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Household-Related Hazardous Conditions With Implications for Patient Safety in the Home Health Care Sector

Gershon, Robyn R.M. PhD*; Canton, Allison N. BA*; Raveis, Victoria H. PhD*; Silver, Alexis RN; Chen, Christine C. ScD; Qureshi, Kristine A. DNSc, RN§; Sherman, Martin F. PhD; Stone, Patricia W. RN, PhD

doi: 10.1097/PTS.0b013e31818936e3
Original Articles

Objectives: The home health care (HHC) setting is unique because it is both a household and a care-giving environment. As such, it may present a risk for adverse events that could affect the health and safety of HHC patients. This study assessed and characterized unsafe household conditions with implications for patient safety in the HHC setting.

Methods: A convenience sample of HHC registered nurses (RNs) from New York State completed a self-administered survey, which addressed the type and frequency of hazardous conditions in the households of their current patients. These nurses were asked to report on potential hazards (biological, chemical, environmental and physical, and violence) observed in patients' households.

Results: A total of 738 RNs completed the survey. Hazardous household conditions were frequently reported including animal hair (n = 543, 74%), cigarette smoke (n = 534, 72%), excessive dust (n = 428, 58%), vermin (n = 328, 44%), and unsanitary conditions (n = 317, 43%). The threat of violence was also frequently reported. Hazardous conditions were significantly associated with a number of patient-related factors.

Conclusions: Hazardous conditions identified in the households of HHC patients present a well-documented risk of injury/illness in the community setting and may also present occupational risk to caregivers. Many of these hazards are readily modifiable, although others may be less amenable to intervention. Additional studies are warranted in order to further assess and characterize the prevalence and risk factors for hazardous household conditions and to determine the relationship between these conditions and adverse patient safety events in the home care setting.

From the *Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York; †Home Care Association of New York State, Albany; ‡Programs in Occupational Therapy, College of Physicians and Surgeons, Columbia University, New York, New York; §School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii; ∥Department of Psychology, Loyola College, Baltimore, Maryland; and ¶School of Nursing, Columbia University, New York, New York.

This work was supported by a grant from CDC/NIOSH #R01OH008215-02. The results of this study do not necessarily represent CDC/NIOSH position or polices.

Correspondence: Robyn R.M. Gershon, MT, MHS, PhD, Columbia University, Mailman School of Public Health, 722 West 168th Street, Suite 1003, New York, NY 10032 (e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.