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Health and Safety Update- Research to Practice. Quality Work, Quality Care: A State-of-the-Art, National Conference for Home Care Stakeholders, April 2, 2012, Washington, D.C. Presenters. Drs. Rosemary Sokas and Jane Lispcomb Dr. Sherry Baron Drs. Margaret Quinn and Pia Markkanen

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Health and safety update research to practice

Health and Safety Update-Research to Practice

Quality Work, Quality Care: A State-of-the-Art,

National Conference for Home Care Stakeholders,

April 2, 2012, Washington, D.C.



  • Drs. Rosemary Sokas and Jane Lispcomb

  • Dr. Sherry Baron

  • Drs. Margaret Quinn and PiaMarkkanen

  • Dr. Robyn Gershon

  • Dr. Linda Delp

  • Moderator: Dr. Joseph Zanoni

Participatory training and interventions rosemary sokas md moh sokas@georgetown edu

Participatory training and interventionsRosemary Sokas, MD, [email protected]

  • Partnership between SEIU, Addus Homecare, U of MD and U of Illinois at Chicago SPH

  • Participatory training in small groups within large group setting

  • Union (peer educator), management, and academic facilitators

  • Labor-Management Safety Committee developed intervention tools

  • Follow-up training with role-play

Wallet card

Wallet Card

Sharps Safety

Used lancets, needles and syringes can pose a

health risk to you, your client, and the public so

please remember to:

Have clients dispose of their own lancets,

needles and syringes in a sharps container or

other puncture proof container after every use.

Ask clients not to dispose of lancets, needles

and syringes in the household trash, coffee

cans or containers made of thin plastic.

Never touch your clients’ lancets, needles or


For sharps disposal options, your client may

contact his or her health care provider or

pharmacist. If home waste disposal is the only

option, seal, put duct tape over the cover and

label the container “Do not recycle.”

Contact Information

*If your client needs a sharps container and does not have one, have him or her contact the local pharmacy to see if a free sharps container is available.

If you experience any injury in a client’s home, or if you are expose to blood on the job, please contact your supervisor immediately.

  • Supervisor: ____________________________

  • Phone number:_312-663-4647______

    If your supervisor is not available please

    contact Sonia or Teresa.

  • Addus Healthcare, Inc., Local 880, Service

  • Employees International Union,

  • University of Illinois at Chicago, School of Public Health.

Refrigerator magnet to give to client

Refrigerator Magnet to give to Client \

Role play training and discussion to help workers practice the conversation

Health and safety update research to practice

Implementation and evaluation of interventions for home care aides on blood and body fluid exposure in large group settings.  Amuwo, S., Sokas, R. K., Nickels, L., Zanoni, J., Lipscomb, J. (2011).   New Solutions, 21(2), pages 242-243

Partnership for safety

“Partnership for Safety”

  • A 5-year community-base participatory study

  • To create and evaluate materials that:

    • Emphasize the importance of worker safety to the overall quality of care

    • Empower home care workers and consumers to identify and reduce hazards in their workplace/home environment

Findings from the program evaluation

Findings from the Program Evaluation

  • 60% of workers had been injured in the past year at work

  • Nonetheless, most workers felt that the risks were low for getting hurt while doing their work tasks: eg. needle sticks

  • Workers who received training and the handbook:

    • Increased their awareness of work hazards and were more likely to know where to find information to reduce those hazards

    • This was especially true for non-English speakers

    • 80% had attempted to apply at least one of the “tips”. Some examples:

      • “Don't bend down to clean the tub; use a longer brush instead”

      • “I have now applied to have continuous use of gloves while handling needles. I was not aware of Universal Precautions”

Workers learn about how to use the handbook and role play how to talk about safety

Comments from a participant:

“I and my mom do not read. I asked other people to read it to me. I found this booklet very helpful in raising my awareness of safety issues.”

Contact information sherry baron md mph national institute for occupational safety and health

Contact Information:Sherry Baron, MD MPHNational Institute for Occupational Safety and Health

Email: [email protected]

Tel: 513 458-7159

Safe home care hc project university of massachusetts lowell umass lowell

Safe Home Care (HC) Project University of Massachusetts Lowell (UMass Lowell)

Dr. Margaret Quinn & Dr. Pia Markkanen

Safe hc project umass lowell introduction background

Safe HC Project – UMASS Lowell: introduction & background

  • Funded by NIOSH

  • Partners with Occupational Health Surveillance Program, Mass. Department of Public Health

    • In collaboration with the MA Executive Office of Elder Affairs, industry associations and agencies, SEIU, and community groups

  • Grew from an earlier Project SHARRP

  • Emphasizes HC worker-client safety & health linkages

  • Project objectives

    • qualitative & quantitative assessment of a broad range of OSH hazards & promising practices in home care

    • map out all the ways sharps medical devices enter & exit homes

    • identify and evaluate preventive interventions

    • develop educational materials

Safe hc project umass lowell pre survey qualitative phase update

Safe HC Project – UMASS Lowell: pre-survey qualitative phase update

  • 12 focus groups: consisted 99 participants

    • Home health aides

    • Homemakers

    • Personal care attendants

    • Companions

  • 25 in-depth interviews

    • 13 home care agency directors/supervisors and labor union representatives

    • 12 home care clients

  • Methods

    • Focus groups & interviews audio recorded

    • Transcripts coded and analyzed with NVIVO 9.2 software

Safe hc project umass lowell pre survey qualitative phase update1

Safe HC Project – UMASS Lowell: pre-survey qualitative phase update

Most frequently coded OSH concerns among aides:

  • Back injuries from various client care tasks

  • Verbal abuse

  • Clients on oxygen addicted to smoking

  • Exposure to bloodborne pathogens & other infectious diseases

  • Long-distance driving

  • Psychosocial stress

    • low pay

    • lacking benefits

    • feeling being taken for granted by the society

Health and safety update research to practice

  • I have a client that is on oxygen and she smokes while she has it on… she doesn’t want to stop, she has had social workers, nurses, everybody you can think of going in there to tell her to stop. I actually see sparks on her nose. So now, when I go in I just tell her, you can’t smoke. Some days I’m there an hour and a half, some days two hours. So she has to go two hours without smoking a cigarette.

Umass lowell safe home care project qualitative findings

UMASS Lowell Safe Home Care Project: qualitative findings

Most frequently requested practices

Other requested practices

Umass lowell safe home care project qualitative findings1

UMASS Lowell Safe Home Care Project: qualitative findings

Health and safety update research to practice1

Health and Safety Update-Research to Practice

Quality Work, Quality Care: A State-of-the-Art, National Conference for Home Care Stateholders, April 2, 2012, Washington, D.C.

Robyn Gershon, MPH, DrPH

Tara McAlexander, MPH

Lourdes Hernandez-Cordero, DrPH

Risk management of household hazards

Risk Management of Household Hazards

  • Building upon risk assessment studies

  • Next step was to develop a tool to easily identify household hazards as a first step towards remediation

  • Wanted a checklist that was:

    • easy to use by care-givers, recipients, patients

    • inexpensive

    • tech light

    • easily translatable

    • would serve as a simple guide to intervention

Findings from the health homes healthy seniors study n 105 households

Findings from the Health Homes, Healthy Seniors Study *(N=105 households)

Hazards Identified

  • 41% Low lighting

  • 36% Excessive dust/peeling paint

  • 33% Mice/rodents

  • 31% Loose rugs/uneven flooring

  • 29% Vermin

  • 28% Mold

  • Elderly Householder Injuries

    • 26 people had 42 falls in previous 12 months (83% were alone), 12 resulted in injury, 8 required treatment, 3 required hospital stay.

    • 102 people had one or more burns (total of 118 burns).

  • *HUD Funding, 2011

    Making home care a better job

    Making Home Care a Better Job

    Job stressors and Job Satisfaction in California’s In-Home Supportive Services Workforce

    Linda Delp, PhD

    UCLA Labor Occupational Safety & Health Program (UCLA-LOSH)

    Quality Work, Quality Care Conference, Washington, D.C. April 2, 2012

    In home supportive services

    In Home Supportive Services


    • Over 200,000 workers statewide

    • Consumer-directed model

    • Worker can be a family member

    • Personal care not health care services

    • Workers represented by a union

      Research Objectives

    • Identify job stressors, control and support

    • Analyze relationship with job satisfaction and health care status

    Data collection analysis

    Data Collection & Analysis

    • 1,614 Questionnaires (English, Spanish)

      • Phone interviews conducted by trained home care workers

      • Multivariate regression analysis

    • 6 Focus Groups 71 workers

      • English (3), Spanish (2), Mandarin Chinese (1)

      • Taped, transcribed, translated

      • Content analysis – ID recurring themes

    La ihss workforce

    LA IHSS Workforce

    • 86% women

    • Mean age: 52

    • 51% married/living together

    • 67% HS grad (49-83)

    • 45% Hisp, 32% Af-Am, 23% White

    • 53% immigrant (2-94)

    • 59% renters

    • Mean income: $10,700 (6,500-18,500)

      • Average hours worked: 34 hrs/week

    • Relative: 71% relative (52% same home)

    What determines job satisfaction

    What determines job satisfaction?

    • Stressors (-)

      • Emotional demands – abuse

      • Schedule – unpaid overtime, >1 consumer

      • Financial strain – unable to see doctor due to cost

      • Job insecurity – worry about losing wages & health benefits

    • Satisfaction (+)

      • Ability to provide quality physical and emotional care

      • Social support – friends, spouse, relatives

      • Active in union

    Significance for home care policy

    Significance for Home Care Policy

    • Health care access – benefits, respite care

    • Prevent adverse physical & emotional health effects – clarify responsibility for worker protection (training, equipment)

    • Wages & job security

    • Key to policy change – unified

      worker and consumer voice to

      support program/rally against


    Stress and satisfaction too

    Stress… and Satisfaction too

    • They are able to stay in their homes…That’s the main goal of home care.

    • You don’t get the fulfillment and the satisfaction out of a check…it’s what you do. You look around this world and say, ‘ She used to be my client’…You can see the improvement.

    • You did this. You made a difference in this person’s life…We allow them to live longer, healthier lives and happier lives.

    Questions and responses

    Questions and Responses?

    • Thanks for your participation!

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