Home Healthcare Hazards and Solutions Meeting Kit

What’s At Stake

Home healthcare workers provide hands-on long-term care and personal assistance to clients with disabilities or other chronic conditions. These workers, who may be home health aides, personal/home care aides, companions, nursing assistants or home health nurses, are employed in patients’ homes and in community-based services such as group homes. Depending on their training and job duties, they help patients with activities of daily living such as meals, bathing, dressing and housekeeping, and may perform clinical tasks such as medication administration, wound care, blood pressure readings and range of motion exercises.

What’s the Danger

HAZARDS IN HOME HEALTHCARE

One of the main concerns for home healthcare workers is ergonomic injury. Transferring, bathing, and dressing patients can cause musculoskeletal disorders if these tasks are not done correctly. Patients may be large, unresponsive, combative, or otherwise limited in mobility.

Practice infection control not just for the patient’s safety, but for your own as well. Monitor for airborne diseases and wear respiratory protection if it is necessary. Use universal precautions and treat all sharps, blood, and other bodily fluids as if they may be contaminated. Wear latex or nitrile gloves at all times when handling patients and their body fluids.

Needlesticks are a hazard for homecare workers. Family members and patients may leave syringes and lancets exposed, so inspect work areas carefully to avoid an accidental stick. Never recap a needle, break it, or tamp down garbage—you could get an accidental stick. Get training in bloodborne pathogens and needlestick prevention.

HOW TO PROTECT YOURSELF

BEST SAFETY PRACTICES FOR HOME HEALTH WORKERS

  1. Getting To and From Work Safely. If you are driving to work, make sure your vehicle is in good working order and keep emergency supplies on hand. While travelling, keep your car locked and stay on well-traveled roads. Park in well-light areas and avoid underground parking lots, dark alleys, or parking next to large vehicles.

If you are using the bus or walking, stay in well-lit areas with high pedestrian traffic.

  1. Slips and falls

Indoor hazards include:

  • Uneven or slippery floors
  • Wrinkled or worn carpets and curling vinyl
  • Clutter in rooms, hallways, and stairs
  • Lack of handrails on stairs
  • Electrical cords on floors or that cross walkways
  • Open drawers

While working indoors, keep your shoes on if allowed by the client and be sure to check the floor surface before walking on it. Watch out for clutter and suggest to the client that items be stored properly.

Outdoor hazards include:

  • Slippery surfaces, such as sidewalks, steps and wooden ramps covered with water, ice, snow, leaves or moss
  • Uneven or damaged sidewalks and driveways
  • Debris or items left on walkways
  • Poor lighting

Wear footwear with a good tread and check all walking surfaces before taking a step.

  1. Violence prevention in the home. Violence refers to any physical force that may cause injury, as well as threatening statements or behavior. Clients and their family members or visitors may become violent or argumentative due to frustration caused by the client’s condition.

If a situation becomes stressful, stay calm and face the person with your elbows at your sides and arms out. Watch for signs that the person might strike out. Don’t argue or raise your voice. Reassure the person that their concerns will be dealt with as soon as possible and tell them how to make a complaint to your supervisor.

  1. Overexertion and repetitive motion – main factors from repetitive motion.
  • Force
  • Repetition
  • Awkward postures
  • Static postures
  • Contact stress

Signs of overexertion and strain from repetitive movements include:

  • Redness
  • Swelling
  • Loss of normal joint movement
  • Shooting, dull, sharp, or aching pain
  • Tenderness
  • Weakness
  • Pins and needles
  • Hot or cold sensations
  1. Transferring or repositioning clients

The best way to avoid injury when transferring or repositioning clients is to use equipment and transfer assist devices, such as lifts or low-friction slide sheets.

If you have to lift manually, it’s important to practice safe patient handling. Lift from a position of power by keeping your head up. Get close to the client while lifting and make sure you have a good hold. Use a staggered stance by positioning one foot in front of the other and remember “nose follows toes” to avoid twisting.

  1. Dressing and bathing clients. When dressing a client, try to avoid awkward positions, such as reaching to dress the client, and static postures, such as supporting the client in one position for a long time.

Other best practices include starting with the client’s weaker side when putting on clothes, helping your client lean forward when putting on shirts and sitting on a stool when assisting with socks and shoes.

  1. Housekeeping hazards. While on the job, there are several household tasks that you might not think are hazardous, including making beds, cleaning, and doing laundry.

FINAL WORD

Home healthcare workers may be employed by a home care agency or may be self-employed independent contractors working directly for patients. They have little control over safety and health hazards. These hazards include bloodborne pathogens and biological hazards, latex sensitivity, ergonomic hazards from patient lifting, violence, hostile animals, and unhygienic and dangerous conditions.