The topic I have chosen for this assignment is “Home health care patients and safety hazard at home”, from the risk assessment topic. This teaching exemplar can be used to educated home healthcare nurse’s organization. Sollecito & Johnson (2013), identified clinical microsystem as the place where most of the errors and mistakes that affect health care quality and safety arise. The clinical microsystem is formed by healthcare personals who work directly with the patient and their families (Sollecito & Johnson 2013).
Background: Home health care is a fast growing industry. All of the healthcare that is provided at home comes under this industry. Home health care is important in supporting and facilitating patient and families in the self-management of health conditions. The role of a health care nurse does not end with following physicians order. The nurse works as an educator and manager of the whole care process. Though physician places the order, the nurse’s role is important as a case manager, in the acquisition of supplies and in the management of nutritional needs. Nurses get to spend more time at the patient’s home when compared to other health care workers. Thus, they have a greater risk of being exposed to occupational hazards of home care. (Henriksen et al., 2008)
Patient issues in home health care: Many seekers of home health care live alone. Poverty rates are high among patient who are in need of home health care. Though Medicare insurance is instituted with the effort to cover people in poverty, there is still patient who lack Medicare. Further, the cost of certain home healthcare requirements is not covered by Medicare.
Home health nurse’s responsibility: Home health care nurses are responsible for knowing the patient point of care (POC). It is also essential that they document the goal and treatment provided to the patient at POC. They are also concerned with providing education to the patient on meeting the health care goals. The health care goals and treatment are reviewed and adjusted from time to time based on the patient’s condition.The nurse is a caregiver and thus a guest in the patient’s family. It is necessary to respect the patient and the family’s personal space and privacy. It is appropriate to not get involved in family quarrels and finances. Nurses may sometimes need to use the refrigerator, microwaves, etc. It is a good practice to ask permission while using some of the appliances in the patient’s home. Refrain from eating food at the patient place and also respect cultural customs and boundaries at home.
Occupational risk factors: The occupational risk hazard can vary with patient’s situations. Nurses involved in the caring of patients with musculoskeletal diseases may have to lift and move the patient. This requires balance and mechanical strength. Frequent lifting of patient and awkward postures can increase the risk for muscular skeletal diseases. Allergic reaction to latex gloves is another important occupational hazard. While some allergies may end as mild skin rashes or dermatitis, others can lead to severe hypersensitivity reaction resulting in breathing difficulties and shock. Bloodborne pathogens and needlestick injuries are the frequently reported in home health care nurses. Though immunization is available for hepatitis B, there is currently no immunization for HIV, hepatitis C virus, and other blood-born infectious diseases. ("Occupational Hazards in Home Healthcare", 2016)
Home health care challenges are quite different from challenges seen in a hospital and this can be stressful. Uncooperative patients, time pressures, family demands, emotions, emphasis on cost saving, etc., can be stressful. Home health care providers are vulnerable to violence in the work place. It is important that the patient and their families provide a safe working environment that is free of threats and physical assaults. Other occupational hazards for home health care nurses are infectious diseases, animals, lack of hygienic practices, falls, accidents, chemicals, weather and fall injuries. ("Occupational Hazards in Home Healthcare", 2016)
Statistics: Figure 1 and Figure 2 are a diagrammatic representation of Occupational health hazard statistics in home health care providers as accessed by Occupational Health and Safety Administration. ("Occupational Traumatic Injuries Among Workers in Health Care Facilities — United States, 2012–2014", 2016)
Figure1: Comparison of Incidence of injury recorded per 10,000 workers -months in U.S, 2012-2014
Figure 2: Comparison of workplace violence injury incidence rate recorded per 10,000 worker-month in U.S 2012-2014
Prevention of Occupational hazards and ensuring safety at the workplace: Home health workers may endure a long period of standing or walking. Interventions that can help reduce this can help reduce strain on muscle and bones. Further, nurses must not be hesitant to seek assistance while transferring or lifting patients. Technology interventions have helped to reduce injuries that can result from lifting and moving the patient who has musculoskeletal difficulties. Adjustable beds, shower chairs, raised toilets seats, grab bars were found to be helpful in reducing musculoskeletal injuries. Slide transfer boards and sheets were also found useful in reducing physical exertion while transferring the patient from chair to bed or from bed to chair. Patient moving sling and rolling toilet chair can also be beneficial. Nurses should always seek help while lifting heavy patients or while moving them. ("Safety and Health Topics | Home Healthcare", 2016)
Nonlatex gloves should be provided to nurses for use in situations that require handling of less infectious material. Powder free, protein free gloves produce less irritation than other gloves. Wash hands with mild soap and dry hands completely after using gloves. Nurses need to be trained in safe use of needles. Even an unexpected movement from the patient can lead to needle injury. Providing support system and quality supervision of workplace environment can help to predict and prevent the occupational hazard. Home health care nurses need sufficient time for traveling, provision for lunch breaks, and a provision through which they can seek help. ("Occupational Traumatic Injuries Among Workers in Health Care Facilities — the United States, 2012–2014", 2016)
Conclusion: Employers have a responsibility towards the safety of their staff. Thus, they must ensure policies and practices that can protect the staff from occupational hazards. They should be trained on coping strategies that can help them come out of hazardous situations. The patient and the family must also be informed about their responsibility towards the nurse. Keeping a close track on staff schedule and workplace can help enable quick response in cases of emergency.
References
Henriksen, K., Oppenheimer, C., Leape, L., Hamilton, K., Bates, D., & Sheridan, S. et al. (2008). Envisioning Patient Safety in the Year 2025: Eight Perspectives. Agency for Healthcare Research and Quality, 1. Retrieved 3 September 2016, from http://www.ncbi.nlm.nih.gov/books/NBK43618/
Occupational Hazards in Home Healthcare. (2016). Centers for Disease Control and Prevention. Retrieved 3 September 2016, from https://www.cdc.gov/niosh/docs/2010-125/pdfs/2010-125.pdf
Occupational Traumatic Injuries Among Workers in Health Care Facilities — United States, 2012–2014. (2016). Cdc.gov. Retrieved 3 September 2016, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6415a2.htm
Safety and Health Topics | Home Healthcare. (2016). Osha.gov. Retrieved 3 September 2016, from https://www.osha.gov/SLTC/home_healthcare/
Sollecito, W. & Johnson, J. (2013). Mclaughlin and Kaluzny's continuous quality improvement in health care. Burlington, MA: Jones & Bartlett Learning.
