Ergonomic and Safety Risk Factors in Home Health Care: Exploration and Assessment of Alternative Interventions

Objective: The goals of this project were to improve the understanding of risk factors that may lead to injury and increased turnover in home health aides, discover unexplored opportunities for intervention, and test those intervention ideas for potential effects, feasibility, and acceptance by home health aides and their employers.

Methods: Analysis of injury data, extensive direct observation and analysis of aide-patient interactions, participatory intervention ideation focus group discussions, and intervention pilot testing was conducted.

Results: A method of categorizing each patient's level of skill in transfer and bathing activities, and their mobility assistance requirements was developed from information collected during the study as well as a review of the literature. In a pilot test, the new categorization scheme was used to control the aides' daily exposure to higher needs patients. The percentage of time that aides worked with patients in higher needs categories was found to be related to the aides' self-reports of end-of-shift fatigue and pain.

Conclusion: Home health care companies may find that developing a scheduling system that manages the exposure of their aides to higher needs patients may be a feasible and effective method for reducing the aides' exposure to risk factors for musculoskeletal injuries.