Home Health Policies: Reducing Patient Infections
According to a study conducted by Columbia University School of Nursing, infection has become a major problem and concern in nursing homes. The study indicated that, over a 5-year period, pneumonia, UTI’s, hepatitis, and other wound infections have been on the rise.
Carolyn Herzig, project director of the Prevention of Nosocomial Infections & Cost Effectiveness in Nursing Homes (PNICE-NH) states: “Infections are a leading cause of deaths and complications for nursing home residents, and with the exception of tuberculosis we found a significant increase in infection rates across the board. Unless we can improve infection prevention and control in nursing homes, this problem is only going to get worse as the baby boomers age and people are able to live longer with increasingly complex, chronic diseases.”
The exact causes for infection remain to be discovered and analyzed, but there are several different practices useful for preventing infection in the place of care.
- UTI’s – Being the most common infection in elderly patients, there are many ways these infections can be prevented. Reducing the use of urinary catheters by substituting them with more frequent assisted bathroom visits or diaper changes.
- Pneumonia – Since pneumonia can be spread through respiratory paths or contact with contaminated surfaces, safeguarding the patients’ environment is essential to reducing pathogens. For home health employees, this is especially important. Home health caregivers should always sanitize their hands before and after a visit in order to reduce the possibility of introducing pathogens.
- Wounds – Continually educating staff, as well as patients about wound care is a vital component to reducing risk of infection. With proper treatment and teaching, wound infection can be noticeably reduced.
The methods listed above address minimizing the most common infections, however, there are several other methods to ensure hygienic practices during patient visits that can be overlooked. For example: make a habit of sterilizing stethoscopes after each patient visit. Stethoscope diaphragms can harbor Staphylococcus aureus and other bacteria. Additionally, make sure that IV lines are consistently changed every 3-4 days and changes are always performed while wearing gloves.
Hand hygiene is one of the most crucial elements to reducing infectious pathogens. The selection below from the journal Nursing Made Incredibly Easy (June 2011 Volume 9) outlines several tips for practicing proper hand hygiene:
“Hand hygiene is the most effective way to prevent transmission of infection. Healthcare workers' hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment. Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing HAIs, but healthcare worker compliance with optimal practices remains low in most settings.
You can reduce the transmission of HAIs by performing hand hygiene consistently before each patient contact, after each patient contact, after contact with environmental surfaces and equipment/medical devices, and before and after donning gloves. Keeping fingernails one-fourth of an inch or less in length and avoiding the use of artificial nails, nail extenders, and nail decorations is necessary to ensure hand hygiene products reach hand surfaces and cuticles. Studies in the medical literature have demonstrated that nearly everything in the healthcare setting-from surfaces, to healthcare workers' hands, to medical equipment-can serve as a reservoir and vector for opportunistic pathogenic organisms. Some bacteria and viruses can live on inanimate objects and surfaces for weeks or even months.
It's important to develop the habit of routinely performing hand hygiene when performing patient-care tasks and procedures or handling medical devices and equipment. Healthcare providers, including nurses, also need to be empowered to hold one another accountable to ensure everyone is compliant with hand hygiene.”
Routinely assessing the hygienic practices of home health staff, as well as within nursing homes should be a priority for all care organizations. In fact, they should play a crucial role in employee evaluations. The rising prevalence of infection and infection-related deaths is a clear indicator that many agencies are lacking in their approach to providing a safe and hygienic delivery of care.