Safety Concerns Affecting Delivery of Home Health Care

Abstract

Factors influencing the remarkable growth of home health care include increased elderly population, decreased average length of hospital stay, and technological advancements that reduce the need for hospitalization. Societal changes have prompted increasing concern about personal risk to home care providers. The purpose of this pilot study was to: 1) ascertain factors related to perception of risk by home health care administrators and staff and to identify strategies used by home health care administrators to reduce risk to staff; and 2) determine whether quality of care is affected when home-visit situations present risk. A convenience sample of 36 home health care administrators and 62 staff was surveyed about risks and measures provided by the home health care agency to minimize risk. Factors associated with risk are geographic location, high incidence of crime, inappropriate patient or caregiver behavior, infectious diseases, and evening assignments. Strategies used to minimize risk include safety programs, preplanning of visits, personal protective equipment, escorts, and buddy systems. Perceived ability to refuse high-risk assignments, however, is questionable, as 66% of the staff stated that they leave a situation "as soon as possible." These findings will be used to strengthen inservice programs and to provide a basis for future studies.

Multiple Risk Factors for Violence to Seven Occupational Groups in the Swedish Caring Sector

“…In fact, only a handful of studies can be found in these areas (e.g. Colenda and Hamer 1991;Dougherty et al 1992;Ghaziuddin and Ghaziuddin 1992;Lusk 1992;Gage and Kingdom 1995;Kendra 1996;Kendra et al 1996;Kiely and Pankhurst 1998;Gates, Fitzwater and Meyer 1999;Lee et al 1999;Fazzone et al 2000), and very few are concerned with Sweden in particular (e.g. Saveman et al 1999;Menckel, Carter and Viitasara 2000;Menckel and Viitasara 2002).…”

“…Carers who have direct, everyday contact with patients or clients seem to be the most heavily exposed (Arnetz, Arnetz and Söderman 1998), but registered nurses, doctors and personnel who make occasional visits to the homes of care recipients also report significant exposure to threats and violence (Arnetz, Arnetz and Söderman 1998;Nolan et al 1999). A further exposed group consists of home-care personnel, who also provide health services and other forms of assistance (Kendra 1996;Kendra et al 1996;Fazzone et al 2000;Riopelle et al 2000). Among Swedish carers, both older and younger workers, and both men and women, are affected, but women appear to be more exposed than men in all age groups (SWEA 2001).…”

“…Symptoms such as irritation, fatigue, sleep disturbance, anxiety and apathy are common (Menckel, Carter and Viitasara 2000). Violence may also impact on work conditions and patient care (Chou, Kaas and Richie 1996;Kendra et al 1996;Arnetz and Arnetz 2001;Duncan et al 2001). Further possible effects of work-related violence are absenteeism and reduced work motivation (Gates 1995;Barling, Rogers and Kelloway 2001).…”

Serving Our Homeless Veterans: Patient Perpetrated Violence as a Barrier to Health Care Access

“…If home health care workers do not feel safe, they will limit the amount of time spent completing the patient assessment, education, and visit(s) or lessen the frequency of visits, which may have a negative impact on patient outcomes (Brillhart, Kruse, & Heard, 2004;Campbell et al, 2013;Campbell et al, 2015;Kendra, Weiker, Simon, Grant, & Shullick, 1996). A study by Kendra and colleagues (1996) found that 68% of homecare workers would cut short a visit with a consumer if they felt unsafe in the home (Kendra et al, 1996).…”

“…A study by Kendra and colleagues (1996) found that 68% of homecare workers would cut short a visit with a consumer if they felt unsafe in the home (Kendra et al, 1996). Participants also stated that they wrapped up their visits "as soon as possible."…”