2. Adequate warning signs when the floor is being washed or mopped, to warn the public passing over the wet surface.
3. Adequate warning signs to warn the public after waxing the floor. 4. Provision of double railings on both sides of the ramps and stairs. 5. Provision of grab bars on both sides of the WC and on walls in the shower area at the convenient height.
Prevention of Tripping and Falling:
Tripping is caused by trapping/obstruction of toes of the foot/shoe, by an obstacle which may be in the form of damaged uneven floor surface or the ‘nosing’ of the steps in the stairs. Patients with foot drop, disturbed balance or poor vision may be more prone to such accidents, which can cause serious injuries including head injuries.
Timely, repairs of all walking surfaces to make them even and smooth. 2. Adequate lighting allowing for the patients with poor vision to see the obstacles.
3. Providing steps without any ‘nosing’ in the stairs. 4. Sharp elevation of the floor level outside the bath room (to prevent bath water overflowing into the room) can be a cause of tripping. It should be replaced by gradual slop, so that the toes do not get obstructed.
5. Carpets can be another cause of tripping. They should be removed. As such, also, they are unhygienic and cause of infections.
Ideally, the flooring should be infection preventive (smooth, non absorbent easily cleanable, scratch/crack resistant), accident preventive (resilient and easy to walk, non skid variety), of acoustical quality (making less noise) and pleasing to the eyes.
People with walking difficulty and using walking aid may have reduced balance, agility, and speed of movement or compromised cognitive sense. Unevenness and raised joints of the walking surface may be hazardous for them, especially small sudden vertical changes in the surface, which are not easily visible. Different areas of the hospital, in view of the nature of activities carried out, require different type of flooring. OT requires conductive, fire resistant and crack/scratch resistant seamless smooth flooring (PVC/Terrazzo). Rooms where electronic equipment is used on patients also require conductive flooring to dissipate the static charge. Machine rooms in radiology department require non conductive flooring hard enough to withstand loads up to 2000 Kg/sq. Similarly, laboratory and pharmacy department would require acid/ alkali resistant flooring.
Carpets should be avoided in any patient care related area of the hospital. They are hazardous in that they promote infections, may lead to tripping of unstable patients, are easily combustible and may cause toxic fumes in case of fire. Bacterial decomposition of spills on carpets may also cause unpleasant odors.
Prevention of other Accidents/Falls:
Cases of patients (mentally disturbed) making suicidal jumps from the terrace or the balcony or even from the top flight of stairs have been happening. Relatives and even the courts have blamed the hospitals for negligence and imposed heavy penalties. It is very difficult to keep a track of all the people (patients, staff, visiting public) at all the times.
Besides it is not possible many times to detect such tendencies. It is therefore; much safer and practical to eliminate the problem by permanent measures such as: i. Provision of protective railing/wall about six feet high all around the terrace; ii. Restricting entry to the terrace to prevent any accidental falls or suicidal jumping of any unstable individuals; iii. Provision of fixed security grills in the windows and high railing/grills on all sides of the balconies of rooms; iv. Provision of high enough protective railing or side walls on both sides of the stairs to prevent any accidental falls/suicidal jumping; v. Stairs to overhead water tank (tower) should be kept locked to deny entry to any unauthorized person; vi.
Entry to the underground water tanks should be kept locked; vii. The lid of the water tank should be kept locked at all times; viii.Shafts carrying the distribution pipes/sewage pipes are often found open and a source of danger. They should be kept locked at all times to prevent any unauthorized entry. ix. Window cleaners/others doing the repair/maintenance work on the outer surface of the hospital buildings should be allowed to commence work only, after ensuring the safety of their hanging arrangement (Jhoola).
x. All manholes /opening to the sewers should be fully protected and no one should be allowed to enter without proper personal protective equipment. xi. Any other spot which can lead to any accidental injuries/suicidal attempts should be attended to without giving anyone a chance to commit crime.