The SAFEST Review: The Shock-Absorbing Flooring Effectiveness SysTematic Review including older adults and staff in care settings. Study Protocol.

Aims of the research: We aim to summarise what is known about shock-absorbing flooring in hospitals and care homes, with regards to reducing injuries from falls. We want to help people decide whether or not to invest in using shock-absorbing floors. We will see if shock-absorbing flooring can: (1) reduce injuries from falls; (2) increase the chances of someone falling over; and (3) lead to injuries in staff who may find it harder to move equipment across a softer floor. We will also summarise any research on the economic costs and savings of shock-absorbing floors. Finally, we will look at any practical issues people had when installing the new floors, and explore the experiences and attitudes of people who have used the floors (staff, residents/patients, and visitors). Background to the research: Falls and fall-related injuries are a major problem in hospitals and care homes. Older people are more at risk of falling, and more at risk of injuring themselves if they do fall. Injuries from falls can lead to loss of independence and mobility, shorter lives, and lower quality lives. Shock-absorbing flooring is one potential solution to help reduce the impact of a fall. Researchers from different countries have been studying the use of shock-absorbing floors in hospitals and care homes, but nobody has brought all of these studies together to summarise their findings in a systematic way. Design and methods used: We will carry out a thorough search to identify all the studies we can find that have looked at shock-absorbing flooring use in hospitals and care homes. We will assess these studies for quality, and gather data on what they did, who they involved, and what they found. We will summarise the information we find, to make it more easily understood. Where appropriate, we will combine the data from different studies to produce an overall result. We will explore the differences between studies, to help us understand which factors might influence whether shock-absorbing flooring works, and to determine how trustworthy the findings are. We will use the findings from studies included in the review to produce recommendations that can guide end-users of the review. Patient and public involvement: Our patient and public members will be involved throughout the project. They will help make sure our findings are easy to understand, and include all the important information. They will check the judgements we make about the quality of the research we find, to make sure we are being fair and clear. They will be involved in meetings to help guide us and make decisions. They will help us make a short video, which explains the findings of our research through patient experiences. Dissemination: We will share our findings in different ways to suit different people. We will publish our report in an academic journal, with universal free access. We will present our findings at two conferences (one in England and one abroad), which have a focus on caring for older people, and online in a webinar. We will hold a half-day workshop, to which we will invite people who may find our review useful. We will produce short reports to give to people who make decisions about which flooring to use in hospitals and care homes. Finally we will make a short online video which tells the findings of the review through the views and stories of patients. This is because many people like to make decisions when they hear patients' or residents' views.