News & Events

Workplace Hazards to Nurses and Other Health Care Workers: Promising Practices for Prevention

From the Massachusetts Nurse Newsletter
March 2008 Edition

MNA’s Health & Safety Division shares conference findings

In June 2007 MNA and the UMass Lowell’s School of Health and Environment held a two-day conference in Marlboro entitled “Workplace Hazards to Nurses and Other Healthcare Workers: Promising Practices for Prevention.”

One of the goals of the conference was to assist participants to work with others in improving work conditions by eliminating or minimizing the hazards they face on the job each day.

Eight breakout sessions were held, with each addressing these hazardous conditions. Follow-up reports were developed after each session in order to share pertinent findings with conference attendees at the end of each of the conference days.

All conference documents are available on the Workplace Hazards Conference page.

What follows is the fourth of several finding summaries that will be shared over the next few months.

Workplace Hazards to Nurses and Other Health Care Workers: Promising Practices for Prevention

Program: Preventing Home Care Injuries
Speakers: Stephanie Chalupka, EdD, APRN, BC, CNS, FAAOHN; Pia Markkenen, ScD
MNA Facilitators: Rosemary O’Brien, RN; Judy Rose, RN; Mary Bellistri, RN

Statement of the Problem
The home health care (HHC) sector represents 5.8% of overall U.S. health care employment and is one of the fastest growing parts of the economy. HHC clinicians face serious occupational hazards including violence in neighborhoods and homes, lack of workstations, heavy patient lifting, improper disposal of dressings or sharps medical devices, and high productivity demands. The social context of the home-work environment challenges the implementation of preventive interventions to reduce occupational hazards in HHC.* Drs. Markannen, Quinn, Chalupka, *J Occup. Environ Med. 2007;49:327-337

JCAHO Regulation that relates to this topic: Joint Commission Regulations do not address home care specifically but certain regulations apply if the home care agency is a hospital supported program. EC. 1.10. Hospitals must manage safety risks. EC. 1.20 Hospitals must maintain safe environments

OSHA Standard that address this topic: OSH Act -5A-1 General Duty Clause – Employers must furnish a place of employment that is free from recognized hazards,1910.1030 Bloodborne Pathogens Standard, OSHA Guidelines for Preventing Workplace Violence in Healthcare and Social Service Settings

OSHA recommended steps to provide a safe work environment: A. Management support and worker involvement, B. Hazard assessment, C. Training and education, D. Program evaluation

Items considered by the breakout session participants

How are patients, visitors or others affected?

Patients, family members and healthcare providers are affected by hazards in the home care including:

  • Improper disposal of sharps, needles, lancets and wound care implements present opportunities for needlestick injuries to all
  • Sharps used on pets (administering insulin) are also disposed of improperly
  • Tripping hazards exist from clutter in the home, scatter rugs, electrical and extension cords
  • Exposures to insects, rodents and animal droppings
  • Medical equipment used in home care can be defective
  • Potential for fire and electric shocks posed by defective medical equipment and extension cords

What are some good practices that you have seen in your workplace?

  • Ergonomic initiatives such as training on equipment designed to facilitate patient transfers from bed to chair
  • Parking spaces made available in multi-resident dwellings to reduce the distance that nurses must walk while carrying their heavy equipment bags
  • Information on the local sex offender registry to warn nurses of the potential for violence and to assure this information is communicated to all caregivers, including home health aides
  • Agency provided security services when requested
  • Agencies encouraging nurses to report injuries
  • Agencies acting upon injury reports so that hazards can be addressed and prevention steps taken

What are some of the barriers and opportunities associated with change?


  • Lack of training in personal/workplace safety
  • Organizations do not allocate time or funds for staff to attend training programs that are available
  • Employees chastised for not attending safety programs even though they were on duty at the time the program was presented and were not provided time to attend


  • Knowledge and training in occupational safety that provide opportunities for change

What are some concrete steps that could be taken to address this problem?

  • Include field staff and home health aides on committees so that the needs found in the field are addressed and the training is relevant

Who are the management people at your workplace who are responsible for worker health and safety and who are five people in your workplace who would help to address an issue?

  • Supervisors, managers, and representatives from human resources, risk management and the admissions department
  • Co-workers who have been affected by unsafe conditions will often advocate for improving the work environment
  • Local union representatives and union staff should be included in discussions that address workplace safety