Types and patterns of safety concerns in home care: staff perspectives

Craven, Catherine K.; Byrne, Kerry; Sims‐Gould, Joanie; Martin-Matthews, Anne

doi:10.1093/intqhc/mzs047

Cited by 49 publications

(62 citation statements)

References 19 publications

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“…35 Besides the potential for violence, home care workers also experience exposure to communicable diseases, allergens, and dirty homes. 36,37 These risks are greater when the home is poorly maintained. 36,37 It is difficult for OHS regulators to inspect workplaces within private homes because of a lack of inspectors and other resources, and concerns about privacy.…”

Section: Risk To All Paid Home Care Workersmentioning

confidence: 99%

On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

Fitzpatrick

Neis

2015

Policy and Practice in Health and Safety

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Home care work is female-dominated, generally precarious, and takes place in transient and sometimes multiple workplaces. Home care workers can engage in relatively complex employment-related geographical mobility (E-RGM) to, from, and often between work locations that can change frequently and are remote from the location of their employer. Like other precarious workers, home care workers may be more likely to experience work-related health and safety injuries and illnesses than non-precarious workers. Their complex patterns of E-RGM may contribute to the risk of injury and illness. This paper explores patterns of E-RGM and ways they influence the risk of injury and illness among unionized home care workers living and working in two regions of the province of Newfoundland and Labrador (NL) on Canada's east coast. It uses Quinlan & Bohle's pressure, disorganization, and regulatory failure (PDR) model to help make sense of the vulnerability of these workers to occupational health and safety (OHS) risks. The study uses a qualitative, multi-methods approach consisting of semi-structured interviews and a review of government and home care agency policies, as well as 20 NL home care collective agreements. It addresses two main questions: What are the work-related health and safety experiences of interviewed NL unionized home care workers? How do policies (government and home care agency) and collective agreements interact with E-RGM to mitigate or exacerbate the OHS challenges confronting these workers? Findings show that these workers experience numerous work-related health and safety issues many of which are related to working in remote, transient, and multiple workplaces. While collective agreements mitigate some health and safety issues, they do not fully address particular OHS risks associated with working alone,

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Section: Risk To All Paid Home Care Workersmentioning

confidence: 99%

On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

Fitzpatrick

Neis

2015

Policy and Practice in Health and Safety

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“…This demographic change is driving the need for health care at an unprecedented rate (CEPAR, 2014a). Home-based health and social care models, in particular, are becoming viable options for aged care policy makers, as they promise greater cost-efficiency, and respect the preferences of an increasing number of people to receive formal care in their own homes (CEPAR, 2014a;Craven, Byrne, Sims-Gould & Martin-Matthews, 2012). Consequently, paid HCW jobs are growing in demand.…”

Section: Working and Learning In Australian Home Carementioning

confidence: 99%

Learning Occupational Practice in the Absence of Expert Guidance: The Agentic Action of Australian Home Care Workers

Palesy

Billett

2017

Professional and Practice-Based Learning

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Learning occupational practice in the absence of expert guidance: The agentic action of Australian home care workers. In Agency at Work (pp. 271-289). Springer, Cham. Many kinds of workers need to both work and learn in socially-isolated circumstances (i.e., in the absence of others who can provide guidance and support). Such circumstances require particular kinds of agency and agentic action by these worker-learners, and they might be described as requiring particularly agentic personal epistemologies. These epistemologies are essential for workers such as home care workers (HCWs), who after a perfunctory classroom training, are expected to work alone in clients' homes providing a range of support, such as mobility and hygiene assistance. This chapter draws on a recent investigation into the work and learning of a small cohort of such HCWs and maps how they exercise agency in their work practice, work-related learning and development. These workers deployed, in different ways, their past personal experiences (e.g., work, life, education), the classroom training provided, opportunities to engage with other HCWs and support from other informed sources in learning the requirements for their role. Moreover, these workers exercised agentic action by "personalising" their scaffolding or learning supports. That is, they constructed, engaged with, and subsequently relinquished scaffolding as personally necessitated, rather than relying on "experts" to decide how and when these forms of learning support should be enacted and withdrawn. Important here is how these workers' subjectivities are found to include actions and monitoring of performance, not just ideas and dispositions. Through an account of how this particular cohort exercised agentic action, some conclusions are drawn and recommendations made for the best ways of progressing the learning and development of such socially-isolated workers.

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“…incontinence pads, bandaging, gloves can introduce and exacerbate physical interaction risks, e.g. leakage of pads (moderate evidence: Markkanen et al, 2007;Craven et al, 2012).…”

Section: Artefacts (Equipment and Technology)mentioning

confidence: 99%

“…Planning and policy makers, guided by both patient (care recipient) preference for care and treatment in their own home and cost-containment pressures, have been increasingly focussing on community care (Craven et al, 2012;EU-OSHA, 2014 ' (WHO, 2008). However the home setting presents challenges for the more established (acute) caregiver-patient interactions and requires adaptation of policies, protocols and routines (Duke et al, 2012).…”

mentioning

confidence: 99%

“…There are different models of home care, for example, hospital in the home (Duke et al, 2012), patient-centred medical home (Bitton et al, 2012) home first policies and aging-in-place (Craven et al, 2012). One of the challenges to providing care and treatment at the patient's home is the safety and risk of injury to caregivers and patients when care is delivered by staff working alone (HSE, 2009) or as part of a team (Simon et al, 2008).…”

mentioning

confidence: 99%

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Safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings: A systematic review

Hignett

Otter

Keen

2016

International Journal of Nursing Studies

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Additional Information:• This paper was accepted for publication in the journal International Jour- Review methods:The included references (n=42) were critically appraised using a modified version of Downs and Black checklist and the Mixed Methods Appraisal Tool. Results:The risk factors are reported using the modified model of human factors of health care in the home to represent the roles of both patients and caregivers in the system. The results are grouped as environment (health policy, physical and social), artefacts (equipment and technology), tasks (procedures and work schedules) and care recipient/provider. These include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables, and clinical tasks. The topics with strong evidence from at least 2 papers relate to risks associated with awkward working positions, social environment issues (additional tasks and distractions), abuse and violence, inadequate team (peer) support, problems with workload planning, needle stick injuries and physical workload (moving and handling patients). Conclusions:As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage safety risks and plan safer care delivery systems. KeywordsHome care services, moving and lifting patients, patient safety, occupational health, community health services HighlightsWhat is already known:• Providing care and treatment at a patient's home presents risks to both caregivers and patients whether care is delivered from one or multiple organisation(s).• There are different models of home care, including the hospital in the home, patient-centred medical home, home first policies and aging-in-place • Care tasks are categorised as basic care, including personal hygiene, mobilisation, nutrition and social company, and advanced care, including medication administration, tube feeding, and operating home care technology (e.g. ventilator, electric wheelchair) What this paper adds• Risk factors for the environment of care are associated with health policies, physical location and social environment.• The risks include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables and clinical tasks.• As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage risks and plan safer care delivery systems.

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Types and patterns of safety concerns in home care: staff perspectives

Cited by 49 publications

References 19 publications

On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers

Learning Occupational Practice in the Absence of Expert Guidance: The Agentic Action of Australian Home Care Workers

Safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings: A systematic review

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