Basic Home Care Industry Safety Guidelines for Field Clinicians
The following is a home health and safety inspection checklist:
- Before making home visits, home health care workers should secure all purses and wallets at the Agency. If you must take a purse or wallet, lock it in the trunk of the car before entering the patient’s home.
- Always have detailed directions to get to the patient’s home. Always know exactly where you are going.
- Alert the patient/family of the time of your arrival so that they are watching and waiting for you.
- At apartment buildings or housing projects, check in with the building captain or security clerk wherever possible.
- If driving alone, drive with windows at “ear-lobe” level and keep all car doors locked. Keep the interior of the care free of personal belongings.
- If making an evening or night visit, park in a well-lit, easily accessible, and safe area.
- Always be cognizant of the surrounding area. Do not stop or leave your car if you feel unsafe.
- The type of nursing bag you use should not look like it carries any medical supplies. Keep all medical supplies out of sight.
- You must carry a hand-held alarm regardless of the patient or neighborhood safety rating.
- Do not partake in heavy or lengthy conversations with family or neighbors no matter how pleasant the parties seem to be.
- Never walk through a crowd to get to a patient's doorway. Find an alternate source of entry into the building or home.
- Do not attempt to break up domestic arguments.
- ALWAYS TRUST YOUR INSTINCTS. Threats to personal safety can happen anytime, anywhere - even if the neighborhood or person’s home does not fit the profile of an unsafe environment.
Advanced Safety Awareness
- Staff who are making visits to homes and neighborhoods with known safety hazards will always carry a cell phone. If the area is remote and the cell phone does not receive a reliable connection, staff should be issued a two-way radio.
- Log in - log out. The Agency should monitor your travel to and from assignments on an Employee Log In - Log Out Form for High Risk Visits. When traveling to an assignment that has known safety hazards, notify the Scheduling Coordinator (SC) that you are leaving for the assignment, and describe the travel route you are taking to get there. When you have arrive, call the SC and inform her/him of your arrival. Give the SC an estimate of the time you will be finished. When you are finished, call the SC and tell her/him you have finished and are leaving to go to your next assignment. Describe the travel route you are taking. When you have arrived at the next assignment, call the SC to inform of your arrival. Follow the above procedures until you have completed assignments with known safety hazards.
- If there have been reported incidences of violent crime such as assault and armed threats, or brandishing of guns in a neighborhood or home, the Agency will provide an escort to accompany the caregiver during the home visit.
Evaluating the Patient and Home for Violence
When the Admission Nurse/Therapist performs the admission visit, IF INDICATED s/he should complete the form Patient “Aggression Towards Others” Assessment Scale. If the patient receives a rating of 0, a caregiver visiting the patient would practice basic safety awareness and carry basic safety devices. If a patient receives a rating of 1 to 25, an assigned caregiver would practice advanced safety awareness, carry advanced safety awareness devices. For a patient who rated a minimum of 26, a caregiver would practice advanced safety awareness and have an escort present during visits.
For all patients with scores of 1 or greater, its recommended that the Case Manager ask the patient/POA to sign a No Harm - Safe Environment Contract. The contract is renewed by the Case Manager every time there is a documented incident of violation of the contract.