Home Health Care Workers: Here's How to Stay Safe During COVID-19
By Kevin Fields
It has always been a challenge for Home Health Care Providers to keep themselves safe while providing safe care to clients. In the era of COVID-19, it can be harder than ever. Here is an overview of best practices to protect both providers and clients.
Prevention Basics:
Practice self-care, personal hygiene, and social distancing.
Stay home when sick.
Wash hands frequently for at least 20 seconds.
Cover coughs and sneezes (into the crook of your arm or elbow).
Quickly dispose of tissues.
The Following Steps Should be Completed Prior, During, and After the Appointment:
Prior to the Appointment
Inventory Supplies:
Full PPE: N95 mask with storage container, face shield, gown, and gloves
Mask - extra in case client/family members need one
Gloves
Eye protection
Approved disinfectant wipe
Hand sanitizer
Medical supplies
Trash bags
Surface barrier (i.e. wax paper)
Contact the Client
Before driving to the home, contact the client and ask the following questions:
Have you, or anyone in your family, been in contact with a person that is in process of being tested for COVID-19?
Have you, or anyone in your family, travelled outside of the United States in the last 2 weeks or just travelled outside of your city?
Have you been medically directed to self-quarantine due to possible exposure to COVID-19?
Have you had any illness symptoms such as fever, cough, shortness of breath, sore throat, fatigue, body aches, or chills within the last 48 hours?
If the answer to any of these questions is YES or the occupant(s) prefers not to have a worker in their home, the visit should be rescheduled or, if possible, conducted virtually. As a general rule, a yes answer requires the visit to be rescheduled for no earlier than 14 days.
If a household member other than the client is a contact, ask them to use a face mask during the visit and to stay in another room, if possible.
Ask if anyone in the household have nebulizer treatments; require nasal/oral suctioning; use Cpap, Bipap, or a Ventilator, and if so, what hours they are used. Note: Visit should be postponed for 3 hours after aerosolized or don full PPE as a precaution.
At the Home
Call the client upon arriving and reassess risk by asking the same questions (listed above) before entering.
If the answer to any question is YES, act as directed above.
Remind the client to:
Keep family members at least 6 feet from you unless the family member is being taught care by the HHCP staff.
Secure any pets.
Ensure that there is a clear path to and from the client.
During the Visit
Prior to entering the home, (only for COVID-19 + clients) don Full PPE. All home routine visits will require mask, goggles/shield, and gloves.
Do not shake hands or touch others when greeting or interacting.
Wash your hands frequently and use hand sanitizer when soap and water is not available.
Use a bleach and water solution to disinfect any work areas. Wax paper can be used as a barrier in homes to sit bags and equipment on.
All equipment should be cleaned with approved disinfectant prior to returning them to your bag.
Limit unnecessary contact with surfaces/items and avoid shared use of tablets, laptops, writing utensils, and cell phones. Regularly wipe down all items.
Follow the current COVID-19 guidelines to protect yourself and those you encounter.
Upon Completing the Exam
If possible, the client should sign off at end of their visits and clean tablet appropriately. If COVID-19 +, do not take tablet into home or place it inside of zip lock bags for protection in the home.
Use appropriate disinfectant cleaners to disinfect any work areas.
Upon Exiting the Home
PPE should be removed outside of the home and discarded by placing in trash bags before departing location.
Perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol.
When a HHCP leaves a client with suspected COVID-19 or positive COVID-19, a specific vehicle should be used to commute to and from the client’s home. This vehicle is cleaned and disinfected daily.
Consider providing a specific room to change clothes and then direct the staff go directly home and shower.
Following these work practices will aid in keeping home health care workers safe on the job.
Resources:
“Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease (COVID-19).” Centers for Disease Control, February 12, 2020, https://cdc.gov/COVID19.
“For Workers Who Visit Homes.” Kansas Department of Health and Environment, https://kdheks.gov/coronavirus.
Melissa Vietor, Director-Home Health & Hospice and Ashley Praest, Media Coordinator, Faith Regional Health Services, http://frhs.org/.
Darla R. Wilken, RN, Employee Health and Infection Prevention, Susan B. Allen Memorial Hospital, http://www.sbamh.com/.
Kevin Fields is a Loss Control Specialist with RAS. He is a member of the American Society of Safety Professionals and is a certified OSHA 10-hour trainer.