Identifying Risks in the Work Environment at Nursing Homes

The work environment in a nursing home is complex and can pose several risks to both staff and residents. Identifying these risks is an important step in creating a safe and healthy environment. This article describes how to systematically work with identifying risks in the work environment at a nursing home and what methods can be used to prevent accidents and ill health.

Why is risk identification important in nursing homes?

Nursing homes often face challenges such as:
- Physical risks, such as falls, injuries during transfers and handling of heavy materials.
- Psychosocial risks, such as stress, burnout and conflicts.
- Biological risks, such as the spread of infection and ill health related to hygiene in care.
- Chemical risks, such as misuse of cleaning agents or drugs.

By identifying these risks early, measures can be taken to reduce the risks and create a safer environment for both staff and residents.

Identifying risks in the work environment

Mapping the work environment:
- Review all tasks and processes at the nursing home.
- Identify potential risk elements, such as transfers, handling of drugs or situations where infection can occur.
- Collect data through observations, surveys and conversations with staff and residents.

There are tools that can facilitate risk identification:
Checklists – Use checklists to systematically review different areas, such as hygiene in care, transfer techniques and fire safety.
Risk matrices By going through the likelihood of different events and the consequences if they occur, you get a basis for prioritizing your work.
Safety rounds – Carry out regular rounds where the staff together with a work environment responsible review the workplace and identify risks.

Involve the staff - The staff's experiences and knowledge are invaluable in risk identification
- Discuss perceived risks and challenges.
- Get feedback on existing routines and processes.
- Collect ideas for improvements and solutions.

Deviations related to the work environment are an important source of knowledge. By analyzing these events, one can:
- Understand the causes of the event.
- Identify system errors or deficiencies in routines.
- Suggest measures to prevent similar events in the future.

Sometimes it may be necessary to involve external experts, such as work environment engineers or ergonomists, to:
- Conduct deeper analyses of specific risks.
- Get advice on technical solutions or adaptations.
- Train the staff in risk management and preventive work.

Here are some examples of common risks in nursing homes:
- Falls among residents and staff.
- Injuries during transfers and handling of residents.
- Strain injuries due to monotonous or heavy tasks.
- Stress and burnout due to high workload.
- Conflicts between staff or between staff and residents.
- Loneliness or isolation among the staff.
- Spread of infection, such as influenza or COVID-19.
- Insufficient care hygiene, such as inadequate hand hygiene or incorrect waste handling.
- Misuse of cleaning agents or disinfectants.
- Exposure to drugs or chemicals.

Measures to Reduce Risks

Once the risks are identified, the next step is to take measures such as:
- Mobile lifts, training, safety locks on certain doors, ensuring at least 80 cm space for places where employees assist residents with transfers, ensuring order and cleanliness - a good safety culture.
- Improve scheduling, create clear routines, continuously work with further education.
- Provide staff with training in transfer techniques, infection control or handling of chemicals.
- Ensure that staff have access to and use protective equipment, such as gloves and masks.

When it comes to risks for the residents, there are several that are part of evidence-based care and should therefore be included in the care. Such are for example risk of falls, pressure ulcers, malnutrition and deficiencies in oral health. These are included in the software Senior alert which facilitates the management. Otherwise, these risk assessments can be done separately, but as said - they are part of evidence-based care in nursing homes.

Reflection Questions - Risk Analysis

Care Staff
- How do you perceive the work environment at your nursing home?
- What risks have you identified in your daily work?
- Have you received enough training to handle risks such as transfer techniques or infection control?

Manager, Nurse, Occupational Therapist and Physiotherapist
- How do you systematically work to identify and manage risks in the work environment?
- How do you involve the staff in the work environment work?
- Do you have access to external experts to analyze complex risks?

Residents and Next of Kin
- How do you perceive the safety and security at the nursing home?
- Have you been informed about how risks are managed at the residence?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day.