The Power of Knowledge: Mastering Infection Prevention for Home Health Care

Session Description: The Centers for Medicare and Medicaid (CMS) defines home healthcare (HHC) as medically necessary skilled care provided by nursing and other therapeutic services in the home setting. These services are a covered benefit of some Medicare plans and are projected to grow significantly over the next decade. Nearly 265 billion Medicare dollars will shift to the HHC sector by 2025. In 2021 approximately 11,500 Medicare certified HHC agencies existed in the United States providing care to approximately 3 million patients. This expansion of care services within the home needs to be appreciated in terms of patient safety and quality monitoring as infection is the primary cause of unplanned hospitalizations for these patients. Types of infection include wound, urinary and respiratory tract, and infection related to intravenous catheters. While the principles of infection control measures are the same across all care settings, adapting to unique workflows and environments in which the patient receives care is needed. For example, one study described the nurse’s equipment bag, as a reservoir for infection with 83.6% of bags testing positive for human pathogens. Other examples describe nursing being responsible for procedures performed in a very different environment whereby sterile technique and compliance with infection control standards may be challenging. Over the course of time, this multi-state, mid-size healthcare system began including non-acute care locations into the enterprise-wide infection prevention and control (ICP) plan with a monthly healthcare associated infection dashboard for the HHC population. Collaboration between the system infection prevention leader and HHC nurse executive led to a comprehensive HHC risk assessment, infection control and surveillance plan for nosocomial infections. This framework has become part of the standard work for quality assurance, performance improvement (QAPI) which has led to focused interventions to mitigate the risk of infection in this patient population within their home.