Volume 7, Number 2—April 2001
THEME ISSUE
4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections
Prevention is Primary
Infection Control in Home Care
Table
Criteria for inclusion in definitions of home-care-acquired infectiona
Site of infection | Clinical data | Laboratory data |
---|---|---|
Catheter-related UTIb | Change in characteristics of urine | Elevated serum leukocytes |
Fever | Evidence of UTI in urinalysis | |
Pain | Evidence of leukocytes in urine dipstick test | |
Positive urine culture (>105 CFU of a single organism per mL urine) | ||
Postoperative pneumonia | Change in character of sputum | Elevated serum leukocytes |
Decreased breath sounds | Sputum Gram-stained smear with | |
Increase in rales and rhonchi | evidence of respiratory infection | |
Fever | Positive sputum culture | |
Shortness of breath | Positive chest X ray | |
Pain | ||
Catheter-related bloodstream infection | Fever with chills and rigors | Elevated serum leukocytes |
Redness, tenderness, or pain at insertion site | Positive blood culture | |
Purulent drainage at site | Positive catheter culture (after catheter removal) | |
Skin and soft tissue infection | Pain, swelling, tenderness at site | Gram-stain smear with leukocytes and organisms |
Inflammation and warmth | Positive culture | |
Purulent drainage | Elevated serum leukocytes | |
Fever | ||
Endometritis in postpartum patients | Uterine tenderness and abdominal pain | Positive Gram-stain smear of lochia |
Purulent vaginal drainage (lochia) | Positive culture of lochia | |
Foul-smelling lochia | Remarkably elevated serum leukocytes | |
Fever |
aSource: Rhinehart E, Friedman M. Infection control in home care. Gaithersburg (MD): Aspen Publishing, Inc.;1999 (22). bUTI = urinary tract infection.
References
- Basic statistics about home care. Washington: National Association for Home Care; 1999.
- White MC, Ragland KE. Surveillance of intravenous catheter-related infections among home care clients. Am J Infect Control. 1994;22:213–35. DOIPubMedGoogle Scholar
- White MC, Ragland KE. Urinary catheter-related infections among home care patients. J Wound Ostomy Continence Nurs. 1995;22:286–90.PubMedGoogle Scholar
- Rosenheimer L. Establishing a surveillance system for infections acquired in home healthcare. Home Healthc Nurse. 1995;13:20–6. DOIPubMedGoogle Scholar
- Zimay DL. Standardizing the definition and measurement of catheter-related infection in home care: a proposed outcome measurement system. J Med Syst. 1999;23:189–99. DOIPubMedGoogle Scholar
- Luehm D, Fauerbach L. Task force studies infection rates, surgical site management and Foley catheter infections. Caring. 1999;18:30–4.PubMedGoogle Scholar
- Woomer N, Long C, Anderson CO, Greenberg EA. Benchmarking in home health care: a collaborative approach. Caring. 1999;18:22–8.PubMedGoogle Scholar
- Rosenheimer L, Embry FC, Sanford J, Silver SR. Infection surveillance in home care: device-related incidence rates. Am J Infect Control. 1998;26:359–63. DOIPubMedGoogle Scholar
- Goldberg P, Lange M. Development of an infection surveillance project for home healthcare. Home Care Magazine 1997;1:1,4-9.
- Rhinehart E. Developing an infection surveillance system. Caring. 1996;15:26–8, 31–2.PubMedGoogle Scholar
- Danzig L, Short L, Collins K, Mahoney M, Sepe S, Bland L, Bloodstream infections associated with a needleless intravenous infustion system in patients receiving home infusion therapy. JAMA. 1995;23:1862–4. DOIGoogle Scholar
- Kellerman S, Shay D, Howard J, Goes C, Feusner J, Rosenberg J, Bloodstream infections in home infusion patients: the influence of race and needleless intravascular access devices. J Pediatr. 1996;129:711–7. DOIPubMedGoogle Scholar
- Tokars JI, Cookson ST, McArthur MA, Boyer CL, McGeer AJ, Jarvis WR. Prospective evaluation of risk factors for bloodstream infections in patients receiving home infusion therapy. Ann Intern Med. 1999;131:340–7.PubMedGoogle Scholar
- Do AN, Ray BJ, Banerjee SN, Illian AF, Barnett BJ, Pham MH, Bloodstream infection associated with needleless device use and the importance of infection-control practices in the home health care setting. J Infect Dis. 1999;179:442–8. DOIPubMedGoogle Scholar
- Friedman M, Rhinehart E. Putting infection control principles into practice in home care. Nurs Clin North Am. 1999;34:463–82.PubMedGoogle Scholar
- Friedman M. Preventing and controlling the transmission of antibiotic-resistant microorganisms in the home care setting. Caring. 1999;18:6–11.PubMedGoogle Scholar
- Davis PL, Madigan EA. Evidence-based practice and the home care nurse's bag. Home Healthc Nurse. 1999;17:295–9. DOIPubMedGoogle Scholar
- Hanchett M. Implementing standard precautions in home care. Home Care Manag. 1998;2:16–20.PubMedGoogle Scholar
- Friedman M. Designing an infection control to meet JCAHO standards. Caring. 1996;15:18–25.PubMedGoogle Scholar
- Smith PW, Roccaforte JS. Epidemiology and prevention of infections in home healthcare. In: Mayhall CG, editor. Hospital epidemiology and infection control. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 1483-8.
- Garofalo K. Home health. In: Olmsted R, editor. APIC infection control and applied epidemiology. St. Louis: Mosby; 1996. p. 90-1-90-11.
- Rhinehart E, Friedman M. Infection control in home care. Gaithersburg (MD): Aspen Publishers, Inc.; 1999.
- Garner J, Jarvis WR, Emori TG, Horan T, Hughes J. CDC definitions for nosocomial infections. Am J Infect Control. 1988;16:28–40. DOIPubMedGoogle Scholar
- Emori TG, Culver D, Horan T. National Nosocomial Infections Surveillance System (NNIS): description of surveillance methods. Am J Infect Control. 1991;19:19–35. DOIPubMedGoogle Scholar
- Home Care Membership Section APIC. Draft definitions for surveillance of infections in home health care. Am J Infect Control. 2000;28:449–53. DOIPubMedGoogle Scholar
- Lee T, Baker O, Lee J, Scheckler W, Steele L, Laxton C. Recommended practices for surveillance. Am J Infect Control. 1998;26:277–88. DOIPubMedGoogle Scholar
- Pearson M. Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol. 1996;17:438–73. DOIPubMedGoogle Scholar
- Wong ES. Guideline for prevention of urinary tract infection. Am J Infect Control. 1983;11:28–31. DOIPubMedGoogle Scholar
- Garner J. Guideline for isolation precautions in hospitals. Am J Infect Control. 1996;17:53–80.PubMedGoogle Scholar
- Centers for Disease Control and Prevention. Recommendations for preventing the spread of vancomycin resistance. Am J Infect Control. 1995;23:87–94. DOIPubMedGoogle Scholar