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Stötdämpande golv som skadepreventiv åtgärd på särskilt boende: En studie av effekten på fallskador och arbetsmiljö
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).ORCID iD: 0000-0003-4840-6424
2015 (Swedish)Licentiate thesis, comprehensive summary (Other academic)Alternative title
Preventing fall injuries with impact absorbing flooring in nursing homes : A study of the effects on injuries and work environment (English)
Abstract [sv]

Omfattande ansträngningar har gjorts för att minska risken för fallskador bland äldre men för de som bor på särskilt boende har det visats sig vara svårt att utforma effektiva åtgärder.  En skada uppstår när kroppens vävnad utsätt för energi som överstiger dess toleranströskel. Åtgärder för att minska energin vid en olycka har tillämpats inom många områden med mycket goda resultat. Antagandet om att energireduktion minskar risken för skada bygger på fysikens grundläggande lagar och benämns inom skadepreventionsområdet för energiprincipen. Idén om ett stötdämpande golv som energireducerande åtgärd för att motverka fallskador dök upp i vetenskaplig litteratur på tidigt 1990-tal, och sedan dess har speciella golv utvecklats och testats i laboratoriemiljö.  Syftet med denna licentiatuppsats är att utvärdera effekter av ett stötdämpande golv på särskilt boende för äldre personer. De aspekter som studerats är den potentiellt fallskadepreventiva effekten för de boende samt påverkan på vårdpersonalens arbetsförhållanden. Resultatet visar att golvet minskar risken för skador samt att personalen är positiva till att arbeta i lokaler med stötdämpande golv.

Abstract [en]

Fall injuries pose a global and national public health problem. Whilst all elderly are at risk of fall injuries, the risk of injury is 10 times as high amongst elderly living in nursing homes compared to elderly living at home.

An injury occurs when body tissue is subjected to external kinetic energy exceeding the tissue's tolerance. Reducing this energy in order to prevent injuries has been successfully applied in many injury prevention fields though less so within fall injury prevention. However, the idea of ​​a shock-absorbing floor as an energy reducing measure to prevent fall injuries has been suggested in scientific literature since the early 1990s and since then, different floors have been developed and tested. The aim of this licentiate thesis is to investigate the potential fall injury reducing effects of a shock-absorbing flooring in a nursing home, as well as the staff's experience of working in premises with shock-absorbing flooring.

The results show that for women the risk of injury following a fall on the shock-absorbing flooring was 59% less compared to falls on ordinary floors, after adjustment for age, BMI, vision impairments, and cognitive impairment. BMI was the only covariate to influence the results, with a lower BMI increasing the risk of injury. With regards to the staff’s experience of the shock-absorbing flooring, the nurses felt that the floor defused the falls and in that way reduced the risk of injury. They were also positively surprised by the change in acoustics. There were also some challenges associated with the floor, for example, adapting to walking on the floor and manoeuvring equipment (eg hoists).

The results suggest, that for an elderly and frail population, shock-absorbing flooring seems to be an effective injury prevention measure. The intervention was generally perceived as positive by the staff, even though some negative aspects were observed. These aspects need to be studied further.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2015. , p. 55
Series
Karlstad University Studies, ISSN 1403-8099 ; 51
Keywords [sv]
äldre, fall, skador, golv, höftfraktur, undersköterskor
National Category
Health Sciences
Research subject
Risk and Environmental Studies
Identifiers
URN: urn:nbn:se:kau:diva-38254ISBN: 978-91-7063-670-7 (print)OAI: oai:DiVA.org:kau-38254DiVA, id: diva2:865326
Presentation
2015-12-14, Eva Eriksson-salen, 21A342, Karlstads universitet, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Funder
Swedish Civil Contingencies Agency, 2013-4176Länsförsäkringar AB, P1/13
Note

Paper 2 i den trycka avhandlingen ingick som manuscript, med titeln Working in a nursing home with Impact Absorbing Flooring - a qualitative study on the experiences of licensed practical nurses. 

Artikeln är nu publicera nu publicerad med titeln Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses. 

Available from: 2015-11-24 Created: 2015-10-27 Last updated: 2019-01-16Bibliographically approved
List of papers
1. Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results
Open this publication in new window or tab >>Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results
2015 (English)In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 21, no 5, p. 320-32-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:Fall-related injuries affect the lives of elderly to a substantial degree. This quasi-experimental study investigates the fall-injury reducing effect of impact absorbing flooring among female nursing home residents.

METHODS:The intervention site is a nursing home in Sweden where impact absorbing flooring was installed in parts of one of six wards (six out of 10 apartments (excluding bathrooms), the communal dining-room and parts of the corridor). The impact absorbing flooring is a 12 mm thick closed cell flexible polyurethane/polyurea composite tile (500×500 mm) with an exterior surface of polyurethane/polyurea. A generalised linear model (log-binomial) was used to calculate the RR of injury from falls on impact absorbing flooring compared to falls on regular flooring, adjusted for age, body mass index, visual and cognitive impairments.

RESULTS:During the study period (1 October 2011 to 31 March 2014), 254 falls occurred on regular flooring and 77 falls on impact absorbing flooring. The injury/fall rate was 30.3% for falls on regular flooring and 16.9% for falls on impact absorbing flooring. Adjusted for covariates, the impact absorbing flooring significantly reduced the RR of injury in the event of a fall by 59% (RR 0.41 (95% Cl 0.20 to 0.80)).

CONCLUSIONS:This is, to our knowledge, the first study evaluating the injury-reducing effect of impact absorbing flooring in a nursing home showing statistically significant effect. The results from this study are promising, indicating the considerable potential of impact absorbing flooring as a fall-related injury intervention among frail elderly.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies; Public Health Science
Identifiers
urn:nbn:se:kau:diva-34772 (URN)10.1136/injuryprev-2014-041468 (DOI)000362779600006 ()25833258 (PubMedID)
Available from: 2014-12-12 Created: 2014-12-12 Last updated: 2018-05-22Bibliographically approved
2. Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses
Open this publication in new window or tab >>Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses
2017 (English)In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 31, no 4, p. 367-381Article in journal (Refereed) Published
Abstract [en]

Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fail-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.

Place, publisher, year, edition, pages
Routledge, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kau:diva-65975 (URN)10.1080/02763893.2017.1335670 (DOI)000419504100004 ()
Note

Artikeln ingick i författarens licentiatuppsats, då med titeln Working in a nursing home with Impact Absorbing Flooring - a qualitative study on the experiences of licensed practical nurses.

Available from: 2018-01-25 Created: 2018-01-25 Last updated: 2019-07-10Bibliographically approved

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