Updated: Mar 28
Home. Home is where everyone feels comfortable, at ease, and the safest. While patients love the idea of receiving care in the comforts of their own home, health care workers face a dilemma that comes with working in this territory.
Home healthcare workers often face a work environment that is unpredictable and irregular each time they work in their patient’s home and communities. Home healthcare workers are at risk of psychological and physical harm because they often work alone, have very little support from their peers, and their work environment is not in their control. They may have to travel to dangerous neighbourhoods, deal with drug and alcohol abusers and family arguments.
Lack of safety during the pandemic
In the US, a few states required care workers to have paid leave when they tested positive for the virus, but workers in the home healthcare industry were left out. The absence of paid sick leave among home healthcare workers forces them to quickly work again, even though they have not fully recovered. This is extremely dangerous and increases the risk of spreading COVID-19 to their patients, our vulnerable population, and their co-workers. Many clinicians working in the homes of their patients see about 5 - 7 patients in a day. In Ontario, nurses and personal support workers typically visit 6 different patients and their respective homes in a day (Contenta, 2020). There is a risk of spreading the virus, as a nurse could walk into one of their patient’s homes after being in contact with the virus from their last patients.
Source/Attribution: Visual Capitalist
Employee safety concerns in home healthcare
A survey conducted by the International Association for Healthcare Security and Safety (IAHSS) highlighted that “as many as 61% of home care nurses have experienced some form of workplace violence” (Lynch, 2017).
The U.S. Bureau of Labor Statistics highlights that workers in the home care industry are twice as likely to get injured than the national workplace injury rate in all other industries (Marrelli & Rennell, 2020). The U.S. Bureau of Labor Statistics also highlights that workers are 50% more likely to get injured in the home care work setting than in hospitals.
The Safe Home Care Project indicated that home healthcare workers are often more vulnerable to physical injuries, such as musculoskeletal injuries, like back pain due to lifting patients. Home care aides are the ones that help their patients get out and into their beds, support their patients while walking, and lack the proper equipment to do so.
Additionally, home healthcare workers are at risk of getting animal scratches and bites from their patient’s homes. Bites from animals can lead to an injury and even surgery.
In the US, a group of workers that are the most likely to receive a threat, verbal abuse, and sexual harassment are home care workers. Home healthcare workers deal with verbal abuse from their patients and their family. When patients are unhappy, they often take it out on the employee and often use unpleasant language.
When the patient or their loved ones becomes threatening and aggressive, it can lead to physical abuse. When violence does occur in the home, home care workers are forced to manage it on their own because their co-workers or manager is not there to help control the situation.
Patient safety concerns in home healthcare
Then there are the safety concerns for patients receiving home care, such as the lack of receiving consistent health monitoring, and environmental hazards in the home, like sanitation, and the control of infection. Due to the home setting, there is a lack of durable medical equipment, creating difficulties to help manage their patient's needs. Since healthcare is at home, it is less sterile than care in the hospital. For instance, drainage bags may be sterilized and then used again, a step that does not typically occur in the hospital. Home healthcare workers have reported instances of hoarding, animal attacks and excrement, food waste, which prevents the worker from creating a sterile work environment in the patient's home. With home healthcare, many patients and their families are at risk by inappropriately disposing of sharps, like needles, syringes, and lancets.
Additionally, medication mistakes are a safety concern for patients receiving care at home. A report indicated that an estimate of roughly 40% of patients receiving care at home experienced a mistake in their medication or a problem in drug therapy (Holly, 2018).
How we can help
Many home healthcare workers who have experienced some form of workplace violence will not report it to their managers or supervisors. Gaining feedback from home healthcare workers helps begin the process of creating a safe work environment. Not only does it help foster a safer environment, but workers feel that they are being heard and valued. To ensure that employees are safe and feel safe, one must listen to their needs, understand their risks, and take that information to create new policies.
Surveys are a great way to deploy these questions to their employees. Pulse surveys are short, frequent surveys that can be tailored to specific topics to assess their change over time. Pulse surveys allow staff members to see the impact of their changes in real-time. The frequent nature of pulse surveys means the information management and staff member sees, will always be current.
Retainify is an employee engagement software that offers a unified solution that allows you to track employee sentiment and measure engagement in real-time. Proactively identify issues that are preventing them from being their best at work. Improve business outcomes by improving the employee experience, and enhance company culture one feedback at a time. Turn Feedback into Action.
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Chandrashekar, P., Moodley, S., & Jain, S. H. (2019, October 17). 5 Obstacles to Home-Based Health Care, and How to Overcome Them. Harvard Business Review. https://hbr.org/2019/10/5-obstacles-to-home-based-health-care-and-how-to-overcome-them
Contenta, S. (2020, April 11). A young boy’s home-care needs highlight the dangers of spreading COVID-19. thestar.com. https://www.thestar.com/news/canada/2020/04/11/a-young-boys-home-care-needs-highlight-the-dangers-of-spreading-covid-19.html
Department of Health and Human Services, National Institute for Occupational Safety and Health, & Centers for Disease Control and Prevention. (2010, January). NIOSH Hazard Review: Occupational Hazards in Home Healthcare. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/docs/2010-125/default.html
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