An Easy Tool to Assess Environmental Hazards in the Households of Elderly Community Members

Objectives: Unsafe household conditions could adversely affect safety and quality in home health care. However, risk identification tools in this setting are lacking. To address this unmet need, we developed and tested a new household safety checklist and accompanying training program. Methods: A 50-item, photo-illustrated, multi-hazard checklist was designed as a tool to enable home health care paraprofessionals (HHCPs) to conduct visual safety inspections in their patients' homes. The checklist focused on hazards presenting the greatest risk to seniors. A convenience sample of 57 HHCPs was recruited to participate in a one-hour training program, followed by pilot testing of the checklist in their patients' households. Checklist data from 116 patient homes were summarized using descriptive statistics. Qualitative feedback was provided by HHCPs participating in a focus group. Results: Pre/post testing determined that the training program was effective; participating HHCPs' ability to identify household hazards significantly improved following training (p < 0.001). Using the checklist, HHCPs were able to identify unsafe conditions, including fire safety deficiencies, falls hazards, unsanitary conditions, and problems with medication management. HHCPs reported that the checklist was easy to use and that the inspections were well accepted by patients. Inspections took roughly 20 minutes to conduct. Conclusions: HHCPs can be effectively trained to identify commonplace household hazards. Using this checklist as a guide, visual household inspections were easily performed. Going forward, studies are needed to evaluate the reliability of the checklist and to determine if the identification of hazards leads to interventions that improve performance outcomes.