1. Nix, Elizabeth PhD, RN, APRN, CNS, CDCES
  2. Altom, Kacie MSN, RN, CNE, CMSRN


Compared to nurses in acute care settings, home care nurses face unique threats to safety, including unsanitary conditions in homes, dangerous pets, firearms in the home, hostile patients or family members, high-crime neighborhoods, and motor vehicle accidents while traveling between patients. The purpose of this descriptive study was to explore specific personal safety and environmental concerns faced by home care nurses. Seventy-five home care and home hospice nurses completed an anonymous Qualtrics survey. Seventy-eight percent admitted to feeling unsafe during a home visit. Safety threats included unsafe neighborhoods, aggressive dogs, aggressive or drug-seeking family members, patients with mental health concerns, sexual harassment, and most alarmingly feeling threatened by a firearm. Participants also identified environmental concerns such as secondhand smoke and bedbugs, and a high number of musculoskeletal injuries they perceived to be related to their work in home care. Home care is a rapidly growing industry with a critical need to attract and retain workers. Safety training specific to the workers' role should be offered at the time of hire and annually thereafter. Home care nurses should be aware of threats to safety and employ the strategies of preparation, awareness, alertness, and prevention before and during visits.