Hazards and the Growing Need for Safety in Community Healthcare
According to the US Department of Labor’s Occupation Safety and Health Administration, workplace violence is a recognized hazard in healthcare that is defined as any act or threat of physical violence, harassment, intimidation or other disruptive behavior that occurs at the workplace. Have you or your workers ever experienced this?
As an increasing number of health authorities move towards providing more and more care in the comfort of the patient’s home, so does the incidence of assaults and abuse towards these health care workers who are venturing into the community alone to provide the needed care. Additionally, there is the added biological threat of COVID-19 when entering a patient’s home and treating these people.
According to a report presented to the House of Commons in June 2019, “Health care workers working in-home care and community-care settings also face greater risks of violence because they are often working alone in these settings and lack training on how to de-escalate violence.” And According to StatsCanada, the total operating revenue for home health care and related services was $5.4 billion in 2017, up 5.1% from $5.1 billion in 2016. These numbers are driven by a growing aging Canadian population who increased from 7.9% in 1971 to 17.2% in 2018. This demographic will continue to grow with the number of Canadian seniors reaching a 23% by 2033 when the entire baby boomer generation will be 65 years or older, needing more, complex home health care and social services.
What hazards exist in home and community healthcare?
To provide these increasingly complex community services, we must address the many safety issues and hazards these nurses face. According to a 2017 study from the Canadian Federation of Nurses Unions, “compared to other workers, nurses experienced far higher rates of serious violence,” finding that six in 10 members (61%) have had serious problems at work with at least one type of workplace violence in the previous 12 months. These are staggering figures, and while no official studies have been performed on community nursing and violence, experts have found that physical and verbal violence is significantly higher in the community than in a traditional hospital setting.
There are significant benefits to treating the patient in the comfort of their own home, but in addition to violence, there are also unique risks that health care and social service workers face when providing treatment away from the security of the hospital or clinic. These can include:
Unique hazards home and community care workers face include:
Chemical hazards like hazardous drugs, and cleaning and sterilizing agents.
Biological hazards like infectious diseases, blood-borne pathogens, needle penetration injuries, and bodily fluids.
Physical hazards like slips, trips, falls, and back injuries.
Unhygienic and potentially dangerous conditions include violent patients, lack of clean water, hostile or unclean animals and even the increased risk of accidents with long commute to the home.
Last but certainly not least emotional and mental health hazards like stress, physical and verbal abuse and violence, and feelings of vulnerability and isolation in the demanding work.
How to protect our community healthcare workers
The threat of violence and other workplace hazards are difficult to control in the vulnerable environment of a patient’s home. There are, however, basic steps that can be taken to increase the safety of these workers:
Trust your intuition
While difficult its effectiveness, home health managers encourage their team to “use their gut” and intuition when assessing if a situation is safe or not. According to a research series from the International Association for Healthcare Security and Safety Foundation, a home health manager should encourage team members to trust their judgment and avoid situations that don’t feel “right,” and for managers to honor that call.
Do the proper training
The US Bureau of Labor and Statistics estimates that community healthcare employment grew 55% in between 2006 and 2016, establishing the area as one of the most rapidly growing healthcare sectors of the past decade. To keep the workforce safe amidst this major growth, community and home nurses need to be trained in well-researched protocols that will keep them safe during dangerous situations. Examples of this include developing a written plan for ensuring personal safety, educating nurses on the risks of their job and how to assess the safety of their environments, and educating staff on the signs of drug use and threatening body language.
Assess the risks and prepare yourself
As mentioned above, a key component to safety while working in the community is assessing any potential risks and preparing yourself appropriately. Questions should be asked like, “Is their parking near the client’s home?” “Do I need any equipment such as a lift to provide the needed care?” “Is the neighbourhood known for criminal activity?” “Does the client have a history of violence?” Once the safety risks are assessed, then the nurse and manager must explore ways to mitigate those risks and hazards.
Utilize available tools and technology
One effective way to mitigate any threats and safety hazards is to use any resources and technology that can help the worker in an emergency. This includes a lone worker safety app with a panic button, or a voice activation tool on the identification badge. Local law enforcement may also have maps of the area showing the levels of crime and violence that have taken place in the past, allowing the community healthcare worker and their manager to prepare appropriately.
Helping those providing care in the community
SafetyLine is a lone worker safety app that has number of valuable features to protect community workers. For years, Seasons Health Therapies in Kamloops has been depending on SafetyLine to protect its team who are out in the community.
“In our organization, we use SafetyLine for all of our on-the-road-people – so anybody in the field,” says Dawn MacKenzie, Clinical Director, Seasons Health Therapies. “They are using (the SafetyLine) app on their mobile phones and are checking into SafetyLine every hour...just to make sure they’re safe. "
Learn more about Seasons Health Therapies’ experience with SafetyLine, and visit our previous blog, Are Health and Community Care workers classified as Lone Workers?
View our case study on Seasons Health Therapies
What can be done to help health care lone worker stay safe?
Before developing a lone worker safety program, check the regulations in your area. Some Canadian jurisdictions have specific laws around working alone.
According to the Canadian Centre for Occupational Health and Safety, there are many steps that can be taken to help ensure the safety of the lone worker:
Avoid having a lone worker whenever possible, especially for jobs with a recognized risk.
Assess the hazards of your workplace.
Talk to workers about their work. Get their input about the work they do and possible solutions.
Investigate incidents at your workplace, and learn from incidents in similar workplaces.
Take corrective action to prevent or minimize the potential risks of working alone.
Provide appropriate training and education to both the lone worker and the person tasked to respond if there is a concern.
Report all situations, incidents, or 'near misses' where being alone increased the severity of the situation. Analyze this information and make changes to a company policy where necessary.
Establish a check-in procedure. Make sure that regular contact is kept with all workers. Establish ways to account for people (visually or verbally) while they are working.
Schedule higher risk tasks to be done during normal business hours, or when another worker capable of helping in an emergency is present.
Support and protection
The final reason is key in this case because health care workers do not have the support and protections that they would in a traditional workplace environment.
“But SafetyLine Lone Worker can provide that needed support and protection,” says Heather Eastman, Director of Sales and Business Development at SafetyLine Lone Worker. “When a nurse or health care worker goes into a patient’s home, they’re vulnerable to several unique risks. SafetyLine keeps them connected to a monitor who can watch their back while providing the worker with an accessible, easy-to-use way to call for urgent help should something happen.”
Canadian regulations for lone workers
The regulations and legislation for Canadian lone workers range across the country. Failing to protect your lone health care workers could result in increased WCB premiums, fines, legal action, or even criminal charges for either an organization or an individual liable.
Easy tips for health care workers who work alone
In addition to implementing the support of SafetyLine and the assigned monitors, you can also:
Make sure you protect your belongings and work gear by locking car doors and keeping any bags or valuables out of sight.
Make sure your cell phone is accessible at all times in case your safety is threatened by a patient and you can use hit the panic button or shake for an emergency with the SafetyLine app.
Using the SafetyLine app, make sure you check in so your managers and monitors know that you are working and where.
If it’s your first time visiting a home, make sure you have clear directions so you aren’t wandering around an unfamiliar neighborhood.
Be cautious around pets and animals on the patient’s property.
“SafetyLine will care for you while you’re caring for others,” Heather says. “It’s an affordable, easy-to-use means to provide the best care possible.”