The objective of the proposed study is to evaluate the risks of exposure to blood and sharps injury a large in population of home health care workers by: estimating the incidence of exposures to blood and percutaneous injuries; identifying and evaluating risk factors associated with these exposures; and assessing the availability and use of medical safety devices. The proposed study will be conducted by a multidisciplinary team working with 3 large home health care agencies and 2 health care labor unions. The partner agencies and unions deliver most of the home health care in eastern Massachusetts. This 4-year study is divided into 5 specific aims.
In aim 1, a surveillance system for blood exposure and sharps injuries (exposure/injury) will be established in the 3 partner home care agencies. Two years of surveillance data will be gathered.
In Aim 2, surveys will be conducted of home health care workers (HHCW) to gather data on exposure/injury, under-reporting, and availability and use of medical safety devices. A first, longer survey will be conducted in year 1, while a second, shorter survey will be conducted in years 3 and 4, after the surveillance system has been functioning for at least 1 year.
Aim 3 will use qualitative research methods to identify institutional barriers and incentives to exposure/injury reporting and the availability and use of medical safety devices.
Aim 4 consists of the quantitative analytic methods for studying the data gathered in the surveillance and risk factor surveys.
Aim 5 describes methods for communication of the findings and the development of training to the partner agencies/unions as well as dissemination of the study results to the broader home health care industry and the scientific community. This work will assist home health care agencies, unions, professional organizations, and government agencies by providing information that can aid in reducing blood exposure and sharps injury.

National Institute of Health (NIH)
National Institute for Occupational Safety and Health (NIOSH)
Research Project (R01)
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Application #
Study Section
Special Emphasis Panel (ZOH1-SPC (03))
Program Officer
Karr, Joan
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University of Massachusetts Lowell
Schools of Earth Sciences/Natur
United States
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Sun, Chuan; Buchholz, Bryan; Quinn, Margaret et al. (2018) Ergonomic evaluation of slide boards used by home care aides to assist client transfers. Ergonomics 61:913-922
Goodyear, Nancy; Markkanen, Pia; Beato-Melendez, Christian et al. (2018) Cleaning and disinfection in home care: A comparison of 2 commercial products with potentially different consequences for respiratory health. Am J Infect Control 46:410-416
Brouillette, Natalie M; Quinn, Margaret M; Kriebel, David (2017) Risk of Sharps Injuries to Home Care Nurses and Aides: A Systematic Review and Meta-Analysis. J Occup Environ Med 59:1072-1077
Markkanen, Pia; Galligan, Catherine; Quinn, Margaret (2017) Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers. J Infus Nurs 40:215-223
Brouillette, Natalie M; Quinn, Margaret M; Kriebel, David et al. (2017) Risk of sharps injuries among home care aides: Results of the Safe Home Care survey. Am J Infect Control 45:377-383
Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J et al. (2016) Occupational health of home care aides: results of the safe home care survey. Occup Environ Med 73:237-45
Markkanen, Pia; Galligan, Catherine; Laramie, Angela et al. (2015) Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention. BMC Public Health 15:359
Tarigan, Lukman H; Cifuentes, Manuel; Quinn, Margaret et al. (2015) Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infect Control Hosp Epidemiol 36:823-9
Galligan, Catherine J; Markkanen, Pia K; Fantasia, Linda M et al. (2015) A growing fire hazard concern in communities: home oxygen therapy and continued smoking habits. New Solut 24:535-54
Markkanen, Pia; Quinn, Margaret; Galligan, Catherine et al. (2014) Characterizing the nature of home care work and occupational hazards: a developmental intervention study. Am J Ind Med 57:445-57

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