Identify two (2) rights and two (2) responsibilities of workers when working in a home-based environment.

QUESTION

You must understand the safety considerations when working as an Enrolled Nurse in a home-based environment.

1. Identify two (2) rights and two (2) responsibilities of workers when working in a home-based environment.
2. Identify two (2) rights and two (2) responsibilities of clients when the care provision is organized in a home-based environment.
3. Identify three (3) high-risk client groups susceptible to fire injury and fatalities in a home-based environment. Provide an example of the contributing behaviors for each high-risk group.
4. Describe the ideal locations for placing smoke alarms in a home-based environment.
5. Who should you liaise with to install a main powered smoke alarm?
6. Identify and describe three (3) key smoke alarm maintenance routines you must follow to provide effective protection.
7. Identify two (2) risks to personal safety when working in a home-based environment and describe the strategies you should implement to minimize identified risks.
8. Identify two (2) common sources of infection in a home-based environment and describe means to minimize the transfer of infectious diseases.
9. What are the risks associated with showering or bathing a person in their own home? (Hint: common physical injuries and causative factors).
10. Describe three (3) practices you could implement to minimize injury to self and clients in relation to the above-identified physical injuries.

ANSWER

Ensuring Safety in Home-Based Enrolled Nursing: Rights, Responsibilities, and Risk Mitigation

Introduction

Working as an Enrolled Nurse in a home-based environment requires a keen understanding of safety considerations to ensure the well-being of both the workers and the clients. This essay will outline the rights and responsibilities of both parties, identify high-risk client groups susceptible to fire injury, discuss the placement and maintenance of smoke alarms, address personal safety risks for workers, explore common sources of infection, and finally, examine the risks associated with showering or bathing clients in their own homes. Additionally, strategies to minimize identified risks and promote safety will be discussed throughout.

Rights and Responsibilities of Workers in a Home-Based Environment:

Right to a Safe Work Environment: Enrolled Nurses have the right to work in an environment that prioritizes safety. This includes having access to necessary equipment, resources, and training to carry out their duties effectively and safely. Workers have the responsibility to advocate for their rights and communicate any concerns regarding safety to the appropriate individuals or authorities.

Right to Informed Consent: Enrolled Nurses have the right to receive informed consent from clients before providing any care or interventions. This ensures that clients understand the nature of the care they will receive and can make informed decisions about their health. Workers have the responsibility to provide clear information, answer questions, and respect the autonomy of clients throughout the care process.

Rights and Responsibilities of Clients in a Home-Based Environment:

Right to Dignity and Respect: Clients have the right to be treated with dignity and respect in their own homes. This includes having their privacy protected, their cultural and personal preferences honored, and their autonomy acknowledged (Olejarczyk, 2022). Clients have the responsibility to communicate their needs, expectations, and preferences to the Enrolled Nurse and to treat the worker with respect.

Right to Quality Care: Clients have the right to receive quality care that meets their individual needs and promotes their well-being. This includes receiving appropriate assessments, treatments, and interventions that are evidence-based and delivered with competence. Clients have the responsibility to actively participate in their care, provide accurate information about their health, and collaborate with the Enrolled Nurse to achieve optimal outcomes.

High-Risk Client Groups Susceptible to Fire Injury:

Older Adults: Older adults may be at a higher risk of fire injury due to age-related factors such as cognitive decline, mobility issues, and sensory impairments. For example, forgetfulness or confusion can lead to leaving stoves or other heat sources unattended. Strategies to minimize risks include educating clients and their families about fire safety, ensuring working smoke alarms are installed, and implementing fire evacuation plans tailored to the individual’s needs.

People with Disabilities: Individuals with disabilities, especially those with limited mobility or cognitive impairments, may face challenges in responding to fire emergencies. Contributing behaviors may include difficulties in safely using cooking appliances or limited ability to escape independently. It is crucial to assess each client’s specific needs and implement personalized fire safety measures, such as installing accessible fire alarms, creating clear evacuation plans, and providing fire safety training.

Individuals with Mental Health Conditions: Some individuals with mental health conditions may engage in behaviors that increase the risk of fire injuries, such as self-harm or neglecting fire safety precautions. For instance, a person experiencing a psychotic episode might be unaware of the dangers associated with mishandling flammable materials. To mitigate risks, mental health assessments should include fire safety evaluations, and appropriate interventions should be implemented to address any identified risks.

Ideal Locations for Placing Smoke Alarms in a Home-Based Environment

Smoke alarms play a crucial role in detecting and alerting occupants to the presence of fire or smoke. In a home-based environment, smoke alarms should be strategically placed to maximize their effectiveness. Ideally, smoke alarms should be installed:

Inside each bedroom: This ensures that occupants are alerted to smoke or fire during sleep when the senses may be less responsive.

Outside sleeping areas: Placing smoke alarms in hallways or common areas adjacent to bedrooms provides early warning to occupants who may be awake or moving around the house.

On every level of the home: Smoke alarms should be installed on each floor to cover all areas of the residence, including basements and attics if applicable.

Liaising to Install a Main Powered Smoke Alarm

To install a main powered smoke alarm, Enrolled Nurses should liaise with qualified electricians or professionals specializing in smoke alarm installation. These professionals have the expertise to ensure that the smoke alarm is correctly wired and integrated into the home’s electrical system. It is essential to follow local regulations and guidelines when installing main powered smoke alarms to ensure compliance and maximize effectiveness.

Key Smoke Alarm Maintenance Routines for Effective Protection

To provide effective protection, Enrolled Nurses must follow these three key smoke alarm maintenance routines:

Regular Testing: Smoke alarms should be tested monthly to ensure they are functioning correctly. This involves pressing the test button on the smoke alarm and confirming that the alarm sounds loud and clear. Any malfunctioning smoke alarms should be reported and replaced promptly.

Battery Replacement: Battery-powered smoke alarms require regular battery replacement to ensure continuous functionality. Batteries should be replaced at least once a year or according to the manufacturer’s recommendations. It is essential to educate clients about the importance of maintaining functional batteries in smoke alarms.

Cleaning and Dusting: Smoke alarms can accumulate dust and debris over time, which may interfere with their performance. Enrolled Nurses should periodically clean and dust the smoke alarms to prevent obstruction of the sensors. It is important to follow the manufacturer’s instructions for cleaning and avoid using abrasive materials or cleaning agents that may damage the device.

Risks to Personal Safety when Working in a Home-Based Environment

Risk of Violence or Aggression: Enrolled Nurses working in home-based environments may face the risk of violence or aggression from clients or their family members (Dunsford, 2022). Strategies to minimize this risk include conducting thorough risk assessments, implementing de-escalation techniques, maintaining clear communication, and seeking support from relevant authorities when necessary.

Risk of Musculoskeletal Injuries: The nature of home-based care often involves manual handling tasks, such as lifting or transferring clients. These activities can put Enrolled Nurses at risk of musculoskeletal injuries if proper techniques and equipment are not utilized. It is crucial to receive appropriate training on safe manual handling, use assistive devices when necessary, and seek assistance from colleagues or equipment suppliers to minimize the risk of injury.

Common Sources of Infection in a Home-Based Environment

Contaminated Surfaces: Home environments may harbor various pathogens on frequently touched surfaces, such as doorknobs, light switches, or kitchen countertops. To minimize the transfer of infectious diseases, Enrolled Nurses should encourage regular hand hygiene practices for clients, provide guidance on proper cleaning and disinfection procedures, and promote the use of personal protective equipment when necessary.

Improper Waste Management: Improper disposal of medical waste, such as used syringes or dressings, can pose a risk of infection transmission. Enrolled Nurses should educate clients about appropriate waste management practices, including the use of sharps containers and proper disposal techniques. It is also important to ensure the availability of waste disposal supplies and coordinate with waste management services to maintain a safe environment.

Risks Associated with Showering or Bathing Clients in Their Own Home

When showering or bathing clients in their own home, the following physical injuries and causative factors may be present:

Slips, Trips, and Falls: Slippery surfaces in bathrooms, inadequate handrails, or improper transfer techniques can contribute to falls during showering or bathing. Factors such as limited mobility, weakness, or cognitive impairments increase the risk of accidents. To minimize these risks, Enrolled Nurses should conduct thorough assessments of the client’s mobility and balance, implement safety measures such as non-slip mats and grab bars, and provide appropriate assistance during transfers.

Scalds or Burns: Clients may be at risk of scalds or burns due to the temperature of the water or inadequate monitoring. For example, older adults with reduced sensation may not perceive excessive heat, leading to scalding injuries (De Rosende Celeiro et al., 2019). Enrolled Nurses should ensure water temperature is set at a safe level, test the water before the client enters, and closely monitor the client during bathing or showering to prevent burns.

Skin Trauma: Friction or excessive force during washing or drying can cause skin trauma, especially in clients with fragile skin or underlying conditions. Enrolled Nurses should adopt gentle washing techniques, use appropriate bathing aids such as soft sponges or washcloths, and ensure proper hydration and moisturization of the skin to minimize the risk of skin trauma.

Practices to Minimize Injury to Self and Clients

Communication and Collaboration: Maintain open communication with clients to understand their specific needs and limitations. Collaborate with clients, their families, and other healthcare professionals to develop individualized care plans that address safety concerns and incorporate appropriate interventions.

Education and Training: Provide comprehensive education to clients and their families regarding safety practices, including fall prevention, infection control, and proper use of assistive devices. Offer training sessions on safe manual handling techniques to Enrolled Nurses to minimize the risk of musculoskeletal injuries.

Regular Risk Assessments: Conduct regular risk assessments in the home environment to identify potential hazards and take necessary precautions. This includes assessing for fire safety, infection control, and environmental risks that may pose a threat to the safety of both the Enrolled Nurse and the client.

Conclusion

 Ensuring safety in a home-based environment is paramount for Enrolled Nurses. By understanding the rights and responsibilities of both workers and clients, identifying high-risk client groups, implementing appropriate safety measures such as smoke alarms and infection control practices, and adopting strategies to minimize personal safety risks, Enrolled Nurses can provide care that promotes the well-being of clients while safeguarding their own safety. By prioritizing safety and implementing preventive measures, Enrolled Nurses contribute to a safe and secure home environment for all involved.

References

De Rosende Celeiro, I., Torres, G., Seoane-Bouzas, M., & Ávila, A. E. R. (2019). Exploring the use of assistive products to promote functional independence in self-care activities in the bathroom. PLOS ONE, 14(4), e0215002. https://doi.org/10.1371/journal.pone.0215002 

Dunsford, J. (2022). Nursing violent patients: Vulnerability and the limits of the duty to provide care. Nursing Inquiry, 29(2). https://doi.org/10.1111/nin.12453 

Olejarczyk, J. P. (2022, November 28). Patient Rights and Ethics. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538279/