommodate distance, intermediate and near vision.
•  Urge residents to avoid adaptive eyeglass lenses that darken or lighten automatically depending on the strength of indoor or outdoor lighting. The delay in color change may present a danger to seniors already experiencing vision difficulties.
•  Help residents take their medications as prescribed, and look for any vision-related side effects linked to any drug or non-adherence to prescribed therapy.
•  Offer programs for residents with low vision.
•  Coordinate care across work shifts via electronic clinical decision support tools or other means so that all personnel are aware of the occurrence and status of any vision-related issues in residents. Medical records—paper or electronic—also can assist healthcare professionals when multiple people are caring for those with multiple chronic illnesses, as often is the case with seniors.

National Restaurant Association, Don’t trip up: Preventing slips and falls.

Nano-Grip is an invisible treatment which actually creates a microscopic tread pattern on floors which makes them “safer wet than dry”. A Nano-Grip applicator can guarantee that your floors meet or exceed industry and Government standards for safety when wet. For a free evaluation of your facility call 855-687-0976. Remember don’t slip, use Nano-Grip.

The following feature appears courtesy of the National Restaurant Association website.

Manage My Restaurant

Don’t trip up: Preventing slips and falls

It just takes one quick slip. A greasy floor, a buckling mat or uneven flooring could send an employee or guest to the hospital and land your business with an expensive lawsuit and rising insurance premiums. Here are some ways to keep your restaurant out of slippery situations:

Track your traction

Know your numbers. “The first step in preventing accidents is to test how safe your floors are,” says Russell Kendzior, founder of the nonprofit National Floor Safety Institute (NFSI), based in Southlake, Texas. Monitor the coefficient of friction (COF) the measure of slip resistance, at various spots throughout your restaurant.

As a general manager for Duffy’s Sports Grill, Benjamin Longanacre had never heard of the COF. But after the South Florida 24-unit chain experienced a series of costly slip-and-fall incidents, the restaurant appointed Longanacre as its first safety coordinator in 2011 and charged him with taking a preventive approach. He quickly learned the importance of the COF, which has two components: static and dynamic.

The static COF measures the “slip potential,” or how much traction it takes to induce a slip, while the dynamic COF quantifies a person’s stopping ability once he or she begins to slip. Walkways with a wet static COF of .60 or greater and a wet dynamic COF of .42 or greater are defined as “High Traction” under the American National Standards Institute (ANSI) B101.1 and B101.3 standards.

Get audited. Consider hiring a “certified walkway auditor” or other qualified professional to test your floor safety. Look for a professional versed in safety standards, experienced at identifying hazards and skilled at using a tribometer, or slip meter, to measure the COF.

Secure your footing

Place your best footwear forward. Require all employees to wear sturdy shoes with slip-resistant soles and low heels. Improper footwear causes about 24 percent of slips and falls, according to the NFSI.

Put out the welcome mat, safely. An entrance mat can be an important first line of defense against slips by removing moisture from footwear. But mats also can contribute to accidents if not carefully selected, correctly placed and properly maintained. Look for mats with high-traction backing to prevent movement, such as those certified by NFSI.

Place mats on a clean, dry surface. “If it’s wet underneath, the mat acts like a surfboard,” shifting across the floor and potentially causing falls, Kendzior warns.

Even things out. Replace buckling, torn or worn carpets and mats. Repair uneven surfaces within the restaurant and on outside walkways. Train staff to report any problems they notice to management.

Put the skids on. Use non-slip matting in kitchen areas that tend to be wet. Beware that some matting might not be effective in areas that tend to be greasy. In those areas, the Occupational Safety & Health Administration (OSHA) recommends using no-skid waxes and floor surfaces coated with grit to create non-slip surfaces.

Start with a solid foundation. If you’re building new or remodeling, select “High Traction” flooring.

Wax on, carefully. Do not wax, polish or treat floors in a way that causes the COF to fall below the “High-Traction” ranges as defined in the ANSI B101.1 and B101.3 floor safety standards.

Clear the way. Keep pathways clear. Close cabinet doors after use. Don’t store items on the floor or in stairwells.

Do not overfill busing containers. Items can fall from overfilled containers, causing tripping hazards. Also, workers might become preoccupied with keeping everything inside an overstuffed container and forget to watch their step, OSHA warns.

Step to it. Keep a stepladder in the storage area to help employees safely reach high items. Never place a ladder on top of boxes or other unstable items.

Stay clean and dry

Mop it up. Train staff to clean up spills as soon they or guests spot them. During peak hours, mop only in areas that need immediate attention.

Caution customers. Don’t leave a spill unattended while getting a mop, recommends Duffy’s Longanacre. Station one team member at the spill, directing guests around it, while another gets the cleaning materials. Place a “Caution: Wet Floor” sign by the spill, and keep it posted until the area is clean and dry.

Cut the grease. Use cleaning tools and solutions designed to cut through grease and grime, without leaving a slippery residue. Bleach is a sanitizer, not a cleaner. “Bleach on top of grease can be slippery,” says Kendzior, who recommends NFSI-certified cleaning products designed to keep floors high traction.

Dry it out. Where wet processes are used, maintain drainage and provide false floors, platforms, mats or other dry standing places where practicable, OSHA recommends.

Color-code your cleaning tools. Avoid using the same mop in the front of the house that you use in the back, says Longanacre. “You’ll just be spreading the grease around.” Duffy’s dedicates red mops, squeegees and scrub brushes for the kitchen; blue for front of the house.

Train your staff. The right tools and cleaning products aren’t enough; make sure staff are trained to use them correctly. Remind employees to keep on top of tasks, such as changing the mop water or replacing mop heads as needed. Motivate staff by emphasizing the importance of preventing falls, Longanacre recommends. For Duffy’s, the hard work has paid off. Since instituting its new cleaning procedures in 2011, the chain has cut its insurance liability claims in half and slashed incurred costs by over 90 percent.

Check out the National Restaurant Association’s “Preventing Slips, Trips and Falls” training DVD, which features both an English and Spanish option. The DVD is sold individually or as part of a three-DVD “Workplace Safety” package.

The coming wave of Slip/Fall lawsuits?

Article published in Attorney at Law Magazine.

Are Slips and Falls the New Asbestos?

By Russell J. Kendzior

We have all seen the television ad that opens by asking, “Have you or someone you know been the victim of asbestos if so please call the law office of …”

Each year hundreds of individuals file claims of asbestosis. A number dwarfed by the 25,000 fall-related fatalities and 8 million Americans who seek emergency room treatment for an accidental fall. More people will either die or become seriously injured as a result of a slip and fall than that of asbestosis yet we have not seen any television ad reaching out to slip and fall victims. That day may soon be coming and the reason may be right under our feet!

When most people select a floor for their home or office they assume that the manufacturer has tested it and that it’s safe. Surprisingly with the exception of the ceramic tile industry all other types of floor coverings (ie: vinyl, wood, laminate, etc.) are not tested for slip resistance and surprisingly the floor covering industry has refused to even adopt a slip resistance test method.

This may be best understood by way of comparison. Remember how the tobacco industry spent decades claiming that based on their research they could not definitively conclude that tobacco is addictive and that they were not engineering tobacco to be addictive. We all know how that turned out! Floor covering manufacturers have taken a page from the same playbook; they’re very much aware of their customer’s multibillion-dollar slip and fall problem. Unlike the tobacco industry, floor covering manufacturers have chosen not to conduct any research that may reveal a relationship between their products coefficient of friction (COF) and that of the millions of slip and fall events.

Floor covering manufacturers see slips and falls as a minefield of liability and avoid discussing the subject publicly. As they see it by not adopting a COF safety standard means that if they are sued, the plaintiff can’t hold them to a standard that in their view doesn’t exist! But in 2009 that changed. That was the year the ANSI/NFSI B101.1 wet static COF test method was published and with a few exceptions applies to just about every type of floor covering material. Furthermore, the ANSI/NFSI B101.1 established the use of portable test devices thus making it possible to test the COF of a floor both in the laboratory as well as in the field. Therein lays the problem and the solution to slip and fall litigation!

Regardless if the manufacturer tested the product or not, end-users are now able to test their floors in their buildings to see which of the three COF traction ranges defined in the ANSI/NFSI B101.1 their floor meets. By empowering property owners, the test method also empowers slip and fall victim’s to which the slip and fall litigation door may now be wide-open.

The ceramic tile industry has taken a different approach. In 2013, the Tile Council of North America (TCNA) amended their longstanding ANSI A137.1 manufacturing standard to include a specific reference to testing the wet dynamic coefficient of friction (DCOF) of ceramic tile. This modification to the previous version of the A137.1 standard was in direct response to the 2012 publication of the ANSI/ NFSI B101.3 DCOF standard and rather than adopting the ANSI/NFSI B101.3 standard the TCNA chose to create their own watered down version which makes it easier for their members’ ceramic tile products to pass. A fact boasted about by one of their industries most respected independent testing labs. (http://www.safetydirectamerica.com/Floor-Friction-Testing.html)

The floor cleaning chemical industry has also failed to clean up their act and like floor covering manufacturers, they to do not test the slip resistance of their products.

An Aug. 25, 2003 study published by the NFSI revealed that 10 out of the 19 best-selling household floor cleaners actually made floors more slippery and averaged an 18 percent decrease in slip resistance.

Meaning that every time someone cleans their floors with any of these products their floors become more slippery.

However most people do not connect the cause of a slip and fall to the floor or cleaning agent used but rather tend to blame themselves for not looking where they’re walking. But what if the actual cause was that of an inherently slippery flooring material or a slippery film left behind by a floor cleaner?

Most slip and fall victims do not file a lawsuit but rather go about their daily lives but for those who do, proving negligence can be difficult… but that too is changing!

A 2004 Jury Verdict Insurance Information Institute study revealed that tort verdicts have been increasing by 13 percent annually and even in tort reform states like Texas jury verdicts have climbed. In 2009, a Dallas County jury awarded a woman $4.4 million for injuries sustained in a DFW area grocery store (Liria Lopez v. Minyard Food Stores, Inc.) making it the largest jury verdict ever awarded in the state of Texas for a slip and fall.

Who knows, maybe the day may soon be near when we see a television ad asking “have you or someone you know been the victim of a slip and fall on any of the following floor coverings?” to which a lengthy list of floor covering manufacturer’s names scroll across the television screen. The question is whose law firm will be the one hosting the ad?

Nano-Grip makes floors “safer wet than dry”. Our process is invisible and costs pennies a foot. For the sake of your employee’s, clients, and peace of mind; call today to be referred to an authorized Nano-Grip applicator. 855-687-0976.

The evolution of Slip and Fall law.

This article appeared in Attorney At Law Magazine.

So What Exactly is the Standard of Care?

By Russell Kendzior

The foundation for any plaintiff’s case is to establish that the defendant “failed to exercise reasonable care” and because of such was negligent. So what exactly is the standard of care in a slip and fall case? To answer this, one must uncover the standards defendants must meet and the standards plaintiffs must prove were violated. Historically such burden was pretty difficult to prove since very few walkway safety standards existed. However, before we can define the standard of care we must first understand what it means to be a standard. According to Blacks Law Dictionary a standard is defined as (1.) “A model accepted as correct by custom, consent or authority. (2.) A criterion for measuring acceptability, quality or accuracy.” So how does a defendant or plaintiff establish acceptability or measure quality as it relates to walkway safety? Obviously by testing the walkway’s slip resistance, right?

As simple as it sounds believe it or not up to 2009 there were no nationally recognized walkway safety standards by which a defendant or a plaintiff expert could rely upon as the basis of establishing the standard of care. Its hard to prove that A defendant failed to meet the standard of care when there were no nationally recognized standards that defined what a safe walkway is. If you ask any defendant if their floors are safe, they will tell you yes. If, however, you ask them how they know they’re safe, they often will respond that based on their history they have had very few, if any, slip and fall claims. Whether you believe them or not, the fact is, it’s hard to prove otherwise.

Numerous test methods have been published by leading standards developing organizations like the American Society of Testing and Materials (ASTM) and the American National Standards Institute (ANSI) however, most have been withdrawn. The ASTM F-1677-05, F-1679-96 test methods lived very short lives and were both withdrawn in 2006 and just last year the ceramic tile industries ASTM C-1028 Standard Test Method for Determining the Static Coefficient of Friction of Ceramic Tile and Other Like Surfaces by the Horizontal Dynamometer Pull Meter Method was withdrawn. However as the ASTM standards were being withdrawn several new ANSI standards have been established.

The ANSI/NFSI B101.1-2009 Test Method for Measuring Wet SCOF of Common and-Surface Floor Materials published in 2009 and in 2012 came the publication of the ANSI/NFSI B101.3- 2012 Test Method for Measuring Wet DCOF of Common Hard-Surface Floor Materials. With the introduction of these two nationally recognized consensus standards the world of slip and fall litigation has changed whereby both plaintiffs and defendants can compete on a level playing field. Although this evolution has and will bring clarity to litigants in a slip and fall lawsuit it will also greatly benefit insurers and their policyholders.

Insurance premiums are based in great part on assumed and predictable risk. Homeowner’s policies are based in part on the type of roof you have, the type of dog you own, and whether or not you live near a flood plain. Health and life insurance premiums are calculated in the same way. If you smoke or drive a motorcycle you pay more. Why, because of the measurable and predictable risk you present to the insurer. Property owners are now going to be held to the same standard. If their floors test poorly (lowtraction) the insurance industry will charge a higher premium, than if their walkways are in the high-traction range as defined in ANSI/NFSI B101.1 or B101.3.

Walkway testing is here to stay and is evolving into a new industry of walkway auditing. Walkway audits bring science to what was once visual inspections and walkway auditors are now a profession being driven by need and will serve as the basis of the standard of care to which both plaintiffs and defendants can benefit. For a defendant who has independent test data from a certified walkway auditor, their defense gets stronger. If, however, they have not had their floors audited, a skillful plaintiff attorney can hire an auditor and use such results to not only prove that the walkway in question was slippery but the defendant, in failing to conduct their own audit was negligent. An independent walkway audit is the standard of care and is supported by the 2012 release of the ANSI/NFSI B101.0 Walkway Auditing Standard.

So is it reasonable that a defendant should test their walkways? Absolutely and is just as reasonable that a cook measure the temperature of their food holding trays or a mechanic test the torque on the lug bolts holding your wheels on your car. Restaurants can’t endanger the public by serving spoiled food so why should property owners be allowed to endanger their invited guests by having slippery floors? The independent walkway audit is reasonable and the COF test results will quantify the slip risk and in-turn will serve to define whether or not the walkway was unreasonably dangerous. Which in the end, can make or break your case.

The application of Nano-Grip on a walking surface will bring that surface into compliance with government and industry standards for slip resistance and provide the building owner with a defense against claims of negligence. For a referral to an authorized applicator call 855-687-0976.

Hospital Slip/Falls a major problem to hospitals bottom line

According to a white paper reported in Beckers Hospital Review, an online industry newsletter slip and fall injuries to patients while hospitalized is a major problem for administrators. The utilization of Nano Grip in patient bathrooms, shower rooms and other common areas can greatly reduce the exposure hospitals face wit this critical problem. To have the floors in your facility evaluated for compliance with industry and Government standards for safety contact Nano Concepts at 855-687-0976 to be referred to an approved applicator. Nano-Grip makes floors  “safer wet than dry”.

Each year, between 700,000 and 1 million patients fall while in the hospital. That rivals the number of patients who contract a healthcare associated infection (HAI). Of those patient falls, 111,000 result in a fatality, and 30-35% result in injuries. Extended stays to treat fall injuries mean bottom-line impacts for the hospital. Increasing focus of government agencies and healthcare industry associations is being brought to bear on reducing what could almost be called the epidemic of slips and falls. Certainly, slip-fall prevention takes a multi-faceted approach.

Small businesses reveal top risk concerns for 2014, Slip/Falls top list

From an article in the online publication Insurance Business America

by Caitlin Bronson | Aug 07, 2014

2014 represents a key turning point for small businesses in the risk arenas of cybersecurity, healthcare affordability and terrorism. However, workplace safety is the number one concern of small business owners this year, a new report from insurance holding company EMPLOYERS reveals.

The survey was conducted from a nationally representative sample of 502 small businesses with fewer than 100 employees, EMPLOYERS said. Participants were asked about their concerns and personal preparations for risks ranging from professional liability to terrorism events.

Workplace safety dominated as both employers’ top worry and top risk management focus—something that should spark attention from producers looking to better service clients in the coming year.

“Small business owners realize they have to protect their most valuable assets—their employees, said Stephen Festa, Chief Operating Officer of EMPLOYERS. “Employee injuries can carry a significant cost, not only in terms of medical and workers’ compensation expenses, but also in terms of lost productivity and potentially lower workplace morale.”

Festa noted that most small businesses accurately cite slips and falls as the most common workplace accident, accounting for nearly a quarter of all nonfatal workplace injuries according to the US Bureau of Labor Statistics. However, roughly four out of five employers said they were not most prepared for such incidents.

Instead, just 21% of respondents said they were prepared to handle a slip and fall incident. Employers felt they were similarly unprepared for the damages caused by motor vehicle accidents, contacts with objects and equipment, fire and exposure to harmful substance or environment.

Acts of violence were the risks employers felt least prepared to deal with, with 29% of survey respondents citing it as the event for which they were least prepared.

Other risks on the minds of small businesses this year include professional liability, cyber security, natural disasters and terrorism. Roughly a quarter of respondents said professional liability and cyber security risks were their biggest worry, with natural disasters and terrorism hovered near the bottom of employers’ risk management priorities.

Nano Grip can eliminate the threat posed by wet floors by actually making them “safer wet than dry”. For a free consultation including an assessment of the safety of your floors call 855-687-0976 to be referred to a qualified professional.