Recently in Home Health Workers Category

Source: Janette S. Dill, John Cagle, Journal of Aging and Health, Vol. 22 no 6, September 2010
(subscription required)

From the abstract:
Objectives: High turnover and staff shortages among home care and hospice workers may compromise the quality and availability of in-home care. This study explores turnover rates of direct care workers for home care and hospice agencies.
Results: Home care agencies have higher total turnover rates than hospice agencies, but profit status may be an important covariate. Higher unemployment rates are associated with lower voluntary turnover. Agencies that do not offer health benefits experience higher involuntary turnover.
Conclusion: Differences in turnover between hospice and home health agencies suggest that organizational characteristics of hospice care contribute to lower turnover rates. However, the variation in turnover rates is not fully explained by the proposed multivariate models. Future research should explore individual and structural-level variables that affect voluntary and involuntary turnover in these settings.

Source: Linda S. Noelker, et al., Public Policy & Aging Report, Winter/Spring 2010
(subscription required)

From a PHI abstract:
This article outlines the preliminary recommendations made by a panel of long-term care experts convened by the Benjamin Rose Institute on behalf of the Institute of Medicine. The panel was tasked with devising ways to strengthen the direct-care workforce. Some of the recommendations include: increasing the supply of direct-care workers by bolstering recruiting efforts; advocating for more intensive federal and state training requirements; and instituting higher standards of evaluation for direct-care workers.

Source: Paraprofessional Healthcare Institute, 19 August 2010

A new study by Pennsylvania State University researchers found that home health aides who had training are less likely to be injured on the job, and aides who felt they did not have good support from their supervisors were also more likely to suffer injuries.

The researchers also concluded that home health aides who had not experienced on-the-job injuries had a higher rate of job satisfaction and lower turnover "intentions."
See also:
Pennsylvania State University press release

Source: Ninica Howard; Darrin Adams, Home Health Care Services Quarterly, Volume 29, Issue 2 April 2010

From the abstract:
An examination of the Washington State workers' compensation claims for home health care workers was conducted. Some comparisons were made with nursing homes, acute care hospitals, and all other industries in the state. Between 1998 and 2007, the average claims rate for home health care workers was 1,375 claims/10,000 full-time equivalents (FTEs) compared to 862 claims/10,000 FTEs for all other industries. The proportion of home health care workers' injuries resulting from interactions with another person (89.6%) was comparable to those for nursing homes and hospitals. Although this industry has important economic and social value, risks are poorly characterized. Continued research is necessary.

Source: Paraprofessional Healthcare Institute (PHI), July 2010

From the summary:
A new PHI PolicyWorks analysis finds that a growing number of states report that personal and home care aides are receiving wages that put them at risk of poverty.

In 2009, 36 states reported average hourly wages that fell below 200 percent of the Federal Poverty Level, up from 32 states in 2008, according to the analysis reported in PHI's updated State Chart Book on Wages for Personal and Home Care Aides (pdf).

Wages below 200 percent of the federal poverty level ($10.42) are low enough to qualify workers for many state and federal public assistance programs.

Source: Nancy Folbre, New York Times Economix Blog, July 26, 2010

Most Americans, even if they have jobs themselves, care about those who can't find jobs. Recent polls report that a strong majority consider it a higher priority to help the unemployed than to reduce the federal deficit.

Most Americans also care about the well-being of the most vulnerable members of our community - individuals with disabilities, the frail elderly and children growing up in poverty. That's why we have programs like Medicaid, Medicare and Head Start. Unfortunately, many states, unable to raise the revenue they need, are cutting spending on such programs.

Maybe we could improve home-care services by providing more federal support for jobs in this sector of the economy.

At least two specific proposals along these lines, based on very different designs, have been put forward.

Source: Candace Howes, Ph.D., Connecticut College, Published with Paraprofessional Healthcare Institute, May 2010

From the press release:
A new study released today by the Institute for Women's Policy Research (IWPR) and PHI concludes that reducing In Home Support Services (IHSS) in California will be costly for taxpayers. Currently, California's Medicaid long-term care program, which includes IHSS, places among the top five states in terms of coverage, balance between nursing home and home- and community-based care, and cost effectiveness.

The study, Costs and Benefits of IHSS for the Elderly and People with Disabilities: A California Case Study, by Dr. Candace Howes, Professor of Economics at Connecticut College, refutes findings of a January 21, 2010, report from California's Legislative Analyst's Office (LAO) on the fiscal impact of the IHSS program, which provides daily supports for seniors and people with disabilities. The study shows the LAO underestimated the increase in costs that will be borne by taxpayers if Governor Schwarzenegger's 2010-2011 budget proposal to reduce or eliminate IHSS services for 444,000 people were to be implemented. The IWPR-PHI study also shows that the state could achieve nearly equivalent savings and improve the quality of life for seniors and people with disabilities by shifting some of those who are in nursing homes into community care.

Source: Linda Barbarotta, Institute for the Future of Aging Services and the American Association of Homes and Services for the Aging, January 2010

From a PHI summary:
More than two dozen proven examples of direct-care worker retention strategies are outlined in a January report from the American Association of Homes and Services for the Aging (AAHSA).

The report explains that the poor quality of many direct-care jobs leads directly to high turnover -- which can in turn degrade the quality of care offered by long-term care providers in the U.S.

Source: Jack K. Leiss, American Journal of Infection Control, published online 26 April 2010
(subscription required)

From the abstract:
Nurses who provide care in the home are at risk of blood exposure from needlesticks. Using safety-engineered medical devices reduces the risk of needlestick. The objectives of this study were to assess provision of safety devices by home care and hospice agencies as well as the use of these devices by home care and hospice nurses in North Carolina, and to examine the association between provision and use.

The percentage of nurses who were always provided with safety devices ranged from 51% (blood tube holders) to 83% (winged steel needles). Ninety-five percent of nurses who were always provided with safety devices, but only 15%-50% of nurses who were not always provided with safety devices, used a safety device the last time they used that general type of device. Among nurses who did not use a safety device on that occasion, 60%-80% did not use it because it was not provided by the agency.

This study suggests that limited access is the primary reason for home care/hospice nurses' failure to use safety devices. The policy goal of providing safety devices to health care workers in all situations in which such devices could reduce their risk of needlestick is not being achieved for home care nurses in North Carolina.

Source: Stuart H. Cohen, Dale N. Gerding, Stuart Johnson, Ciaran P. Kelly, Vivian G. Loo, L. Clifford McDonald, Jacques Pepin, Mark H. Wilcox, Infection Control and Hospital Epidemiology, Volume 31, Number 5, May 2010
(subscription required)

From the abstract:
Since publication of the Society for Healthcare Epidemiology of America position paper on Clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment of this infection. C. difficile remains the most important cause of healthcare‐associated diarrhea and is increasingly important as a community pathogen. A more virulent strain of C. difficile has been identified and has been responsible for more‐severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.