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Infections and infection risks in home care settings
1Department of Mental Health, Community and Administrative Nursing, University of California, San Francisco 94143-0608.
Objectives:
To describe the characteristics of home healthcare clients with respect to infection risks and the presence of infections.
Design:
Descriptive survey of client charts using a point prevalence design.
Setting:
A private San Francisco, California, Bay area home care agency.
Participants:
A random sample of 175 clients (28%) was taken from the active client list for a single day; demographic data and clinical data from the last visit prior to the selection day were collected from each chart.
Results:
The clients were predominantly elderly (mean = 68.6) with an average of 3.6 co-morbid conditions; 12% had an invasive device. Over 20% had an infection on the day surveyed. Five percent had an infection that occurred during home care delivery.
Conclusions:
A substantial proportion of home health clients have infections, and they represent persons with a number of the risks associated with infections. Guidelines for defining and monitoring infections in home care need to be developed. Hospital-based surveillance methods are not altogether appropriate in this setting; redesigning methods such as targeted surveillance, monitoring rehospitalization, or immunization practices are discussed as potential ways to measure quality of care in the home setting.