home visiting safety
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Sally Torres MSW LMSW JoAnne Vincent MSN RN CPNP. HOME VISITING SAFETY. THE IMPACT. From 2004- 2006 at least five home visitors (SW) murdered across the country Today, home visiting is less safe than even ten years ago - PowerPoint PPT PresentationTRANSCRIPT
Sally Torres MSW LMSWJoAnne Vincent MSN RN CPNP
THE IMPACT From 2004- 2006 at least five home
visitors (SW) murdered across the country
Today, home visiting is less safe than even ten years ago
Lack of education regarding home visiting safety, yet home visiting has been a mainstay of service delivery for social workers, teachers, nurses, and others for many years
THE BENEFITS OF HOME VISITING
See client in living environment
Tailor services
Reach families not in system
Cultivate special relationship
SAFETY: Even the Pros Need Reminders
THREE BASIC RULES DO stay alert
Keep your mind on your surroundings, who’s in front of you and who is behind you. Don’t get distracted.
DO communicate the message that you are calm, confident, and know where you are going. Stand tall, walk purposefully, and make quick eye
contact with people around you.
DO trust your instincts! If you feel uncomfortable in a place or situation,
LEAVE
THREE ELEMENTS OF A CRIME
DESIRE: The desire of a criminal to commit a crime. We as citizens can not affect this desire from the criminal.
ABILITY: The criminals ability to commit a crime. We as citizens can impair the criminals ability by practicing good crime prevention methods.
OPPORTUNITY: The criminal’s opportunity to commit a crime is where we have the biggest opportunity to impact the event. We can take away the opportunity for the crime – thus preventing us from becoming a victim.
SELF DEFENSE
Use your voice first, last, and during conflict
Decide ahead of time whether to fight or FLEE
Fighting back Control breathing : Don’t hold your breath Targets: Knees, groin, sternum, throat, eyes Your weapons: Fists, elbows, feet, knees, teeth,
head
PREPARING FOR HOME VISITS
CAR PREPARATION
Gas/well maintained Hand sanitizer/first aid kit Emergency roadside assistance numbers Jumper cables, spare tire, shovel, blanket,
extra food, water, and clothing Maps and/or GPS system Know public transportation options Plan for the weather
PREPARATION FOR HOME VISIT
Conduct a “Risk Assessment” Review available files and histories Identify high risk potential
History of violence History of mental illness Suicide attempts Any incidents involving firearms or weapons History of substance abuse Extreme political or religious views
PREPARATION FOR HOME VISIT (cont’d)
Conduct a reconnaissance drive-by
Neighborhood & neighbors Parking Front porch and door Cars and foot traffic Dogs Signs, bumper stickers Blackened-out windows
PREPARATION FOR HOME VISIT (cont’d)
Revise your risk assessment after drive-by
Develop your plan High risk
Meet at neutral location Medium Risk
Buddy system Daylight visit
Low Risk – is it??
PREPARATION FOR HOME VISIT (cont’d)
Develop an Itinerary Let a co-worker or someone else know
when you are leaving and when you expect to be back, and destinations
Set code word (SOS) with co-worker or someone else
Keep addresses and phone numbers of homes to visit in a location that co-workers or someone else can get to if needed
Co-worker or someone else should know make, model, license number of your vehicle
PREPARATION FOR HOME VISIT (cont’d)
Clothing and Equipment Shoes with protective soles and toes Loose fitting clothing Nothing around the neck that can be
used to grab hold of you Avoid jewelry and valuables Charged cell phone Loud whistle
ARRIVING AT THE HOME
ARRIVING AT THE HOME
“Combat Park” Close by but not directly in front of the home
or in driveway Leave room to make quick getaway
Enough to pull straight out / not enough for someone to park in front of you
Lock vehicle and set alarm Put valuables in trunk before arriving
Look, Listen and Smell as you approach Any changes since your reconnaissance?
ARRIVING AT THE HOME (cont’d)
Call from car to announce your arrival
Leave if you feel in danger Trust your instincts!!!
Use door as a shield Stand on door handle side at 45 degree
angle Avoid standing in front of windows
ARRIVING AT THE HOME (cont’d)
Knock loudly and identify yourself If in doubt about activities inside, ask the
person to come onto the porch If no answer – go back to car and call on
phone if necessary DOGS:
Block outer/screen door with your foot Ask owner to put ANY pets away before
entering Don’t look dog straight in the eyes
IN THE HOME
IN THE HOME Establish rapport
Include other family members if appropriate
Review visit purpose and anticipated length of visit
Minimize distractions
IN THE HOME
When entering building or home, follow- do not lead
Determine who else is in the home Take note of your surroundings (left to
right/top to bottom) Hold visit in central location (kitchen, living
room or dining room) Sit near door with back to wall Identify escape routes Sit on furniture edge, do not lean back
IN THE HOME
Be respectful of a person’s personal space
Use discretion if accepting food, drinks, gifts
Don’t turn your back – most vulnerable position
Be confident
IN THE HOME
When can you leave? If you feel threatened If you are asked to leave When you recognize potentially dangerous
situations
TRUST YOUR INSTINCTS!!!
MEETING AT A NEUTRAL SITE
How to have a private meeting in a public place You choose the site
Neither you or other party should be regulars Meet in between normal meal hours 10a-2p Place should have two exits
You choose the seating Nobody within earshot View of whole room – especially exits “We are having a private business lunch, may we sit over
there”
You get there first Do drive-by Check safety inside and out
Talk quietly and change the discussion if you have to
FOLLOWING THE HOME VISIT
Report in after leaving
If feeling threatened, proceed to nearest police or fire station
Debrief urgent concerns
Document visit
OUT OF CONTROL BEHAVIOR
Don’t argue or try to reason Let it be known that you are not a threat
Break eye contact – but don’t turn your back Hold your hands-up (surrender/non
aggressive sign) Nod your head in agreement Yield all possible space
GET OUT OF THERE!!! Back away at an angle
ADMINISTRATIVE RECOMMENDATIONS Orientation and safety training
Develop policies regarding home visiting Refusing visits Cancelling visits (weather, current events) Abandoning visits (weather, pets, staff abuse) Supplies and equipment Code word or phrase for staff SOS call Plan if home visitor doesn’t call/return Post trauma support Termination of visits
Yearly safety education
Document visit
BE SAFE!!!
We would like to acknowledge Charlie Dickson and all of the officers at Children’s Hospital of Michigan and the Detroit Medical Center for keeping us safe...
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Denard Goldman, K. & Jahn Schmalz, K. (2008). The “Home Ranger” rides again! Making home visits safer and more effective. Health Promotion Practice. 9:4. 323-327.
Every, M. (2002). Safe community working. Royal College of Midwives Journal. 5:6. 194.
Homecare Education Management. (1996). American Health Consultants: Atlanta ,GA. 5-7.
REFERENCES Jodway, V. (2004). Knock before you enter. Home
Healthcare Nurse. 22:6. 427-428.
Kendra, M. A., Weiker, A., Simon, S., Grant, A., & Shullick, D. (1996). Safety concerns affecting delivery of home health care. Public Health Nursing. 13:2. 83-89.
McPhaul, K. (2004). Home Care Security. American Journal of Nursing. 104:9. 96.
O’Boyle, M.E. (1995). Preparing for a safer home health care visit. Home Health Care Management Practice. 8:1. 34-43.
OSHA. (2008). Home Visitor Safety: Taking Charge of Your Personal Safety.