BackgroundConsumer-driven homecare models support aging and disabled individuals to live independently through the services of homecare workers. Although these models have benefits, including autonomy and control over services, little evidence exists about challenges homecare workers may face when providing services, including workplace violence and the negative outcomes associated with workplace violence. This study investigates the prevalence of workplace violence among homecare workers and examines the relationship between these experiences and homecare worker stress, burnout, depression, and sleep.MethodsWe recruited female homecare workers in Oregon, the first US state to implement a consumer driven homecare model, to complete an on-line or telephone survey with peer interviewers. The survey asked about demographics and included measures to assess workplace violence, fear, stress, burnout, depression and sleep problems.ResultsHomecare workers (n = 1,214) reported past-year incidents of verbal aggression (50.3% of respondents), workplace aggression (26.9%), workplace violence (23.6%), sexual harassment (25.7%), and sexual aggression (12.8%). Exposure was associated with greater stress (p < .001), depression (p < .001), sleep problems (p < .001), and burnout (p < .001). Confidence in addressing workplace aggression buffered homecare workers against negative work and health outcomes.ConclusionsTo ensure homecare worker safety and positive health outcomes in the provision of services, it is critical to develop and implement preventive safety training programs with policies and procedures that support homecare workers who experience harassment and violence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-014-1340-7) contains supplementary material, which is available to authorized users.

Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed.

The potential route of contamination by skin microorganisms onto the distal tip of central venous catheters during insertion was investigated. Thirty patients undergoing cardiac surgery who required a central venous catheter (CVC) as part of their clinical management were studied. Following catheter placement, the device insertion equipment and the skin at the insertion site were sampled for microorganisms. The distal tips of the CVCs were also sampled in situ within 90 min post insertion. Bacteria were isolated from 20 of 30 (66%) CVC skin insertion sites, from 15 of 30 (50%) guidewires, and from five of 30 (16%) catheter distal tips in situ. These findings suggest that despite rigorous skin disinfection and strict aseptic technique, viable microorganisms are impacted during insertion onto the distal tip of the CVC, which may act as a subsequent nidus of infection.

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To what degree can an approach involving the use of circle time improve the quality of relationships within a class? The writers report on a piece of research they undertook involving a Year 6 class which sought to answer this question. The research was initiated because of a concern about the poor quality of relationships within the class. The writers worked together on seven weekly circle-time sessions of 45 minutes each. There was a clear focus on relationships and the discussion of feelings. Evaluative questionnaires were given at the outset and on completion of the programme. The results were generally encouraging, in particular in terms of more positive and less negative feelings about others in the class. The authors conclude by suggesting that the reactive nature of their programme lessened its effect and emphasise the need for and value of a more proactive approach.