Keep Your OR Free of Slipping and Tripping Hazards


Protect your clinical team by keeping floors dry and clutter-free.

It’s common to back-burner an issue that you know needs addressing when a repeat occurrence has not happened for a while. But after a handful of slips, trips and falls incidents last year at our busy community hospital, we knew we could no longer look the other way. One employee who was taking specimens to the lab slipped on a wet spot when they stepped out of the elevator. Another employee tripped over a pillow that had fallen on the floor in the OR. One nurse was behind a surgical technologist during a room turnover and they both moved in the same direction at the same time, causing the nurse to trip over the tech’s foot and fall. She suffered a large hematoma on her knee and elbow and paid a visit to employee health and an orthopedic surgeon. Luckily, she did not require further medical treatment, but it took a while for the swelling to resolve.

With so much recent focus on the pandemic and infection prevention, a slip or trip injury can seem trivial, but they are more common than you might think. According to the U.S Bureau of Labor Statistics, slips, trips and falls were the second most common cause of lost-workday injuries in hospitals in 2009. In 2020, 447,890 nonfatal occupational injuries and illnesses were reported in the healthcare and social assistance industries.

Slips, trips and falls are preventable, but not without effort. These are some of the methods and practices that we utilize to help keep our staff safe and upright.

Slow down. One of the most effective strategies is also the most straightforward. Remind your team that their own well-being trumps perceived pressures to move fast. Yes, room turnover time is an important metric to measure, but it is not more important than the safety of your staff. We all know how chaotic it can get when you need to clean a room in an efficient manner, but never compromise your hardworking team members just to shave a few seconds off your time. We simply encourage our staff to slow down and watch their step. This may sound trivial, but sometimes team members need to be reminded of the basics. Asking your staff to take care of themselves shows that you also care about their safety.

Keep floors dry. We recently switched our mop heads from string, which held quite a lot of water and fluid, to microfiber. Not only is it considered best practice to use a microfiber mop, but the nice thing about them is they do not hold as much water, so the floor is not as slippery and it dries more quickly.

We perform a lot of urology and arthroscopic procedures that tend to produce a significant amount of fluid. During urology procedures, we use a bed attachment that collects fluid runoff and drains it to suction. For arthroscopy procedures, we use a floor-based wicking device that easily and quickly sucks up extra fluid. These items are extremely helpful in keeping the OR clean and the floor dry, so no one slips and falls. If these items are not available at your facility, use rolls of disposable padding to soak up any excess fluid.

Light the way. When we are performing laparoscopic or minimally invasive cases, we ask the team members to keep some form of ambient light on in the background so they can see where cords are located and move safely around the room. We turn one OR light on its lowest setting and point it away from the field and toward the circulating nurse to add some background light. We also equipped each circulator desk with a small desk lamp.

Low lighting can make viewing information and handling equipment and instruments more difficult. Some newer ORs feature blue or green ambient lights that keep the room illuminated enough to allow team members to move about the room safely and operate effectively.

Making the Workplace Safe for Everyone
PATIENCE PAYS OFF The surgical team would wait to plug items in that would block the path to the OR table for a pediatric surgeon with a musculoskeletal disorder.

I once worked with a tenured orthopedic surgeon with a musculoskeletal disorder. He performed orthopedic trauma cases as well as elective cases such as spinal fusions for scoliosis. The spinal fusion cases required specialty equipment, including a C-arm and reamed irrigation aspirator (RIA).

The OR team was aware the surgeon could not lift his feet high enough off the ground to safely walk over cords. In order to prevent an injury, the team waited to plug in equipment that would block his path to the OR table. Once the surgeon was in the room and at the table, equipment was brought into place and plugged in.

This type of teamwork highlights how we can all work together to ensure each other’s safety. Workplaces should consider providing accommodations to those with a disability, as these workers can benefit patient care, mentor new staff members and help address the staffing issues most healthcare organizations are experiencing. 

Janice Nichols, MSN, RN, CNML

SLIPPERY WHEN WET Microfiber mops do not hold as much water, so the floor is not as slippery and dries much quicker.

Control the clutter. We’re fortunate in that all six of our hospital’s ORs are equipped with booms. Most of the electrical outlets are in the booms along with laparoscopic and video equipment and electrosurgery platforms. The ORs have fewer carts and cords running to outlets on the wall because of the booms, which help to keep rooms organized. Unfortunately, most ORs were designed 20 or 30 years ago, so many do not have the infrastructure in the ceiling to accommodate booms without having to resort to a big construction project to augment the ceiling support.

I do think cord covers are important when you need to bring in equipment such as a C-arm that does not plug into a boom. Sometimes during a case we might need various electrosurgical devices brought in as well as microscopes. When extra equipment is needed during a case, it’s always a good idea to use cord covers. Orange cord alerts are nice because they are bright and easy to see. They’re also an inexpensive option and can be placed and removed fairly quickly.

While the strategies involved in preventing slips, trip and falls may seem elementary, it only takes one injury to make you realize you could have done more to avoid it. Prioritizing the prevention of slips, trips and falls has paid off for us so far, as we have had no injuries to date this year. OSM

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