SAFETY ORIENTATION FOR HOME
HEALTHCARE WORKERS

INTRODUCTION:

As a home healthcare worker, you encounter potentially hazardous situations every day.  According to the National
Institute of Occupational Safety and Health (NIOSH), the healthcare industry reports more job-related injuries and illnesses
than do other hazardous industries.

Some of the hazards that you may face in your daily work at patients’ homes are:

  • Slips, trips and falls
  • Back injuries
  • Electrical hazards
  • Fire
  • Bloodborne pathogens
  • Medical waste handling
  • Personal risk.

HAZARDS IN THE HOME

Healthcare workers in the home face the same risks as those who work in institutions.  However, in the home, the work
environment is less standardized, less predictable and less controlled.  

Additional risks may present themselves, such as:

  • Small bedrooms, crammed with heavy furniture
  • Patients in sagging, double beds
  • Limited equipment
  • Tiny bathrooms
  • Narrow stairways
  • Poor lighting
  • Treacherous weather conditions
  • Dangerous neighborhoods

Because you are working the homes of your patients, you have less control over your working environment.  You should
be aware of potential hazards and know how to handle or avoid them.

SLIPS, TRIPS AND FALLS

Slips, trips and falls are a common cause of injuries on the job.  

To avoid this hazard be aware of your surroundings.  Injuries are often caused by:

  • Wet floors
  • Debris
  • Loose carpets or throw rugs
  • Electrical cords
  • Poor lighting or glare from too much lighting.

To avoid injuries due to slips, trips and falls:

  • Watch where you are going.
  • Don’t rush.
  • Keep your center of balance under you.
  • Take shorter, slower steps.
  • Wear sensible shoes that have adequate traction and support.
  • Instruct patient/caregiver on hazards and how to correct them for their safety.

BACK INJURIES

Back injuries are a common occurrence among home healthcare workers.  You often have as much strain on your back as
a construction worker.

To avoid a back injury:

  • Use proper techniques for lifting and transferring patients.
  • Maintain good posture.
  • Stay physically fit.

Use proper body mechanics when lifting or transferring patients:

  • Bend at the hips and knees.
  • Lift with your leg muscles, not your back or arm muscles.
  • Avoid any twisting motion.
  • Never lift a load higher than your waist.
  • Keep the load close to your body.
  • Don’t attempt to lift or move something that seems too much for you to handle safely.

If you have a patient who is too large for you to move by yourself, ask your agency to assign a second caregiver on some
days to help with bathing or ambulating the patient.

ELECTRICAL SAFETY

Each year, healthcare workers suffer pain, injuries and death from shocks o fires caused by electricity.  

Manage electricity safely by taking sensible precautions:

  • When planning to use home medical equipment, assess the home for the appropriate number of outlets.
  • Order the equipment from a Durable Medical Equipment supply company.
  • Examine all cords and plugs for damage or if they heat up when used.
  • Keep cords away from heat and water.
  • Don’t run cords under rugs or through doors.  Never perforate them with tacks or pins.
  • Always use grounded, three-hole electrical outlets.
  • Never break off or bend the third prong on a grounded plug.
  • Never use “octopus plugs” or other adapters that let you plug extra cords into one outlet.
  • Always disconnect electrical equipment from the power source before cleaning.
  • Know where the circuit breaker box is located so you can turn off power at the breaker if necessary.
  • Be sure you know what to do in the case of a power outage.  

If you have a patient on life support:

Notify the local power company at the time of admission.
Tell them whether you have an emergency generator or battery pack and how long it will last
If a power outage occurs, that home will be listed as a Prior One with the power company to report power.

FIRE SAFETY

No one likes to think about fire, but fire is another hazard that can and does happen.  

Here are basic rules to follow in case of a fire:

  • Know where the exits are located.
  • Plan emergency routes for quick exit.
  • Identify locations of smoke detectors and telephones.
  • Know the telephone number of your location.
  • Learn how to operate the first extinguishers in the home if they are available, and know where they are.

When a fire occurs, act quickly.  The first two to three minutes are most critical for safety.  It is a
RACE safety!

  1. RESCUE patients.
  2. Activate the ALARM by calling 911.
  3. CONFINE the blaze.
  4. EXTINGUISH it if it is small, otherwise EVACUATE.

Heat and smoke are just as deadly as flames.

  • Don’t open doors without first testing for heat radiating from them.
  • Remember to touch walls and doors with the back of your hand, instead of your palm.
  • Stay close to the floor to avoid inhaling too much smoke.

MEDICAL WASTE HANDLING

OSHA’s Bloodborne pathogens Standard includes guidance for healthcare workers who handle medical waste.

Your employer’s Exposure Control Plan contains information about this standard specific to your agency.  Make sure you
are familiar with both the OSHA standard and the Exposure Control Plan.  Your continuing good health may depend on
that knowledge.

Blood and body fluids can carry many infections, such as the human immunodeficiency virus (HIV), the hepatitis B virus
(HBV) and hepatitis C virus (HCV) – even when there are no signs or symptoms.  Therefore, it is important that all medical
waste related to patient care be treated as potentially hazardous.  

Medical waste includes items such as:

  • Sharps
  • Blood
  • Body fluids
  • Specimens
  • Soiled laundry
  • Dirty dressings.

Always dispose of medical waste properly by following your agency’s policy.  Handle contaminated laundry as little as
possible.  Launder contaminated items as soon as possible and, when appropriate, use chlorine bleach as a disinfectant.

PERSONAL PROTECTIVE EQUIPMENT

Personal protective equipment (PPE), provides a vital barrier between your body and dangerous hazards.  

Appropriate PPE may include:

  • Gown
  • Apron
  • Goggles
  • Face shield
  • Mouthpiece
  • Gloves
  • Shoe covers
  • Head cover.

Follow your agency’s policies on the appropriate use of PPE in your setting.  Replace PPE as soon as practical when
contaminated, or immediately if torn or punctured and no longer able to offer barrier protection.
When handling potentially hazardous material, use close-fitting, disposable, single-use gloves.
Heavy-duty gloves should be used for housekeeping duties.  Remember to cover cuts or abrasions with bandages before
being gloves.

GLOVE REMOVAL AND HANDWASHING

Correct use of gloves and proper handwashing procedures are vital to your safety.  If Infectious material gets on your
hands, the sooner you wash it off, the less your chance of becoming infected.  Handwashing also keeps you from
transferring contamination to other areas of your body, to other patients or to your environment.

  • Always wash your hands thoroughly before donning gloves.
  • Use running water, soap and frictions on all surfaces of the hands for a minimum of 15 seconds.
  • Wear gloves when handling any potentially hazardous material.
  • After each activity you should remove your gloves and thoroughly wash your hands before putting on a new pair.

Be careful when removing your gloves.

  • While both hands are gloved – peel one glove off from the outside top and hold it in the gloved hand.
  • With the exposed hand, peel the second glove down from the top, tucking the first glove
  • Inside the second.
  • Don’t touch the outside of the glove.
  • Dispose of the entire bundle in a proper waste container.
  • No barrier is 100 percent effective, so washing your hands after glove removal is critical.

The CDC recommends use of waterless alcohol antiseptic hand rubs if your hands are not visibly soiled.

PERSONAL SAFETY

Providing home healthcare is becoming increasingly dangerous due to the epidemic of violence in our country.

You can protect yourself and prevent personal harm by following safety rules:

  • Before you make the visit.
  • While traveling to the visit
  • During the visit
  • In case you must defend yourself.

SAFETY TIPS BEFORE THE VISIT

  • Review the patient’s chart for history of violence, substance abuse, or mental illness.
  • Plan morning visits to areas of questionable safety.
  • Give details of our expected schedule for the day to the office including names, addresses, phone numbers, visit
    times and time of return.  Let them know if your schedule changes during the day.
  • Make sure you know exactly where you are going.
  • Get accurate directions.
  • Have a map or GPS system available.
  • Do not carry a purse.  Keep your purse out of view.
  • Keep your cell phone charged in case you need to call for help.
  • Be alert and aware of your surroundings at all times.  
  • Have the family watch you get safely into and out of the house and back to your car.

TRAVELING SAFETY TIPS

  • Keep your car well-maintained.
  • Fill your tank with enough gas for the entire day.  Never let your fuel gauge read below a quarter tank.
  • Follow safe driving rules.  Wear a seat belt.  Follow posted speed limits.
  • When driving, keep your doors locked, and keep your windows closed at least up to earlobe level.  Keep the inside
    of your car free of personal belongings.  If you have car trouble, stop in a well-lighted, populated place if at all
    possible.
  • Park within sight of your destination.  Avoid deserted streets or alleyways.
  • Be alert and cautious in parking lots and garages.  Stay clear of vans or trucks that can obstruct your view.

VISITING SAFETY TIPS

  • Before getting out of the car, check the surroundings – activities of people, condition of buildings.  If you feel
    uneasy, don’t get out of your car.  Contact your office from a safe area or via your cell phone.
  • Project confidence with your body language.  Look like you know what you are doing – always.
  • Dress simply and do not wear jewelry.  Wear an inexpensive watch.
  • Keep all medical equipment out of sight in an appropriate bag which does not appear tempting.
  • Keep one arm free.
  • Never walk through a crowd.  Cross the street at the first sign of trouble.
  • Be alert to building surroundings, elevators and body language of persons you encounter.  Strong eye contact may
    ward off a lot of trouble.
  • Always knock on the door before entering a person’s home.  Call out and identify yourself to those inside.
  • Do not attempt to break up domestic arguments – they can be quite volatile.
  • If the situation appears unsafe for any reason, leave the area and contact the office, the police or both.
  • Have car keys in hand and between your fingers when walking toward the car for accessibility and as a potential
    weapon.

SAFETY TIPS IN DEFENDING YOURSELF

Be prepared to defend yourself should you run into an aggressive or assaultive situation.  Be trained to recognize and
divert escalating hostile behavior.  Carry hand-held alarms or noise devices.  Be trained in proper use of pepper spray.

If you encounter hostile behavior:

  • Scream
  • Yell “Fire!” or “No!” loudly
  • Kick shin, instep or groin
  • Scratch
  • Act insane
  • Blow a whistle
  • Use chemical sprays

YOUR SAFETY IS UP TO YOU

Even though you are exposed to many hazards every day, you can handle and avoid these risks by being aware of your
situation, by following basic safety rules and by using your common sense.  Your health and safety is really up to you.  Be
aware.  Be healthy.  Be safe.









   Revised 12/5/2016
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