Injury Prevention in Institutional Settings in Sweden.

Paper in proceeding, 2017

This paper analyses injury events in different Swedish welfare settings, with an aim to highlight prevention potentials and applicable strategies in the institutional settings. Previous research has mainly focused on preventing strategies related to primary or individual level, but this study instead examine the possibilities of injury prevention or injury reduction by modifications of the physical environment, so called situational prevention. The preventive approach in the study is related to previous work in the field of crime prevention and health promotion through environmental design. These welfare institutions are designed to shelter vulnerable individuals, but they are the second most frequent injury place according to previous research. We used an extract from Injury Data Base, containing information from all emergency rooms visits in four Swedish municipalities from the year 2013. We conducted both within- and cross-case analyses, in order to explore the situational elements of the events. In general, the results show that the majority of injury events involve individuals that are above 80 years old, and the most common injury type is fall related injuries. Moreover, the injury pattern interrelates with activity. Conform activity, defined as day-to-day activity, related to unintentional injuries, such as tumbling, tripping and falling. These situations mainly occurred in institutions such as nursing homes, retirement homes and accommodation for individuals with disabilities. The non-conform activity, such as creating opportunity for self-harm acts, were more frequent in closed institutions such as psychiatric wards, youth accommodations or prisons. These findings implicate that two different prevention strategies are suitable. The first aiming at reducing the risks connected to mobility by reducing uneven floor surface, place rails on the wall or install impact-absorbing floors. The second strategy aims to design a physical environment that facilitates a higher degree of surveillance inside the institution.