Risk Assessment Survey for Home Healthcare Nurses

Abstract

The Risk Assessment Survey for Home Healthcare Nurses is a comprehensive, 152-item self-administered questionnaire developed by Gershon and colleagues in 2008. It was designed primarily to assess occupational risk among home health care nurses, focusing specifically on identifying the frequency and context of exposure to bloodborne pathogens and the associated risk of percutaneous injuries. This instrument was initially utilized in a pilot study involving 72 nurses to better understand safety practices and environmental hazards in non-hospital settings.

The development of this tool addressed a critical gap in occupational health research, as traditional risk assessment tools often focused exclusively on hospital environments, neglecting the unique challenges faced by nurses providing care in diverse home settings. The scale provides detailed data regarding specific exposure incidents and safety behaviors.

Keywords

Risk Assessment, Home Health Care, Bloodborne Pathogen, Percutaneous injuries, Occupational Safety, Nursing, Exposure Risk, Safety Practices

Authors

Gershon, R. R., Pogorzelska, M., Qureshi, K. A., & Sherman, M.

Purpose

The primary purpose of the Risk Assessment Survey for Home Healthcare Nurses is to systematically quantify and qualify the risk of exposure to blood and body fluids encountered by nurses working outside of traditional hospital settings. This tool helps researchers and public health officials identify high-risk tasks, environmental factors, and behavioral patterns that contribute to injury risk.

The 152 items are structured to capture a broad range of data, moving beyond simple incident reporting to encompass organizational factors, training received, availability of safety equipment, and specific procedural details related to invasive tasks performed in patient homes. It serves as a crucial instrument for informing targeted prevention strategies and developing specialized safety protocols for the growing field of home health care.

Construct

The central construct measured by the survey is Occupational Exposure Risk in Non-Hospital Settings. This construct is multifaceted and encompasses several key dimensions:

• Exposure Frequency: The self-reported number of times a nurse has been exposed to blood or body fluids.
• Specific Risk Behaviors: Practices related to needle disposal, handling of sharps, and use of personal protective equipment (PPE).
• Environmental Hazards: Unique risks inherent to the home setting, such as lack of proper sharps containers or unpredictable patient environments.
• Injury Experience: Documentation of previous percutaneous injuries (e.g., needlesticks).
• Training and Compliance: Assessment of the nurse’s knowledge of safety protocols and adherence to universal precautions.

Validity

Specific detailed psychometric validation data, such as concurrent or predictive validity coefficients, are typically elaborated upon in subsequent research papers following the initial pilot study. The primary reference (Gershon et al., 2008) established initial face validity through expert review and content validity by ensuring the items comprehensively covered the known risks associated with bloodborne pathogen exposure during common home health care procedures.

The extensive nature of the 152 items suggests a strong attempt at ensuring content validity, covering administrative, behavioral, and environmental facets of occupational risk. Further research would be required to establish robust construct validity by correlating scale scores with actual incident rates over time.

Reliability

Information regarding the internal consistency (e.g., Cronbach’s alpha) or test-retest reliability of the full 152-item instrument was not explicitly detailed in the source abstract of the pilot study. Given the comprehensive nature of the self-administered questionnaire, which likely includes demographic and descriptive sections alongside behavioral measures, reliability estimates may vary significantly across different subscales within the survey.

For a tool intended for risk assessment, high reliability is crucial to ensure consistent measurement of exposure risk across different cohorts of home health care nurses. Researchers utilizing this scale should consult the full 2008 article for any reported internal consistency measures derived from the pilot data.

Factor Analysis

Formal exploratory or confirmatory factor analysis results are not provided in the background information derived from the primary source. Due to the instrument’s length (152 items) and its likely coverage of multiple distinct dimensions (e.g., administrative support, behavioral compliance, environmental factors), it is highly probable that the authors intended for the survey to be scored using several subscales.

Factor analysis would be necessary to empirically confirm the hypothesized structure of the scale and identify the key latent factors contributing to the overall measure of percutaneous injury risk. Users should investigate subsequent publications by Gershon and colleagues for evidence of structural validation.

Instrument

Test Type: Self-administered questionnaire (Survey)

Format: 152 items, primarily closed-ended or structured response questions, designed for self-report.

Language Available: English (assumed, based on publication context)

Population Group: Registered Nurses (RNs) working in non-hospital settings.

Age Group: Adult working population (specific age range not provided)

Population Details: The initial pilot study involved 72 actively practicing home health care nurses. This group was specifically targeted due to their unique exposure risks compared to hospital staff.

Test Methodology: Data collection involved distributing the questionnaire, likely via mail or in person, to collect retrospective and current data regarding occupational practices and exposure incidents.

Keywords

Occupational Health, Needlestick Injury, Registered Nurse, Safety Protocol, Risk Exposure, Survey Instrument, Public Health, Environmental Safety

Authors

Author ORCID Identifier: Not specified in primary source.

Affiliation Email addresses: Not specified in primary source.

Correspondence Address: Correspondence details related to the primary author (R. R. Gershon) would be found in the original journal publication.

Permissions & Fee and Test Year

Permissions: Permissions for use should be sought directly from the primary author, R. R. Gershon, or the publisher of the journal (American Journal of Infection Control). Academic use may be permissible with citation.

Fee: Fee information is not specified. The instrument is generally available for research purposes, though licensing for commercial or large-scale clinical use may apply.

Test Year: 2008 (Year of initial publication and pilot study).

Reference’s

• Gershon, R. R., Pogorzelska, M., Qureshi, K. A., & Sherman, M. (2008). Home health care registered nurses and the risk of percutaneous injuries: A pilot study. Am J Infect Control. 36, 165-72.

Items of the Risk Assessment Survey for Home Healthcare Nurses

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The specific 152 items comprising the Risk Assessment Survey for Home Healthcare Nurses are not provided within the source text. However, the original document file for the survey can be accessed via the link below:

The original questionnaire file can be downloaded here: Risk Assessment Survey for Home Healthcare Nurses (DOCX file)