Health care providers (HCPs) and social service providers are increasingly working out of the traditional facility environment and more in the homes of patients and clients. This environment entails special risks and hazards that can cause injury or even assault for the HCP. This session will review home hazard evaluation, personal risk management and mitigation techniques for home visits, and provide the home HCP with a tool box of injury-prevention techniques.

This paper will enable the reader to:

  • Identify common risks and hazards in a home-based health care environment

  • Identify potential warning signals of violence or assaultive behavior

  • Describe key elements of a personal workplace violence prevention program

  • Identify steps to mitigate or eliminate workplace violence

  • List various other health and safety concerns in a home-based environment

Workplace Violence-Facts

According to OSHA:

  • Over two million employees are assaulted yearly.

  • Homicide is the leading case of workplace death for females, second for males

  • Over 1000 people are murdered at work each year: 15 people die weekly, 3–4 supervisors monthly.

  • 42% of on-the-job fatalities among women are homicides.

  • The number of employees who murder their supervisors has doubled in the last ten years.

According to the BLS, there were 724 workers killed in residences between 1992 and 2002. This does not include thousands of non-fatal assaults and unreported cases. Some examples of violence related to home visits, social workers and health care workers include:
  • A 63-year-old real estate agent was raped at knifepoint in a vacant Coral Gables home

  • A children's services agency caseworker was stabbed to death while interviewing a couple

  • A nurse was killed after she discovered two victims shot in Girard, Kansas

  • A 27-year-old social worker was raped by a father during a case discussion

  • A child welfare worker was beaten with a hammer and suffocated during a home visit

  • A Daytona Beach real estate agent was stabbed to death by someone posing as a customer

According to a Society of Human Resource Managers (SHRM) Survey, HR Managers were surveyed regarding violent incidents within the workplace:
  • 33% of the managers experienced at least one violent incident

  • 54% reported between 2 and 5 acts of violence had occurred within the five years prior to the survey

A recent University of Pittsburg study of social workers showed:
  • 43 % of workers had their own or the agency's property damaged by clients

  • 86% had been threatened by clients

  • 42% experienced attempted or actual physical attacks by clients

In another study, one-third of the respondents became frightened on the job at least monthly. They feared not only for themselves, but that a family member might be a target.

Injuries Sustained by Victims:

  • 22% of the incidents involved serious harm

  • 42% of the incidents required medical intervention

  • 41% of the organizations reported increased stress levels after the violent incident

  • 20% reported higher levels of paranoia

  • 18% reported increased mistrust among employees

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