Patient handling may up risk of assault

Study bolsters need for home health lifts

Here's yet another reason to improve patient handling: Health care workers involved in patient handling tasks may be at greater risk of assaults from patients.

In a study of 677 home health care workers, 94% of the workers who reported having been assaulted by a patient at least once in the past 12 months said they routinely performed patient handling tasks, such as transferring patients from a bed to a chair. In all, 29 (8%) of the 373 workers who routinely handled patients reported having been assaulted. In contrast, only two (0.7%) of 304 home health care workers who did not routinely handle patients reported assaults.

"Patient handling interventions are a promising way to not only reduce overexertion and injury of the worker and falls for the patient, but also assaults by patients," says the study's lead author, Traci Galinsky, PhD, research psychologist with the Human Factors and Ergonomics Research Team of NIOSH in Cincinnati and a captain in the Commissioned Corps of the U.S. Public Health Service. (The study has not yet been published.)

Unfortunately, lift and transfer devices are much less common in home health care than in institutional settings. (See related article, left.)

Assaults by patients have a negative impact on both the worker and on patient care. Assaulted health care workers may suffer from fear, anxiety, cognitive difficulties, reduced job performance and satisfaction, and depression, studies have shown.

Galinsky and her colleagues found that when they felt concerned for their safety, assaulted workers were more likely to shorten home visits, compared with workers who had not been assaulted. "When a visit is shortened, it's going to have a negative impact on care quality," she notes. "In safety training, [home care workers are told], 'If you feel threatened, leave.' That is a necessary safety strategy, but the unfortunate side effect of that is reduced care quality."

Another consequence may be higher turnover among employees. Researchers at the Mailman School of Public Health at Columbia University in New York City found a strong link between verbal and physical assaults of home health workers and job dissatisfaction and retention.1


1. Sherman MF, Gershon RR, Samar SM, et al. Safety factors predictive of job satisfaction and job retention among home healthcare aides. J Occup Environ Med 2008; 50:1,430-1,441.