The impact of crime on home care services.

George

2001

Risks associated with home visiting have been acknowledged in the nursing literature since the 19th century, yet there is not a well-defined body of literature on this subject. This void in the literature needs to be addressed in view of the current emphasis on practice in the community and the increase in the number of nurses and other health professionals that are new to the field who currently make visits. This article explores how different disciplines define risk and risk taking, identifies attributes of those who become involved in risk situations, and proposes the Cognitive-Perceptual Model of Risk in Home Visiting (CPMRHV) for community and public health nursing. The CPMRHV model provides a framework for identifying how field workers (FWs) perceive, assess, and evaluate situations relative to risk and suggests the development of policies and procedures to empower them and to assure the quality of care.

Section: The Cognitive‐perceptual Modelmentioning

confidence: 99%

Defining Risk in Home Visiting

George

2001

“…Several studies were found that addressed how agencies have responded to changing environmental factors associated with delivering nursing care to homebound patients. Snow and Kleinman (1987) reported results of a telephone survey of 49 Veterans Administration home care programs regarding whether these programs had safety policies. Thirty-two of these programs reported having clients in "dangerous areas."…”

Section: Literature Reviewmentioning

confidence: 99%

“…In summary, the need for home health care services has increased remarkably-not only as a result of the increasing elderly population needing care for their chronic illnesses, but also because of increased numbers of high-risk clients, such as mothers and babies, as well as clients needing infusion therapy. Snow and Kleinman (1987) and Smith ( 1988) suggest strategies for minimizing threats to personal safety of those delivering home health care by refusing to make visits in defined areas, developing protocols for tracking staff making visits in areas that pose risk, providing escort services, and planning inservices related to min-imizing risk. What seemed to be lacking in the literature is an overall assessment of how home health care administrators plan for reducing risk to staff and how staff themselves plan to reduce risk.…”

Section: Literature Reviewmentioning

confidence: 99%

Safety Concerns Affecting Delivery of Home Health Care

Weiker²,

Simon³

et al. 1996

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.

“…Few empirical studies related to home visiting address the issue of risk. Articles that do exist are anecdotal, and prescribe various protocols for reducing the potential for being at risk (Smith, 1988;Snow & Kleinman, 1987). Finney (1988) suggests that violence should be taken seriously and all community nurses should insist on education related to managing violent situations.…”

Section: Literature Reviewmentioning

confidence: 99%

Perception of Risk by Home Health Care Administrators and Field Workers

1996

The home health care industry has grown significantly over the past 15 years, primarily as the result of an increasing percentage of elderly needing services. Although personal risk has always been a contextual factor of home visiting, an additional challenge facing home health care administrators today is ensuring field worker safety, because visits are now made 24 hr a day, 7 days a week. The purpose of this study was to compare home health care administrators' with field workers' perceptions of risk involved in making home visits. The Home Health Care Perception of Risk Questionnaire (HHCPRQ), a self-report measure, was administered to a national random sample of 93 home health care administrators and 705 field workers to determine perception of risk within the context of making home visits. Findings indicate significant differences between home health care administrators' and field workers' perceptions of risk in making home visits. Suggestions for enhancing communication among all agency personnel and developing in-service education programs that are specifically for field workers are identified.