Infection Control and the Home Care Environment

Abstract

Introduction: The epidemiology of multidrug-resistant organisms is changing as evidenced by a shift to the community. Hospitalized patients are admitted to home health care with multidrug-resistant organisms. Numerous states have reported an increased incidence of community-acquired infections caused by multidrug-resistant organisms where reportedly no exposure to antibiotics or health care in the 3 months before symptom onset occurred. Method: A cohort research design with four separate home care agencies and a total of 127 nurses’ bags were cultured. Conclusions: The present study hypothesizes that the implementation of infection prevention and control strategies including education and training on proper hand hygiene and appropriate decontamination of high-touch surfaces (nurses’ bags) will interrupt the chain of transmission. Hand hygiene practices and environmental disinfection methods differ for Clostridium difficile than for other multidrug-resistant organisms, underscoring the need for addressing environmental factors. If present, implications for routine care and cleaning of nurses’ bags and specific changes in hand hygiene practices before and after home care visits are necessary.