Infection control in home care agencies

The purpose of this study was to describe the characteristics of home care agencies, including the nature of care provided and the presence of infection control standards and education.

Study design was cross-sectional and descriptive; the survey of home health agencies included questions about agency type, nature of care delivered, and infection control policies and educational programs. The sample included all directors of home care agencies in northern California.

The response rate was 33.5%. Agency directors reported that 15.3% of their clients required high-technology nursing care; in response to a list of invasive procedures generally considered high in infection risk, more than 90% cared for urinary drainage devices, some categories of wound care, and intravenous management. Of those performing high-risk procedures, more than 75% had policies covering the procedures. Nearly all (87.7% to 100%) had policies on universal precautions, handwashing, handling of needles and sharps, and the cleaning and disinfection of equipment; however, nearly a quarter (24.6%) had no education program regarding the handling of contaminated equipment.

Among agencies responding to this survey, care that is considered high risk for infection is delivered and the agencies for the most part have infection control policies and educational programs. Research is needed to define more clearly infection control efforts in home health care. More work is needed to adapt the knowledge of infection control in hospitals to the home setting.