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Evaluating Home Healthcare Workers' Safety Hazard Detection Ability Using Virtual Simulation

Lavender, Steven A. PhD, CPE; Polivka, Barbara J. PhD, RN; Darragh, Amy R. PhD, OTR/L; Sommerich, Carolyn M. PhD, CPE; Stredney, Donald L. MA; Wills, Celia E. PhD, RN

doi: 10.1097/NHH.0000000000000780

Home healthcare workers (HHWs) are routinely exposed to occupational safety hazards when servicing patients in their homes that put them at risk for injury. These hazards can be broadly classified as “electric, fire and burn,” “environmental,” or “slip, trip, and lift” hazards. To better train HHWs regarding their potential exposure to these hazards, a home healthcare virtual simulation training system (HH-VSTS) was developed. The HH-VSTS contains three training modules, corresponding to the aforementioned hazard categories, and an assessment module. In each training module, the trainee must navigate the virtual space, via a mouse click, and identify items or conditions that represent hazards. Once an item has been clicked on, the HH-VSTS asks the user if the item or condition is a hazard. For items or conditions that are hazards, additional text boxes present material to the user as to why the item constitutes a hazard and potential remediation approaches. Thus, it is important that hazards be identified and clicked on for the trainee to receive the educational component of the training system. This article evaluated the ability of 49 HHWs to find hazards in each of the three categories. In all modules, participants found the most salient hazards (e.g., clutter on stairs, unattended candles, biohazard stains) but struggled to find some of the less salient hazards. Several less salient hazards included the pet food bowls in the path of travel, the frayed electrical cord, oxygen tube leaking into a mattress, hot water that was too hot, and elevated room temperatures. Overall, this analysis found that most of the hazards within the training modules could be found by naïve HH-VSTS users. These data suggest the need for including hints that guide users toward hazards with which they are less familiar.

Steven A. Lavender, PhD, CPE, is an Associate Professor, Departments of Integrated Systems Engineering & Orthopaedics, The Ohio State University, Columbus, Ohio.

Barbara J. Polivka, PhD, RN, FAAN, is an Associate Dean of Research & Professor, School of Nursing, University of Kansas Medical Center, Kansas City, Kansas.

Amy R. Darragh, PhD, OTR/L, is an Associate Professor, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.

Carolyn M. Sommerich, PhD, CPE, is an Associate Professor, Departments of Integrated Systems Engineering, The Ohio State University, Columbus, Ohio.

Donald L. Stredney, MA, is Director, Interface Lab, The Ohio State University, Columbus, Ohio.

Celia E. Wills, PhD, RN, is an Associate Professor, College of Nursing, The Ohio State University, Columbus, Ohio.

The authors declare no conflicts of interest.

Address for correspondence: Steven Lavender, PhD, CPE, Integrated Systems Engineering, 1971 Neil Avenue, Rm. 210, Columbus, OH 43210 (

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