This course addresses the common safety-related factors in the community and home environments. Home care team members can be exposed to a number of potentially serious hazards which range from dangerous pets (eg. biting) to firearms (ie. guns) in homes. Environmental hazards include smoke, needlesticks, unhygienic homes, germs and pathogens, structural house problems, hoarding and many others. This course seeks to identify some of these safety hazards and dangers so that clinicians and managers/leaders can better understand and apply their risk management and safety policies related to such situations and protect their team members.
Kim Corral, RN, BSN, MA Ed, COS-C
Kim is a registered nurse with a master's degree in education and more than 30 years of home health experience. She is an experienced leader in home health care, having held both clinical and operational positions at regional and national levels for large corporate home health organizations. She brings a passion for providing the clinical…Read full bio
Tina Marrelli, MSN, MA, RN, FAAN
Tina Marrelli is the president of Marrelli and Associates, Inc., a publishing and consulting firm working in home care for more than 30 years. Tina is the author of 13 books, including the Handbook of Home Health Standards: Quality, Documentation, and Reimbursement (6th edition, 2018). Other books include A Guide for Caregiving: What's Next? Planning…Read full bio
1. The Community Environment: A Reflection of Society
A knowledge of the community is key to safety-related initiatives in providing home care visits to people in varying neighborhoods and areas. Sadly, we only have to watch the news to hear that there is another random shooter or other dangerous and scary event. This chapter seeks to help answer the question: what if? The Centers for Medicare and Medicaid Services (CMS) established national emergency preparedness requirements for all organizations, such as home care and hospice, participating in the Medicare and Medicaid programs. In the State Operations Manual (section 484.22) are the related Conditions of Participation for Home Health Agencies (HHAs). These became effective in November, 2017. The bottom line is that we have an important role to play and that we must be prepared, whether the emergency be caused by nature, such as ice storms, tornadoes, or hurricanes, or other situations, such as an active shooter situation.
2. The Windshield Assessment: Assessing and Observation by Driving Around
There is a method of assessing a neighborhood or community through an effective and detailed Windshield Assessment. This seemingly simple process can identify much information about a given neighborhood or area. This windshield assessment is accomplished to identify possible safety hazards and risks for both the clinicians and their patient populations.
3. Driving and Identifying Safety Concerns in the Community
The fundamentals for home visit safety begin on the road. This includes a car in good working condition, a method for getting roadside assistance, having a full tank of gas, not leaving your purse on the passenger seat where it can be seen, and not leaving patient records where patient information might be seen (HIPAA). This also includes looking around your car for safety concerns on getting in and out of the car. These and other common safety concerns will be addressed in this chapter.
4. Safety Hazards in the Patient's Environment of Care: The Home
There are a number of common and known hazards in homes. The home care clinician must have an awareness of their surroundings at all times in the community and in the patient's home. Hazards found in the home can include dangerous pets, smoking, poor structural maintenance, infestations, unclean homes, blood-borne pathogens, unsafe water, tripping hazards, and many more. Others include risks to personal safety from violence, stalking, and abuse.
5. Being Safety Aware and Minimizing the Risks
Sadly, there have been instances of home care clinicians walking into situations that resulted in death and injury. These are related to the practice environment. This chapter seeks to educate and help minimize such situations, when possible.
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