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1. OSHA & NIOSH
Occupational Safety and Health Administration & National Institute for Occupational Safety and Health
Safety and Health Topics
Home Healthcare
CareCo Medical, Inc. January 2023

2. CONTENTS
1. Introduction to OSHA
2. Overview
3. Hazards in Home Healthcare
4. Bloodborne Pathogens Standard
5. Preventing Needlestick Injuries
6. Preventing Exposure To Unsafe Conditions
7. Preventing Latex Allergies
8. Preventing Musculoskeletal Disorders
9. Preventing Violence On The Job
10. Preventing Driving-Related Injuries
11. Summary
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3. OSHA's Mission
With the Occupational Safety and Health Act of 1970, Congress created the Occupational Safety and Health Administration (OSHA) to
ensure safe and healthful working conditions for workers by setting and enforcing standards and by providing training, outreach,
education and assistance.
Organization
OSHA is part of the United States Department of Labor. The administrator for OSHA is the Assistant Secretary of Labor for
Occupational Safety and Health. OSHA's administrator answers to the Secretary of Labor, who is a member of the cabinet of the
President of the United States.
OSHA Coverage
The OSH Act covers most private sector employers and their workers, in addition to some public sector employers and workers in the 50
states and certain territories and jurisdictions under federal authority. Those jurisdictions include the District of Columbia, Puerto Rico,
the Virgin Islands, American Samoa, Guam, Northern Mariana Islands, Wake Island, Johnston Island, and the Outer Continental Shelf
Lands as defined in the Outer Continental Shelf Lands Act.
NIOSH Mission
To develop new knowledge in the field of occupational safety and health and to transfer that knowledge into practice.
Organization
The National Institute for Occupational Safety and Health is the United States federal agency responsible for conducting research
focused on the study of worker safety and health, and empowering employers and workers to create safe and healthy workplaces.
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4. Overview
Home healthcare is healthcare provided in the client's home. Home healthcare workers
provide hands-on clinical and theraputic care to clients with health issues, disabilities or
other chronic conditions that keep them homebound. Home Healthcare workers are
home health aides, nursing assistants, home health nurses or physical and occupational
therapist, are employed to provide care in a patients' home. Depending on their training
and job duties, they help patients with activities of daily living such as meals, bathing,
dressing, and may perform clinical tasks such as medication administration, wound
care, blood pressure readings and range of motion exercises.
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5. What are the hazards in home healthcare?
Home healthcare workers may be employed by a home care agency or may be self-
employed independent contractors working directly for patients. They have little control
over their work environment which may contain a number of safety and health hazards.
These hazards include bloodborne pathogens and biological hazards, latex sensitivity,
ergonomic hazards from patient lifting, violence, hostile animals and unhygienic and
dangerous conditions. In addition, if their daily work schedule requires them to provide
care for multiple patients, they face hazards on the road as they drive from home to
home.
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6. Bloodborne
Pathogens
Standard

7. The Bloodborne Pathogens Standard requires that every employer perform an
exposure determination as part of their exposure control plan. This
determination must delineate the job classifications or specific tasks and
procedures an employee may perform which constitute occupational exposure.
"Occupational exposure" is defined in the standard as "reasonably
anticipated skin, eye, mucous membrane, or parenteral contact with
blood or other potentially infectious materials that may result from the
performance of an employee's duties." Those employees with occupational
exposure are covered by all requirements of the standard.
OSHA has jurisdiction over employee safety and health and its applicable
regulations cover all employers, regardless of the workplace setting. OSHA
has identified and cited residential care providers who are not in compliance
with the Bloodborne Pathogens Standard, and OSHA intends to continue its
enforcement of the Bloodborne Pathogens Standard.
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8. Preventing
Needlestick
Injuries

9. How to Prevent Needlestick & Sharps Injuries
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Needlesticks and other sharps injuries are a serious hazard in any
healthcare setting.
Contact with contaminated needles, scalpels, broken glass, and
other sharps may expose healthcare workers to blood that contains
pathogens which pose a grave, potentially lethal risk.

10. ACTIVITIES WITH POTENTIAL FOR
NEEDLESTICK INJURIES
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Home healthcare workers can be at risk for needlestick or sharps injuries when they:
• Handle needles that must be taken apart or manipulated after use.
• Dispose of needles attached to tubing.
• Manipulate the needle in the client.
• Recap a needle.
• Use needles or glass equipment to transfer body fluid between containers.
• Fail to dispose of used needles in puncture-resistant sharps containers.
• Lack proper workstations for procedures using sharps.
• Work quickly.
• Bump into a needle, a sharp, or another worker while either person is holding a sharp.
If you experience a needlestick or sharps injury or are exposed to the blood or other body fluid
of a client during the course of your work, immediately follow these steps:
• Wash needlesticks and cuts with soap and water.
• Flush splashes to the nose, mouth, or skin with water.
• Irrigate eyes with clean water, saline, or sterile irrigants.
• Report the incident to your supervisor.
• Immediately seek medical treatment

11. Preventing
Exposure in Unsafe
Home Conditions

12. UNSANITARY CONDITIONS
Home healthcare workers may encounter unsanitary homes, temperature extremes, homes without water
that is safe to drink, or hostile pets.
Hygiene may be an issue of concern for home healthcare workers in some client locations. Unsanitary
homes may harbor pests such as rodents, lice, bedbugs, or mites. These unsanitary conditions can cause
contamination of medical supplies and equipment, as well as spread disease and infection.
If a home is unsanitary:
• Use clean pads with plastic on one side to place under equipment and supplies.
• Take in only the necessary equipment and supplies so pests infest fewer things.
• Avoid setting objects such as purses and bags on a carpeted floor or upholstered furniture.
• Consider wearing disposable coveralls.
• Use non-latex disposable gloves and hand sanitizer 12

13. HOME TEMPERATURE EXTREMES
Some clients’ homes may be very hot or very cold. If this is the case, take the following
steps:
• If you are concerned about the home being too cold and you cannot change the
thermostat, ask your employer to contact social service agencies to help the client. Local
resources may be available to help pay heating bills.
If a home is uncomfortably warm, ask for permission from the client to open the
windows and use fans. If necessary, apply cool compresses to your neck. Drink plenty of
water. If you believe the client is at risk from the heat, ask your employer to contact
social service agencies to help the client.
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14. LACK OF WATER
Home healthcare workers may encounter a home with no running water or water that is
of poor quality.
Homes may use bottled water for drinking and have access to cisterns for flushing and
bathing.
• If conditions present a health hazard, ask your employer to contact social service
agencies to help the client.
• Use hand sanitizer.
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15. HOSTILE ANIMALS
In some situations, home healthcare workers may be threatened, bitten, or otherwise
injured by unrestrained animals.
When facing a threat from an animal:
• Wait outside until the pet is restrained.
• If you see fleas or other pests, discuss appropriate control measures with the client and
contact your supervisor.
• If the client isn’t receptive to pest control measures, ask your employer to contact
social services to help the client and make it possible to work there.
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16. How to Prevent
Latex Allergies

17. LATEX EXPOSURE REACTIONS
Three types of reactions can occur when using latex products:
• Irritant Contact Dermatitis This is the most common negative reaction to latex. Symptoms include dry, itchy,
irritated skin—most often on the hands.
• Allergic Contact Dermatitis (delayed hypersensitivity) This skin reaction looks like the rash from contact with
poison ivy and usually shows up 24–96 hours after contact.
• Latex Allergy (immediate hypersensitivity) This type of reaction usually happens within minutes of exposure, but
symptoms can also show up a few hours later. Symptoms of a mild reaction are skin redness, hives, or itching.
Symptoms of more serious reactions might include runny nose, sneezing, itchy eyes, scratchy throat, wheezing,
coughing, or difficulty with breathing. Rarely, shock may occur, but a life-threatening reaction is seldom the first sign
of sensitivity. A latex-exposed worker developing any serious allergic reactions should be taken to a doctor
immediately.
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18. IF YOU HAVE A LATEX ALLERGY
IF YOU ARE DIAGNOSED WITH LATEX ALLERGY:
• Avoid touching, using, or being near latex-containing products.
• Avoid areas where latex is likely to be inhaled (for example, where powdered latex gloves are being used).
• Inform your employer and your personal healthcare professionals that you have latex allergy.
• Wear a medical alert bracelet.
• Follow your doctor’s recommendations about latex allergy.
• Before receiving any shots (such as a flu shot), be sure the person giving it uses a latex-free vial stopper.
• Before undergoing a medical procedure or surgery, consult the specialist who will perform the procedure about any
modifications that may be needed.
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19. How to Prevent
Musculoskeletal
Disorders

20. STRAINS, SPRAINS & PAINS
IN HOME HEALTHCARE
A work-related musculoskeletal disorder is an injury of the muscles,
tendons, ligaments, nerves, joints, cartilage, bones, or blood vessels in the
arms, legs, head, neck, or back that is caused or aggravated by work tasks
such as lifting, pushing, and pulling. Symptoms include pain, stiffness,
swelling, numbness, and tingling.
Lifting and moving clients create a high risk for back injury and other
musculoskeletal disorders for home healthcare workers.
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21. PREVENTIVE MEASURES
EMPLOYEES SHOULD:
• Use ergonomic assistive devices if available.
– Products such as slip sheets, slide boards, rollers, slings, belts, and mechanical or electronic hoists (to lift the client) have been designed to help
healthcare workers and clients.
– Equipment such as adjustable beds, raised toilet seats, shower chairs, and grab bars are also helpful for reducing risk factors for
musculoskeletal injuries. These types of equipment can allow the client to help during transfer.
• Use proper body mechanics. Even when assistive devices are used during client care, some amount of physical exertion may still be necessary.
– Move along the side of the client’s bed instead of reaching while performing tasks at the bedside.
– When manually moving the client, stand as close as possible to the client without twisting your back, keeping your knees bent and feet apart.
To avoid twisting the spine, make sure one foot is in the direction of the move. Using gentle rocking motions can also reduce exertion.
– Pulling a client up in bed is easier when the head of the bed is flat or down. Raising the client’s knees and encouraging the client to push (if
possible) can also help.
– Apply anti-embolism stockings by pushing them on while you are standing at the foot of the bed. You can use less force in this position than
standing at the side of the bed.
• Notify your employer promptly of any injury in the workplace.
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22. How to Prevent
Violence on the Job

23. WORKING IN VULNERABLE ENVIRONMENTS
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Home healthcare workers can be vulnerable as they face an unprotected and
unpredictable environment each time they enter a client’s community and home. The
spectrum of violence ranges from verbal abuse, to stalking or threats of assault, to
homicide. Verbal abuse from the client, family members, or people in the community
is a form of workplace violence. Verbal abuse may be subtle, such as asking for help
beyond the scope of the job (such as with cleaning), or it may be obvious, such as
complaining about job performance or worker appearance—or even threatening to
cause harm.

24. MANAGING VIOLENT SITUATIONS
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• Home Healthcare Workers should consider working with an escort in high-crime areas, and if possible, schedule visits during daylight hours.
• Be sure of the location and have accurate directions to the house or apartment.
• Always let your employer know your location and when to expect you to report back.
• When driving alone, have the windows rolled up and doors locked.
• Park the vehicle in a well-lit area, away from large trees or shrubs where a person could hide.
• Keep healthcare equipment, supplies, and personal belongings locked out of sight in the trunk of the vehicle.
• Before getting out of the car, check the surrounding location and activity. If you feel uneasy, do not get out of the car.
• Stay in your car and contact your manager if you notice anything that might threaten your security, such as strong odors from a drug lab,
gunshots, or shouting and sounds of fighting.

25. MANAGING VIOLENT SITUATIONS
(con’t)
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• Stay in your car and contact your manager if you notice anything that might threaten your security, such as strong odors from a drug lab, gunshots, or shouting and
sounds of fighting.
• During the visit, use basic safety precautions by (1) being alert, (2) evaluating each situation for possible violence, and (3) watching for signals of impending violent
assault, such as verbally expressed anger and frustration, threatening gestures, signs of drug or alcohol abuse, or the presence of weapons.
• Notify your employer if you observe an unsecured weapon in the client’s home.
• Maintain behavior that helps to defuse anger by (1) presenting a calm, caring attitude, (2) not matching threats, (3) not giving orders, and (4) acknowledging the
person’s feelings.
• Avoid behaviors that may be interpreted as aggressive (for example, moving rapidly or getting too close, touching unnecessarily, or speaking loudly).
• If possible, keep an open pathway for exiting.
• Trust your judgment.
• Avoid situations that don’t feel right.
• If you are being verbally abused, ask the abuser to stop. If the abuser does not stop, then leave and notify your employer.
• If you cannot gain control of the situation, shorten the visit and remove yourself from the situation. If you feel threatened, leave immediately.
• If you need help, use your cell phone to call your employer or 911, depending on the severity of the situation.
• If you observe a crime, contact the police.

26. How to Prevent
Driving-Related
Injuries

27. EMPLOYEE SAFE DRIVING TIPS
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Driving from client to client, home healthcare workers are at high risk for motor vehicle-related injuries.
These issues can contribute to motor vehicle-related injuries during an accident:
• Distracted driving
• Aggressive driving
• Lack of seatbelt use
• Driving while tired
• Driving after using alcohol or drugs
• Poor weather conditions
• And, poorly maintained vehicles
These safeguards contribute to safe traveling and aid in mitigating injuries, if you are involved in an accident:
• Use seatbelts
• Stop the vehicle before using a cell phone
• Avoid distracting activities such as eating, drinking, and adjusting radio and other controls while driving
• Avoid driving when over-tired. Use detailed maps to determine your route before you leave, or use a GPS
• Have the vehicle checked and serviced regularly
• Keep the gas tank at least a quarter full
• Carry an emergency kit containing a flashlight, extra batteries, flares, a blanket, and bottled water

28. DRIVING IN INCLEMENT WEATHER
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A TORNADO WARNING
• Get out of the vehicle immediately and go to the lowest floor of a nearby building, a storm shelter, an overpass
or laydown in a ditch beside the road you are traveling.
A BLIZZARD OR ICE STORM
• Drive only if absolutely necessary. If you must drive:
– Travel during daylight hours
– Keep others informed of your schedule
– Stay on main roads; avoid backroad shortcuts
– Use snow tires or chains when appropriate
• If a blizzard or ice storm traps you in the vehicle:
– Turn on hazard lights and hang a distress flag or help sign from the radio antenna or window
– Call 911 and your employer if you have a cell phone
– Remain in your vehicle. Rescuers are most likely to find you there
– Do not set out on foot unless you can see a building close by where you know you can take shelter

29. Summary
At CareCo Medical, we believe the key to a safe and healthful work environment is a
comprehensive injury and illness prevention program.
Most successful injury and illness prevention programs are based on a common set of key
elements. These include management leadership, worker participation, hazard identification,
hazard prevention and control, education and training, and program evaluation and
improvement.
Together, we can ensure all employees have safe and healthful working conditions.
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30. Thank you
Suzanne Marvin, MBA
CareCo Medical Administrator​
amarvin@carecomedical.com
www.carecomedical.com