Safety Concerns Affecting Delivery of Home Health Care

Authors

  • Mary Agnes Kendra Ph.D., R.N., C.N.S.,

    Corresponding author
    1. Mary Agnes Kendra is with Cleveland State University, Department of Nursing, Cleveland, Ohio.
      Address correspondence to Mary Agnes Kendra, Ph.D., R.N., C.N.S., Cleveland State University, Department of Nursing, Rhodes Tower 910, 1860 East 22nd Street, Cleveland, OH 44115-1123.
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  • Aloise Weiker B.S.N., R.N.,

    1. Aloise Weiker, Susan Simon, Abigail Grant, and Diane Shullick are with interim HealthCare of Northeast Ohio, Inc., Shaker Heights, Ohio.
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  • Susan Simon B.S.N., M.A.,

    1. Aloise Weiker, Susan Simon, Abigail Grant, and Diane Shullick are with interim HealthCare of Northeast Ohio, Inc., Shaker Heights, Ohio.
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  • Abigail Grant M.S.W., LISW,

    1. Aloise Weiker, Susan Simon, Abigail Grant, and Diane Shullick are with interim HealthCare of Northeast Ohio, Inc., Shaker Heights, Ohio.
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  • Diane Shullick B.S.N., R.N.

    1. Aloise Weiker, Susan Simon, Abigail Grant, and Diane Shullick are with interim HealthCare of Northeast Ohio, Inc., Shaker Heights, Ohio.
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Address correspondence to Mary Agnes Kendra, Ph.D., R.N., C.N.S., Cleveland State University, Department of Nursing, Rhodes Tower 910, 1860 East 22nd Street, Cleveland, OH 44115-1123.

Abstract

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.

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