Role of the Home Care Worker in Injury Prevention

Managing the Environment

As the eyes and ears of the healthcare team, the Home Health Aide/Personal Care Aide plays a very important role in preventing patient injuries. They will be the person spending the most time in the home, and will become very knowledgeable about their patient, their family, and any changes in their condition and within their environment.

The key for Home Health Aides/Personal Care Aides in preventing injury with patients is to properly manage the environment, and to use all of their senses as they observe the patient within their environment. By completing household tasks within the home, they will be helping to keep the patient’s home free from clutter, dirt, pests, and infection. By assisting their patient with daily living tasks, such as bathing, they will help to maintain their well-being and general health.

Proper Body Mechanics

The use of proper body mechanics is an important way to prevent injury to to the health care worker as well as to the patient. Home Health Aides/Personal Care Aides should always keep in mind proper body mechanics during their work with patients, whether it is while bathing, ambulating, or assisting with transfers. Ensure all the equipment used with the patient is in good working order. Always keep in mind the importance of ensuring locks are braked on wheelchairs, chairs, and beds, to prevent accidental injuries.

Handwashing

To prevent the transmission of disease, proper hand washing is of utmost importance. Home Health Aides/Personal Care Aides must wash their hands prior to and after contact with patients and their belongings. Ensure that they wash their hands after contact with body fluids such as blood, urine, feces, and vomit. Gloves should be worn whenever they come into contact with body fluids, food, or while performing household chores such as laundry in which body fluids may be present. Remember to wash hands when removing gloves and to change gloves whenever they are soiled or ripped.

Home Health Aides/Personal Care Aides have an important role in educating their patients and their families about the importance of handwashing. Encourage the patients to wash their hands after using the bathroom, before preparing food or eating, after contact with any body fluids, or whenever they are soiled. For patients who are immobile or who have difficulty with mobility, Home Health Aides/Personal Care Aides can provide them with a wet, soapy washcloth or alcohol sanitizer to use to keep their hands clean and free of germs.

 Fire Safety

In addition to preventing accidental injuries from falls, burns, cuts, choking, and poisoning, Home Health Aides/Personal Care Aides also play an important role in fire prevention and fire safety. They must be aware of potential fire hazards and take steps to prevent fires.

Guidelines for Fire Prevention:

• Ensure smoke detectors and carbon monoxide detectors are present and working in the home. If their patient’s home does not have detectors, discuss their concern with their supervisor. There may be community and agency resources available to provide these to the patient.
• Check batteries in smoke and carbon monoxide detectors several times a year to ensure they are properly working.
• Encourage and assist families to develop fire safety plans and to practice fire drills.
• Every family should have a designated safe meeting place in the event they must leave the home during a fire.
• Teach children fire safety.
• Teach patients to stop, drop, and roll if their clothing ever catches on fire.
• Never leave unattended candles or items such as incense that have a flame where a potential burn can occur. Discourage patients to use these items if they need supervision.
• Do not smoke in the home and discourage patients and family from doing so. Ensure cigarettes are fully extinguished. Prior to emptying ashtrays, ensure there are no hot ashes.
• Never leave the stove unattended while cooking.
• Pay attention that pots do not boil over.
• Take care not to splash oil to prevent grease fires.
• Empty the lint trap after every use of the dryer. Never run the dryer when you are not home.
• Never leave space heaters, electric heaters, kerosene, or gas heaters on unattended and when someone is not home. Ensure all these types of appliances are in good working order.
• Ensure fire extinguishers are in the home, that they have not expired, and that you know how to use them.
• Do not store fire extinguishers near the stove where you may not be able to reach it if there is a fire on the stove.
• Do not wear loose clothing while working on the stove. Teach patients to roll up sleeves and to also avoid wearing loose clothing while cooking.
• Ensure hallways and exits, such as doorways and windows are not cluttered to prevent emergency exit.
• Keep emergency numbers near the phone for easy access.

How to Use a Fire Extinguisher:

When using a fire extinguisher, the acronym PASS should be kept in mind.

P: Pull the pin

A: Aim at the base of the fire

S: Squeeze the handle

S: Sweep back and forth at the base of the fire

In Case of A Fire:

In case of fire, remember the acronym RACE.

R: Remove patients from danger

A: Activate 911

C: Contain the fire if safe and possible to do so

E: Extinguish fire or call the fire department to do so

Other Things to Remember in Case of a Fire:

The first priority is to get the patient to safety. Remain calm and direct the patient and others in the home to safety. Never try to put out a large fire or put yourself or others in danger. Stay low in rooms with fire. Close doors and if possible, plug doorways with blankets to prevent smoke from entering. Place a wet towel over the patient’s face and your face to decrease smoke inhalation. Should a person’s clothing catch on fire, remember to tell them to stop, drop, and roll. Keep the patient and all others far away from the home once you have left. Wait for instruction from the fire department. Notify the supervisor once you have reached a safe destination.

Personal Safety

It is important that Home Health Aides/Personal Care Aides take precautions to keep themselves safe while working within the community and in the patient’s home. They should follow these guidelines to protect their safety.

• Always know the route. Have maps and directions with you and know where you are going in advance. If needed, call the patient for directions or obtain them from the agency prior to leaving for the destination.
• If you have a cell phone, keep it charged and with you. Do not use it while driving.
• Do not take unsafe shortcuts while driving or walking to and from a patient’s home. Never alter your route without telling the agency. Always inform a supervisor about your whereabouts.
• Observe surroundings at all times and remain vigilant (watchful). Do not become distracted by talking, music, or using a cell phone.
• Keep your eyes on the road while driving and look around at your surroundings while walking to and from a patient’s home.
• Do not carry a purse, large amounts of money, or wear expensive jewelry. This makes you a target for possible thieves. If you must carry a purse or belongings, hold them securely against your body.
• Lock your car and keep valuables hidden in the trunk, out of sight.
• Carry your keys in your hand so that you can quickly unlock your door.
• Park in well-lit areas and try to park as close to the patient’s home as possible to reduce walking time.
• If you ever feel unsafe, leave the area immediately and go to a safer location. Call a supervisor for assistance.

Pets

 Some patients may have pets in their home. Find out prior to going to a patient’s home for the first visit if they have pets on the premises. Ask the patient how their pet is around strangers. If the patient says that the pets are aggressive or do not like strangers, Home Health Aides/Personal Care Aides should inform their supervisor and seek direction from him or her. Ask the patients to place their pets in a secured area during a visit. When being introduced to a pet, such as a dog, remain calm. Home Health Aides/Personal Care Aides should allow the pet to become familiar with them. Do not begin petting him or her before they become acquainted with you. Some pets are more friendly and accepting of strangers.

While walking to and from their car, Home Health Aides/Personal Care Aides should be aware of pets in the neighborhood. Should there be a loose dog, try to stay away from the dog. Do not start panicking or running. A Home Health Aide/Personal Care Aide should cross the street or return to their car if they are concerned about their safety.

If Home Health Aides/Personal Care Aides should receive a dog bite from any dog, run cool water over the area of the bite for several minutes to wash away the saliva and accompanying bacteria. Do not squeeze the site of the bite. This pulls bacteria inside the wound. Inform the supervisor of the incident. Seek medical attention if necessary. Obtain the identifying information about the dog and vaccination records, such as rabies vaccination. If the pet is not up to date with vaccinations, Home Health Aides/Personal Care Aides will need to get the rabies vaccination when they seek medical treatment.

Transportation Safety

It is important for Home Health Aides/Personal Care Aides to stay safe while driving to and from their patient’s home. Follow these guidelines for transportation safety.

• Be familiar with the roads and stay aware of surroundings. Have directions and a map handy.
• Ensure there is always enough fuel in the car. This helps to prevent unwanted stops in strange areas.
• If using your personal car, ensure it stays in good operating condition. Keep up to date with your annual inspection and keep insurance and registration materials current and in the car.
• Ensure that tires are inflated to the appropriate pressure and obtain vehicle maintenance on a regular basis.
• Know how to drive in inclement (bad) weather.
• Drive the appropriate speed limit to prevent accidents and tickets.
• Drive with the car doors locked.
• Never use a cell phone while driving. To avoid other distractions, limit talking and music.
• Always wear a seat belt. Ensure other car occupants wear their seat belt.
• Remember that there should be no children under the age of 12 riding in the front seat.
• All children must wear seat belts in the car.
• Child safety seats must be used with children under 8 years of age. Inspect the child safety seat frequently to ensure it is in good working order. Make sure you know how to use it. If you do not, ask the patient or a supervisor for instructions.
• Never ingest alcohol or drugs prior to or during driving.

 Introduction

While Home Health Aides/Personal Care Aides work to keep their patient and their home safe, there are situations where an accident may occur. It is important that Home Health Aides/Personal Care Aides are aware of their agency’s policies regarding incidents. Most agencies will have provided them with training in how to deal with emergency situations. This will include the agency’s policies and procedures and an emergency contact list. If Home Health Aides/Personal Care Aides have not been informed about their agency’s policies and procedures, they should speak with their supervisor to find out what the procedures are in dealing with emergencies. Whenever in doubt, call a supervisor.