Home visiting, risk assessment and safety

Introduction Many health care professionals undertake roles that require them to visit the home of the client or a range of other possible locations, rather than the client coming into the health care service setting. Primary health care nurses usually work alone and often have little control over the environment, requiring a different approach to risk management . Assessment of risk is necessary to identify any potential harm or risk to safety. These should be considered from both personal and professional perspectives. Although risk is present in all activities of life, the management of risk is essential when providing services that meet the needs of clients while minimising the chance of undesirable incidents . Employers have a key responsibility to provide a safe and healthy workplace. Risk assessment and risk management are essential components of the duty of care employers have for their employees. Occupational health and safety legislation exists to ensure the well-being of the employee. However, employees also have a duty of care for their own health and safety, as well as for others who may be affected by their actions. The risk management process requires the identification and introduction of suitable actions aimed at reducing hazards to all involved in a particular activity. The perception of risk is shaped by personal, social and cultural values, experience and knowledge (Hawkins, Redley & Holland, 2011). Clinical, economic, cultural, social, political and ethico-legal aspects need to be considered, while maintaining the focus on promoting efficient, effective, quality care (Leyshon, 2005). Examples of risk management practices include education and training in relation to movement and handling procedures, and the development of protocols, guidelines and pathways to provide guidance to staff in complex situations (Reynolds, 2009). Risk avoidance must occur when a potential hazard cannot be controlled or reduced. In such circumstances the only option is to change the way practice is delivered. When it is not possible to control or avoid the risk, risk acceptance may occur. However, the level of risk to be tolerated may differ between the organisation, individual professionals and clients. Evaluation of risk requires finding a balance between perceived hazards and benefits of the action. Risk management must be embedded in community practice to ensure the health and safety of health care professionals and clients (Reynolds, 2009).