• Follow your employer’s infection-control plan.
• Use appropriate personal protective equipment, including medical exam gloves and respiratory protection, when necessary.
• Train patients, family members and home visitors on proper cough etiquette, hand hygiene, and social distancing.

• Make restraint of animals a condition of giving home healthcare.

• Wait outside until the pet is restrained.
• If you see fleas or other pests, discuss appropriate control measures with the patient and contact your supervisor.
• If the patient isn’t receptive to pest control measures, ask your employer to contact social services to help the patient and make it possible to work there.

• The home healthcare worker may discover temperature extremes in the homes.

Recommendation for employers

• Train employees about acceptable temperature ranges and what they should do if the home they visit is extremely cold or warm.

• If you’re concerned about the home being too cold and you cannot change the thermostat, ask your employer to contact social service agencies to help the patient. Local resources may be available to help pay heating bills.
• If a home is uncomfortably warm, open the windows, use fans, and if necessary, apply cool compresses. Drink plenty of water. If you believe the patient is at risk from the heat, ask your employer to contact social service agencies to help the patient.

Recommendations for workers

• If a home is unsanitary, consider using clean pads with plastic on one side to set down under equipment and supplies.[7]
• Take in only the necessary equipment and supplies so potential pests infest fewer things.
• Avoid setting things such as purses and bags on a carpeted floor.
• Use non-latex disposable gloves and hand sanitizer.

Recommendation for employers

• Train employees about potable and nonpotable water and how to ask the patient about available drinking water in their home.

• If conditions present a health hazard, ask your employer to contact social service agencies to help the patient.
• Consider bringing several gallons of water if it is needed for patient care.
• Use hand sanitizer and do not use the toilet in a patient’s home with minimal water.[7]

Recommendation for employers

• Train workers about fall protection and steps they can take to identify and reduce fall hazards for both themselves and the patient.

• Wear sturdy, flat shoes with good slip protection.
• Walk slowly on icy or wet surfaces.
• Examine the patient’s walking path to the bathrooms, eating areas, and sitting areas:
• Remove or securely tape down rugs using double-sided tape if the patient gives you permission to do so.
• Secure cords and any other loose materials in the walking path that could cause the patient or you to slip, trip, or stumble.[9]
• Use handrails.
• Turn on outside lights before returning to your car in the dark.
• Clean up spills as soon as they happen.

Recommendations for employers

• Create a severe weather program and train employees.

Recommendations for workers

• Seek shelter immediately if the area you are in is under a tornado warning.
• Go to a designated shelter area such as a safe room, basement, storm cellar, or the lowest building level.
• If there is no basement, go to the center of an interior room on the lowest level (closet, interior hallway) away from corners, windows, doors, and outside walls.
• Put as many walls as possible between you and the outside.
• Get under a sturdy table and use your arms to protect your head and neck.
• Do not open windows.
• If you are in a mobile home, leave. Mobile homes, even if tied down, offer little protection from tornados.
• If you are in a vehicle, get out immediately and go to the lowest floor of a sturdy, nearby building or a storm shelter.

• Follow local evacuation orders.
• If you are in a mobile home, leave. Mobile homes, even if tied down, offer little protection from hurricane winds.

• Be aware that some earthquakes are actually foreshocks and a larger earthquake might later occur.
• If you are indoors:
• Drop to the ground.
• Take cover by getting under a sturdy table or other piece of furniture.
• Hold on until the shaking stops.
• Cover your face and head with your arms and crouch in an inside corner of the building if you are not near a table or desk.
• Stay away from glass, windows, outside doors and walls, and anything that could fall, such as lighting fixtures or furniture.
• If you are outdoors:
• Stay there.
• Move away from buildings, streetlights, and utility wires.
• If you are in a moving vehicle:
• Stop as quickly as safety permits and stay in the vehicle. Avoid stopping near or under buildings, trees, overpasses, and utility wires.
• Proceed cautiously once the earthquake has stopped. Avoid roads, bridges, or ramps that might have been damaged or destroyed by the earthquake.

• Drive only if absolutely necessary. If you must drive, do the following:
• Travel during daylight hours, don’t travel alone, and keep others informed of your schedule.
• Stay on main roads; avoid backroad shortcuts.
• Use snow tires or chains when appropriate.
• If a blizzard or ice storm traps you in the car, do the following:
• Turn on hazard lights and hang a distress flag from the radio antenna or window.
• Remain in your vehicle where rescuers are most likely to find you.
• Do not set out on foot unless you can see a building close by where you know you can take shelter.

Recommendations for employers

• Create a program for response to community emergencies and train employees.

• If you are asked to evacuate an area, do so immediately.
• Stay tuned to a radio or television for information on evacuation routes, temporary shelters, and procedures.
• Follow the routes recommended by the authorities—shortcuts may not be safe. Leave at once.
• If you are told to seek shelter and you are in a vehicle, stop and seek shelter in a building.
• If you must remain in your car, keep car windows and vents closed, and shut off the air conditioner or heater.
• If you are requested to remain indoors, do the following:
• Close and lock all exterior doors and windows.
• Close vents, fireplace dampers, and as many interior doors as possible.
• Turn off air conditioners and ventilation systems.
• Stay in a room that is above ground and has the fewest openings to the outside.
• Seal gaps under doorways and windows with wet towels or plastic sheeting and duct tape.

Recommendations for employers

• Enforce mandatory seatbelt use.
• Ensure that workers who drive for the job have valid driving licenses.
• Include fatigue management in safety programs.
• Ensure necessary worker training for driving specialized vehicles.
• Avoid requiring workers to drive irregular hours or significantly extended hours.
• Ensure that employer-owned vehicles are serviced on a regular basis.
• Consider providing vehicles that offer the highest occupant protection in the event of a crash.
• Provide maps or global positioning systems (GPS) to employees.

Recommendations for workers

• Use seatbelts.
• Don’t use cell phones while driving.\
• Avoid other distracting activities, such as eating, drinking, or adjusting non-critical vehicle controls, like the radio, while driving.
• Use detailed maps or a GPS.
• Have the car checked and serviced regularly.
• Keep the gas tank at least a quarter full.
• Carry an emergency car kit containing a flashlight, extra batteries, and flares.

• CDC. Avian influenza (bird flu) [www.cdc.gov/ flu/avian/].
• DHHS. Employer preparedness checklists for pandemic and avian flu [www.flu.gov].
• DHS. Disaster planning guide for home health care providers [www.dhs.gov/xprepresp/programs/gc_1221055966370.shtm].
• FEMA. [www.fema.gov/hazards/types.shtm].
• NHTSA. National Highway Traffic Safety Administration home page [www.nhtsa.dot.gov/].
• NIOSH. Motor vehicle safety [www.cdc.gov/ niosh/topics/motorvehicle/].
• OSHA. Guidance for protecting employees against avian flu [www.osha.gov/dsg/ guidance/avian-flu.html].
• University of Illinois—outreach, community, and home care workers health and safety: Great Lakes Center for Occupational and Environmental Safety and Health, Chicago, Illinois [www.uic.edu/sph/glakes/ce/health&safety/index.htm].