Four tips to protect your agency's employees

Protecting employees as they travel throughout the area and into many different types of situations often means giving them trainings and tools that can help them avoid, or escape, a dangerous situation. Conversations with home health nurses and aides, as well as review of incidents that have occurred, help you discover what issues need to be addressed, explains Carrie Krueger, RN, BSN, clinical director of home care services at Cincinnati Children's Hospital Medical Center.

Some of the changes or enhancements to her agency's protocol for visits include:

1. Use a duress signal.

A code word or phrase that is known by all staff members is used when a nurse believes he or she may be in a potentially dangerous situation. "The nurse tells the family that a page must be returned, then he or she calls the office," says Krueger. "The staff person who answers the call and hears the duress signal calls the police," she explains. It is important that the nurse give the location by saying, "I'm at [patient's name] home on [street name]" so the office staff member answering the phone knows the exact location. "It is also important that the office staff member taking the call stay on the phone with the nurse until the police arrive," she points out. If it is not possible to stay on the phone, the nurse should leave the cell phone on and in his or her pocket so others can hear what is going on, Krueger continues.

2. Communicate location.

"A nurse should make sure that someone knows where she or he is going at all times," Krueger points out. "During the weekday, it is easy because we have staff in the office and it is easy to check in with each other," she says.

"Nurses who go out in the evenings and on weekends need to make sure a family member knows where they are going and how long it should be until they return," Krueger suggests. "Family members should also have a list of contact numbers for managers and supervisors in the agency if the nurse doesn't return on time and can't be reached," she adds.

3. Establish good relationship with police.

Although the nurses no longer rely upon police escorts for visits into high-risk areas, agency schedulers regularly check in with police in the different districts when a new patient with an address that is in an area that might be high risk is referred to the agency. By talking with a specific, designated contact, the scheduler is able to determine if the location is considered high risk and requires that the nurse have an escort from the protective services group at the hospital, says Krueger.

4. Don't schedule some visits in evening.

"If the patient is located in a known high-risk area, we don't schedule night visits," Krueger says. If the patient needs care at 11 p.m., have them go to the emergency department, she adds.