Personal Care Assistants and Blood Exposure in the Home Environment: Focus Group Findings

Abstract

Focus group findings will be used to implement a union-based participatory primary prevention intervention for the reduction of blood exposure among PCAs.

Client history and violence on direct care workers in the home care setting

“…Although the survey question was limited to health problems, it is not unreasonable to think that they neither received information on client history of previous violence, mental illness or substance abuse before they saw their clients. DCWHs have reported that they felt vulnerable when they were not informed of clients’ contagious health condition [Zanoni et al, ]. Having no or limited information for potential hazards before meeting clients for the first time may put DCWHs at a very high risk of being a victim of violence.…”

Occupational blood exposure among unlicensed home care workers and home care registered nurses: Are they protected?

“…Some activities with the potential for bloodborne contact (e.g., changing wound dressings or giving injections) are outside the formal PCA scope of practice. However, both qualitative [Zanoni et al, 2007] and quantitative data demonstrate that the tasks for which PCAs are responsible often involves handling contaminated dressings or needles. For example, bathing an individual with a wound will often require removal and replacement of bandages, changing linens and clothing that may be contaminated with blood, and clients who use needles or lancets may not dispose of them properly [Beltrami et al, 2000;Markkanen et al, 2007;Chalupka et al, 2008].…”

“…Despite the variation in services and providers in home care, certain features of home care are similar for all workers; that is, workers travel to and provide care in clients' homes, creating significant limitations on their ability to control the work environment. The usual features of an institutional work setting are absent such as security, housekeeping, standard room configurations and bed types, and on-site colleagues and supervisors [Zanoni et al, 2007]. Also, standard healthcare environmental hazard controls such as needle disposal systems and safety-engineered needles and sharps may not be available.…”

“…In a prospective study of nurses providing home infusion services, Beltrami and colleagues at the CDC found ''2.8 blood contacts per 1,000 procedures involving blood and a percutaneous injury rate of 0.6 per 1,000 procedures involving needles or lancets.'' Work activities reported to contribute to BBF contact in home care include the changing and disposing of wound dressings [Markkanen et al, 2007;Zanoni et al, 2007;Chalupka et al, 2008;Gershon et al, 2008]. Other commonly reported risk factors include improper disposal and needle recapping [Beltrami et al, 2000;Ernst, 2001;OSHA, 2001;Perry et al, 2001;Jagger, 2002;Hatcher, 2002;Doebbeling et al, 2003;Gillen et al, 2003;Mendelson et al, 2003;Dement et al, 2004;Haiduven and Ferrol, 2004;Vaughn et al, 2004;Markkanen et al, 2007;Chalupka et al, 2008;Gershon et al, 2008].…”

Perceived Stress and Health among Home Care Aides: Caring for Older Clients in a Medicaid-Funded Home Care Program

“…A small but growing literature indicates that HCAs face challenging working conditions such as job demands, lack of respect and isolation, and hazardous exposures ranging from slips, trips, and falls to sharps injuries and blood/body fluid exposure. 10–15…”