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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.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. , 55 p.
Karlstad University Studies, ISSN 1403-8099 ; 51
Keyword [sv]
äldre, fall, skador, golv, höftfraktur, undersköterskor
National Category
Medical and Health Sciences
Research subject
Risk and Environmental Studies
URN: urn:nbn:se:kau:diva-38254ISBN: 978-91-7063-670-7OAI: diva2:865326
2015-12-14, Eva Eriksson-salen, 21A342, Karlstads universitet, Karlstad, 13:00 (Swedish)
Swedish Civil Contingencies Agency, 2013-4176Länsförsäkringar AB, P1/13
Available from: 2015-11-24 Created: 2015-10-27 Last updated: 2015-11-24Bibliographically 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, 320-32- p.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
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: 2016-01-12Bibliographically approved
2. Working in a nursing home with Impact Absorbing Flooring: a qualitative study on the experiences of licensed practical nurses
Open this publication in new window or tab >>Working in a nursing home with Impact Absorbing Flooring: a qualitative study on the experiences of licensed practical nurses
(English)Manuscript (preprint) (Other (popular science, discussion, etc.))
Abstract [en]


Fall-related injury prevention is an important part of the daily tasks for staff in nursing homes. Whilst a limited number of injury prevention interventions have proven to be effective for nursing home populations, impact absorbing flooring (IAF) has shown promising injury-reducing results. However, IAF is in the testing stages and therefore, it is important to collect information on all aspects of this intervention, alongside the primary intended outcome, in order to explore the consequences of installing IAF in nursing homes.


The aim of this qualitative study was to describe the licensed practical nurses (LPNs) experiences of working and caring in a nursing home with IAF.


The study was part of a research project evaluating different aspects of IAF. Focus group interviews were carried out with LPNs working in a nursing home with IAF. The interviews were analyzed with content analyses.


A purposive sampling strategy was used. All LPNs with at least one year of experience from working on the ward with IAF were asked to participate. All potential participants took part in the study.


From the focus group interviews, a general theme evolved; Working in a unique ward. A main category was identified; Weighing the pros and cons, reinforced by two categories; Affecting falls and injuries and Affecting everyday life. The LPNs felt that the flooring defused the falls and thereby prevented injuries as well as greatly improving the acoustic environment. Although initially experiencing the IAF as challenging to walk on and that maneuvering heavy equipment, strategies were adopted to cope with the new circumstances.


IAF in nursing homes is a new and innovative step towards preventing fall-related injuries among frail elderly. Despite some negative consequences of installing the IAF, overall the LPNs were positive towards the flooring. Nonetheless, this type of intervention needs to be further evaluated regarding the long-term effects on staff as well as the effect on residents.

Accidental falls, nursing homes, nursing staff, injury prevention, environmental health
National Category
Medical and Health Sciences
Research subject
Risk and Environmental Studies
urn:nbn:se:kau:diva-38253 (URN)
Available from: 2015-10-27 Created: 2015-10-27 Last updated: 2016-06-29

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