title: Safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings: A systematic review.
abstract: OBJECTIVE
  To explore the safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings.
  
  
  METHODS
  Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis.
  
  
  METHODS
  British Nursing Index (BNI), Allied and Complementary Medicine Database (AMED), Applied Social Sciences Index and Abstracts (ASSIA), Cinahl, Cochrane Library, Embase, Ergonomics Abstracts, Health Business Elite, Health Management Information Consortium (HMIC), Medline, PsycInfo, Scopus, Social Care online, Social Science Citation Index.
  
  
  METHODS
  The included references (n=42) were critically appraised using a modified version of Downs and Black checklist and the Mixed Methods Appraisal Tool.
  
  
  RESULTS
  The risk factors are reported using the modified model of human factors of health care in the home to represent the roles of both patients and caregivers in the system. The results are grouped as environment (health policy, physical and social), artefacts (equipment and technology), tasks (procedures and work schedules) and care recipient/provider. These include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables, and clinical tasks. The topics with strong evidence from at least 2 papers relate to risks associated with awkward working positions, social environment issues (additional tasks and distractions), abuse and violence, inadequate team (peer) support, problems with workload planning, needle stick injuries and physical workload (moving and handling patients).
  
  
  CONCLUSIONS
  As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage safety risks and plan safer care delivery systems.
authors.affiliation: Loughborough Design School, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK. Electronic address: S.M.Hignett@lboro.ac.uk.
authors.forename: Sue
authors.initials: S
authors.lastname: Hignett
authors.affiliation: NIHR RDS East Midlands, Department of Health Sciences, University of Leicester, Leicestershire, UK. Electronic address: mleo1@leicester.ac.uk.
authors.forename: Mary
authors.initials: M
authors.lastname: Edmunds Otter
authors.affiliation: NIHR RDS East Midlands, Faculty of Health & Life Sciences, De Montfort University, Leicestershire, UK. Electronic address: ckeen@dmu.ac.uk.
authors.forename: Christine
authors.initials: C
authors.lastname: Keen
mesh_terms: D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D061214:Patient Safety; D011369:Professional-Patient Relations
keywords: Community health services; Home care services; Moving and lifting patients; Occupational health; Patient safety