A number of environmental nursing home risks can pose dangers to the health and safety of both residents and staff members. In order to 
reduce the occurrence of environmental nursing home risks, state and federal nursing home laws require that facilities provide safe, comfortable, and sanitary environments. Facilities must pass annual safety inspections that are aimed at decreasing environmental nursing home risks and increasing overall resident quality of life.
Types of Environmental Nursing Home Risks
Environmental nursing home risks may be present within several aspects of a facility. Environmental nursing home risks can be posed through hazardous substances, unsafe physical conditions, and decreased staff performance. Poor indoor air quality can lead to inhalation of hazardous agents.
Unsafe Environmental Conditions
Environmental nursing home risks involving physical conditions may significantly contribute to hazards such as slips and falls. According to the Centers for Disease Control and Prevention (CDC), environmental nursing home risks account for roughly 16-to-27 percent of resident falls. It is estimated that falls cause roughly 1,800 nursing home deaths each year.
Environmental nursing home risks such as poor lighting, wet floors, improperly maintained or fitted wheelchairs, and incorrect bed height may contribute to falls. In order to prevent falls, facilities should make environmental adjustments. Installing grab bars, raised toilet seats, and handrails can provide a safer environment for residents.
Exposure to Toxic Substances
Cleaning agents may pose environmental nursing home risks. For example, ethylene oxide is a common sterilization agent used in nursing homes and other health care facilities. According to the U.S. Department of Health and Human Services, ethylene oxide has been associated with hazards such as central nervous system effects, respiratory tract infection, and chemical burns.
Environmental nursing home risks may also be presented by hazards such as:
- Contaminants found in a facility’s water supply
- Carbon monoxide or radon poisoning, which may occur from appliance leakage
- Moisture around the nursing home facility, which may harbor mold
Workload Issues
Work organization changes in a nursing home facility can lead to an increase in environmental nursing home risks. Downsizing, restructuring, and layoffs can have a direct impact on the facility’s safety conditions and level of resident care. Additionally, workload changes can lead to overworking of nursing home staff members. In turn, residents may not receive the care that is necessary to attain or maintain their highest possible health levels.
Spread of Disease and Infection
Infectious disease poses environmental nursing home risks to residents and staff members. Due to the nature of aging, every nursing home faces the possibility of infection within the facility. If the infection is not aggressively maintained, the spread of the condition is extremely likely. In addition to self-contained facility infections, residents who require hospitalization may unintentionally transmit pathogens from the hospital to the nursing home facility.
Factors that may contribute to spread of disease within nursing homes may include:
- Grouped living quarters and shared spaces
- Immunosenescence, or immune system deterioration from natural aging
- The potential presence of multiple diseases
Preventing the Spread of Infection
Federal nursing home laws require that each nursing home facility has an infection control program. Under this program, the facility must actively investigate, control, and prevent facility infections. If an infectious disease is present, the nursing home facility must decide how best to isolate and maintain the source of the infection. In cases where a resident is the source, the nursing home facility must use the least restrictive form of isolation possible while maintaining the condition.
Nurse Responsibility in Reducing Environmental Risks
Nurses working in a long-term care facility play a critical role in the assessment, reduction, and prevention of environmental nursing home risks. Nurses should be constantly aware of the current state of residents in order to decipher potential environmental nursing home risks and issues. For example, an increase in resident confusion after floor mopping may be an indicator of harmful cleaning chemicals. If a nurse establishes this connection, he or she can then advocate for safer cleaning practices or work to help protect residents from direct exposure.
Sources:
Barnes, Glenda, et al. “Incorporating Environmental Health into Nursing Practice: A Case Study on Indoor Air Quality.” Pediatric Nursing. 36.1 (2010): 33-40. Print.
“CMS Manual System.” Centers for Medicare and Medicaid. Centers for Medicare and Medicaid, 2 Dec 2009. Web. 9 Sep 2013. <http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/r55soma.pdf>.
Davis, Allison Del Bene. “Home Environmental Health Risks.” Online Journal of Issues in Nursing. 12.2 (2007): n. page. Web. 9 Sep. 2013. <http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No2May07/HomeEnvironmentalHealthRisks.html>.
“Falls in Nursing Homes.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 29 Feb 2012. Web. 9 Sep 2013. <http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html>.
Juthani-Mehta, Manisha, and Vincent Quagliarello. “Infectious Diseases in the Nursing Home Setting: Challenges and Opportunities for Clinical Investigation.” Clinical Infectious Diseases. 51.8 (2010): 931-936. Print.