A Needs Assessment: Infection Control Practices in Home Healthcare and Current Standards of Care

Abstract

ISSUE: There is little research evidence on infection control practices in home healthcare agencies. Clinical guidelines set for acute- and long-term-care institutions have been used to “bridge the gap” to the home-care setting. Very little research evidence exists regarding the use of supplies for wound care and best practices in the home-care setting. PROJECT: A needs assessment was conducted to assess both the extent of the problem of wound care supplies in the home and the microbiological impact on patients with special emphasis placed on the presence of multidrug-resistant organisms. Items that the home-care nurses take from home to home as possible sources of fomites were examined, especially when multidrug-resistant organisms from institutions have been identified. RESULTS: Clearly, the needs assessment established that the extent of the problem of wound care supplies in the home, and guidelines for the treatment of wound infections in the home, require more research. The one research study done on bacterial contamination and wound care supplies found that bacteria were present in 75% of all wound care supplies left in homes for 7 days or more. Further research is necessary in this area to provide agencies with sound scientific data and to serve as guidelines for the development of evidence-based policies and procedures. LESSONS LEARNED: A tool for the quantification of the living conditions of the home-healthcare patients must be generated. Strong evidence can be provided for cause-and-effect relationships, with control of potential bias in the measurement of predictor variables.