256748 An Easy Tool to Assess Environmental Hazards in the Households of Elderly Community Members

Sunday, October 28, 2012

Robyn R.M. Gershon, DrPH , Department of Epidemiology and Biostatistics, UCSF Philip R . Lee Institute for Health Policy Studies and UCSF School of Medicine, San Francisco, CA
Maureen Dailey, RN, DNSc , National Center for Nursing Quality, American Nurses Association, Silver Spring, MD
Lori Magda, MA , School of Psychology, Fairleigh Dickinson University, Secaucus
Halley Riley, BA , Mailman School of Public Health, Columbia University, New York, NY
Jay Conolly, BA , Partners in Care, Partners in Care, New York, NY
Alexis SIlver, RN , Home Care Association of NYS, Home Care Association of NYS, Albany, NY
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.

Learning Areas:
Provision of health care to the public
Public health or related nursing

Learning Objectives:
1. Describe the most common household hazards that present the greatest risk to elderly householders. 2. List at least three most prevalent adverse outcomes in the elderly that are associated with household hazards. 3. Discuss at least two approaches to hazard remediation

Keywords: Environmental Health Hazards, Frail Elderly

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctor of public health, trained at Johns Hopkins. I am currently a Professor in the Dept of Epidemiology and Biostatistics at UCSF and Professor Emerita at Columbia University, School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.