Hazardous Occupational Exposures and Injuries in Home Care: Results from the Safe Home Care Survey

Size: px

Start display at page:

Download "Hazardous Occupational Exposures and Injuries in Home Care: Results from the Safe Home Care Survey"

Marjory Hamilton
8 years ago
Views:

1 Hazardous Occupational Exposures and Injuries in Home Care: Results from the Safe Home Care Survey Margaret Quinn Professor Dept of Work Environment University of Massachusetts Lowell IOHA Conference 29 April 2015 London

2 Safe Home Care Research Team: Pia Markkanen Laura Punnett Daniel Okyere Catherine Galligan Angela Laramie Susan Sama David Kriebel Letitia Davis Natalie Brouillette Rebecca Gore Daniel Okyere In Collaboration with the Occupational Health Surveillance Program, Max Chuan Sun MA DPH In Partnership with the Home Care Aide Council, 1199 SEIU & 8 Aide agencies Funded by the U.S. National Institute for Occupational Safety and Health (NIOSH)

3 Safe Home Care Research Team

4 Safe Home Care Survey Objectives To protect & promote the occupational health & safety (OSH) of the home care (HC) workforce Specifically to: 1. Quantitatively assess the risks and benefits of a wide range of working conditions 2. Compare OSH risks of aides: employed by agencies (Agency Aides) vs. directly hired by clients (Direct-hire Aides) 3. To serve as a basis for preventive interventions

5 Why protect & promote HC aides health & safety (H & S)? Aides are fastest growing occupation in U.S. U.S. and European populations aging rapidly while available caregivers are decreasing H & S impacts on aides severe due to low income, access to health care & health information, and low resources for daycare H & S increases recruitment and retention, reducing turnover & training costs & insuring continuity of care HC worker safety is closely linked to client safety & ability to deliver high quality care.

6 Safe Home Care Project Phases 1. Focus groups & interviews to characterize work 2. Cross-Sectional Survey 3. Focus groups & interviews for interpretation & identification of preventive interventions Research to Practice

7 METHODS Part 1: unit of analysis = aide In the past 12 months have you experienced the following Part 2: unit of analysis = client visit Information obtained about the most recent visits, up to 5 visits All participants paid $20 Agencies Aides collected during in-service trainings Direct-hire Aides collected via postal mail

8 Results Safe Home Care Survey Population 7 agencies, 1 union 1,249 participants Agency Aides: 634 Direct Hire Aides: 615 3, 484 client visits

9 Population Demographics Age (Mean) 47 years Gender: 87% Female 13% Male Race/ethnicity: 40% Black 40% White 17% Latino/Hispanic 4% Asian

10 Feelings about their work I continue to work in my current job because: Agency Aides % Direct Hire % I enjoy caring for others I feel good about the work I do I have a flexible schedule or hours I can work independently Feelings about the next visits with my clients: Looking forward to visit Neutral Not looking forward to visit 3 5

11 Health & Safety Hazard Results Sharps & other blood exposures Other infectious agents, Cleaning & Disinfection Violence Musculoskeletal injuries Musculoskeletal strain Client handling & mobility

12 Blood & Sharps Exposure Percent of client visits (N = 3,484 ) ALL (N = 3,484) AGENCY Aides Direct Hire Aides N % % % Contact with blood Sharps lying around during visit Used a sharp during client visit Disposed of sharp during client visit

13 Infectious Agents, Cleaning & Disinfecting Chemical Use Most Recent Visits (N = 3, 484) Infectious Agents Cleaning & Disinfecting Feces 20% Clean Bathroom/kitchen 80% Incontinence 25% Bleach Use 25% Infectious Disease 4% Ammonia use 8% Pet Waste 10%

14 About 7% of aides reported physical aggression and 19% verbal aggression (past 12 months) Client/Family Behavior Physical % of all aides (n=1,249) Aggressive physical contact 5 Verbal Objects thrown 2 Sexual assault 1 Bitten or spit on 1 Bodily fluids thrown 1 Yelled at 15 Made to feel bad about self 8 Racist language 5 Verbal threat of harm 4

15 11% of all aides reported a job-related injury or pain serious enough for lost work time or need for medical care (past 12 months)* The most common reports: Injury due to: % of reports Handling client 17% Slips, trips, falls outside the home 16% Slips, trips, falls inside the home 11% Traffic accident 11% * Of 1,249 aides who completed the survey, 140 of them reported serious injury/pain

16 1/3 of all aides reported back pain in the past 12 months. Not reported 4% No 62% Yes 34% Of those with Low Back Pain: 59% experience pain once a week or more (23% have pain daily) 76% perceive pain is related to their home care work 68% take medication for the pain

17 Client Handling & Mobility Agency (n=2564 visits) Union (n=920 visits) Direct Hire (n = 920 visits) Any client handling activities reported Assist with dressing Assist with tub bath or shower Help client into/out of sitting position Help the client into/out of bed Help with tight support stockings Move the client in bed Catch the client while falling Use client transfer and handling devices 32% 19% 24% 12% 10% 34% 22% 35% 56% 81% 54% 73% 48% 64% 64% 58% 46% 46%

18 Conclusions HC aides have substantial OSH risks, similar to aides in nursing homes and other healthcare institutions HC aides work in isolation and may be impacted even more than aides in institutional settings by: musculoskeletal strain, violence bloodborne pathogen exposures Other infectious exposures

19 Conclusions Preventive interventions for some of these risks exist for other healthcare settings or industries Need to evaluate existing & new interventions Implement interventions while promoting positive job dimensions, especially Ability to develop caring relationships & Job autonomy

20 Thank you! Photo by Earl Dotter, Commissioned by the Universities of Maryland & Illinois Chicago

Prevention of Injury at Work: Promoting Staff Health and Psychological Well-being. Susan Goodwin Gerberich, PhD University of Minnesota, USA

Prevention of Injury at Work: Promoting Staff Health and Psychological Well-being Susan Goodwin Gerberich, PhD University of Minnesota, USA OVERVIEW Healthcare Workforce: Globally and in the United States