Title Page

  • Facility Name

  • Patient Home Address
  • Healthcare Worker

  • Conducted on

Home Healthcare Worker Safety Checklist

Home Healthcare Worker Safety

  • My home health employer has an active safety program with a safety manager and a safety committee that includes employees from across the company

  • My employer provides initial and annual safety training

  • Annual training reviews new safety issues identified throughout the previous year

  • I have received training in ergonomics and safe patient handling and have a way to obtain necessary ergonomic equipment for the home I work in

  • Training includes latex allergy hazards, and nonlatex gloves are made available

  • The bloodborne pathogens plan is part of training, is updated annually, and is always available to workers

  • I am a part of the selection process for needle devices with safety features

  • I consistently follow standard precautions with all blood and potentially infectious materials

  • I have a properly labeled, leak-proof, puncture-resistant sharps container

  • An infection control plan has been developed

  • I consistently follow infection control and prevention measures (e.g., hand washing)

  • I am taught how to identify stressors and techniques for reduction

  • I have access to an employee assistance plan or other means of counseling support

  • There is a no-weapons policy for patient homes, or a policy requiring weapons to be disabled and locked up before the worker arrives

  • Locations of new patients are researched to determine local crime statistics

  • I am taught how to recognize violent or aggressive behavior and how to defuse an angry patient

  • I am taught to recognize illegal drug activities

  • I am taught what to do if I feel uncomfortable about a patient’s community or if I believe that I am in danger

  • Iam taught how to identify verbal abuse and what to do about it

  • There is an animal control policy requiring animals to be restrained

  • I am taught how to deal with bad weather

  • I am taught what to do in the event of a chemical spill or an act of terrorism

  • I am taught safe driving skills and how to report incidents and traffic offenses

  • My employer verifies safe driving records for all home healthcare providers

  • I have a cell phone or other reliable way to communicate with an employer or law enforcement

  • I am taught to observe surroundings and park in well-lit areas, away from visual obstructions

  • I wear sturdy, low-heeled, slip-resistant shoes


  • Additional Comments

  • Healthcare Worker Name & Signature

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