By | January 31, 2019

At the core of home care services is protecting your clients’ safety. From a fiscal standpoint, you depend on client referrals and satisfaction to keep your agency operating. Prioritize client safety and everyone wins, but to do so your caregivers must be able to recognize all the hazards in a visit. How would they do on this visit to Joe?

A Visit with Joe

You have a new assignment to care for Joe in his home. It is downtown on a block that is known as being a high crime area. You knock on the door and Joe opens the door. He tells you to come on in.

As he leads you through the hallway, you look around. You notice some throw rugs on the floor. There are stairs going upstairs, and each step has dirty laundry on it. You smell cigarette smoke but do not know where it is coming from.

Joe seems to lean to one side as he walks and uses the wall to balance. He asks you to sit with him at his kitchen table. He asks if you would like something to drink and grabs a beer for himself. You notice there are empty beer bottles on the counter, an overflowing garbage can, and a burning cigarette on a plate beside the stove.

Joe slurs his words as he talks to you. You ask him how he feels. He tells you he feels fine. He says he just tested his blood sugar and it is normal. You notice his used fingerstick needle, covered with dried blood, is lying beside the sink.

At the end of your visit, you pack up your bag and tell Joe goodbye. As you walk to your car, you think about the things you saw that could make Joe’s home less safe.

The list you put together in your head looks something like this:

  • Joe’s home is in a well-known high crime area.
  • There were throw rugs on his floors.
  • The stairs are cluttered with dirty laundry.
  • There is a burning cigarette on a plate.
  • Empty beer bottles are sitting on the counter.
  • An overflowing garbage can is in the kitchen.
  • Joe’s used fingerstick needle with dried blood is lying next to the sink.
  • Joe seemed to be affected by alcohol and drank a beer while you were there.

You identified quite a few hazards, all of which can be harmful. Most of them are hazards that are inside Joe’s home. The last hazard is a factor that has to do with Joe himself.

Risk Factors for Clients

Clients themselves may have conditions that increase their risk for injury in the home. For example, Joe seemed to be having trouble with balance as he walked down the hall. This puts him at risk for falling. He also slurred his words. Slurred speech can be caused by many medical conditions. Slurred speech may also indicate trouble with clear thoughts and decision making.

Confused thinking can lead to accidents and injury. Confused thinking can be caused by a medical condition, disease, side-effects from medications, and drug or alcohol use.

Some of these factors can be controlled, and some cannot. It is your responsibility to be alert to anything about your clients that might affect their safety.

Hazards in the Home

Each home care setting is different. That means you need to be prepared for anything and know how to react. Your agency will have policies and procedures that you should follow. And always pay attention to your instincts or “gut feelings.” They will often tell you the truth.

Conditions in the Home

Your agency will have specific guidelines to follow that can help decide if a home is safe place for you to work. You should follow your own agency’s policies and procedures when in a home with safety concerns. The National Institute for Occupational Safety and Health also provides guidelines that might be useful to you as you encounter various safety concerns.

Unclean Conditions

An unclean home is a problem because of the risk for contact with pests such as insects and rodents, as well as the spread of disease.

Temperature Extremes

If you think the client’s health is at risk from extreme temperatures, you need to report it immediately and intervene appropriately to correct the problem.

Lack of Water

You may enter homes that have no running water or have water that is unclean. If a lack of clean water creates a health hazard, you can ask for help from social services.

Slips, Trips, and Falls

There are certain conditions that you should be careful with to prevent a fall by anyone, including you. Do your best to notice hazards and remove them.

Visitors and Family

It is wonderful to hope that your time with clients and their family or friends will be pleasant. However, you may find yourself part of a problem between people who are not happy. Unhappy people can sometimes become threatening to others’ safety.

Weapons and Violence

Unfortunately, we live in a culture where violence does happen. And weapons are often part of that violence. Violence can be part of your clients’ home lives, and you need to stay alert to signals that something is or may go wrong.

Hazardous Materials and Medical Waste

Hazardous materials can be chemicals that are in the home. Safety data sheets provide information about chemicals. Your agency will provide safety data sheets to you if you need them. Medical waste is healthcare waste that is potentially contaminated by blood, body fluids, and other materials that can cause infection.

Electrical Safety

It is always best to have a certified electrician fix an electrical problem. Your job is to notice the problem and report it.

Fire Emergencies

Most fires are accidental, so you should be vigilant and strive to prevent them. Encourage the use of smoke alarms and proper battery maintenance, as well as planned escape routes in the case of a fire emergency.

Carbon Monoxide

Carbon monoxide alarms are important, especially in homes that use natural gas.

Natural Disasters

Your agency will have an inclement weather plan and an Emergency Preparedness Plan. This information is always available to you, as well as the clients in your care.

 

Again, at the core of home care services is protecting your clients’ safety. To do this is your staff must be able to recognize individual factors that may place clients at higher risk for injury, as well as potential hazards in the home.

Is your staff set up for success?

Do they have the knowledge and skills to protect their client?

Develop their competency and skill sets so that they can confidently put measures into place to prevent injury.

Jennifer Burks, RN, MSN

Jennifer W. Burks, R.N., M.S.N. earned her Bachelor of Science in Nursing from The University of Virginia in 1993, and her Master of Science in Nursing from The University of North Carolina, Greensboro in 1996. She has over 20 years of clinical and teaching experience, and her areas of expertise are critical care and home health. Her professional practice in education is guided by a philosophy borrowed from Florence Nightingale’s Notes on Nursing, “I do not pretend to teach her how, I ask her to teach herself, and for this purpose, I venture to give her some hints.”

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