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Volume 7, Number 2—April 2001
4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections
Prevention is Primary

Infection Control in Home Care

Emily RhinehartComments to Author 
Author affiliation: AIG Consultants, Inc., Atlanta, Georgia, USA

Main Article


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
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
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

aSource: Rhinehart E, Friedman M. Infection control in home care. Gaithersburg (MD): Aspen Publishing, Inc.;1999 (22). bUTI = urinary tract infection.

Main Article

  1. Basic statistics about home care. Washington: National Association for Home Care; 1999.
  2. White  MC, Ragland  KE. Surveillance of intravenous catheter-related infections among home care clients. Am J Infect Control. 1994;22:21335. DOIPubMedGoogle Scholar
  3. White  MC, Ragland  KE. Urinary catheter-related infections among home care patients. J Wound Ostomy Continence Nurs. 1995;22:28690.PubMedGoogle Scholar
  4. Rosenheimer  L. Establishing a surveillance system for infections acquired in home healthcare. Home Healthc Nurse. 1995;13:206. DOIPubMedGoogle Scholar
  5. Zimay  DL. Standardizing the definition and measurement of catheter-related infection in home care: a proposed outcome measurement system. J Med Syst. 1999;23:18999. DOIPubMedGoogle Scholar
  6. Luehm  D, Fauerbach  L. Task force studies infection rates, surgical site management and Foley catheter infections. Caring. 1999;18:304.PubMedGoogle Scholar
  7. Woomer  N, Long  C, Anderson  CO, Greenberg  EA. Benchmarking in home health care: a collaborative approach. Caring. 1999;18:228.PubMedGoogle Scholar
  8. Rosenheimer  L, Embry  FC, Sanford  J, Silver  SR. Infection surveillance in home care: device-related incidence rates. Am J Infect Control. 1998;26:35963. DOIPubMedGoogle Scholar
  9. Goldberg  P, Lange  M. Development of an infection surveillance project for home healthcare. Home Care Magazine 1997;1:1,4-9.
  10. Rhinehart  E. Developing an infection surveillance system. Caring. 1996;15:268, 31–2.PubMedGoogle Scholar
  11. 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;23:18624. DOIGoogle Scholar
  12. 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;129:7117. DOIPubMedGoogle Scholar
  13. 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;131:3407.PubMedGoogle Scholar
  14. 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;179:4428. DOIPubMedGoogle Scholar
  15. Friedman  M, Rhinehart  E. Putting infection control principles into practice in home care. Nurs Clin North Am. 1999;34:46382.PubMedGoogle Scholar
  16. Friedman  M. Preventing and controlling the transmission of antibiotic-resistant microorganisms in the home care setting. Caring. 1999;18:611.PubMedGoogle Scholar
  17. Davis  PL, Madigan  EA. Evidence-based practice and the home care nurse's bag. Home Healthc Nurse. 1999;17:2959. DOIPubMedGoogle Scholar
  18. Hanchett  M. Implementing standard precautions in home care. Home Care Manag. 1998;2:1620.PubMedGoogle Scholar
  19. Friedman  M. Designing an infection control to meet JCAHO standards. Caring. 1996;15:1825.PubMedGoogle Scholar
  20. 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.
  21. Garofalo  K. Home health. In: Olmsted R, editor. APIC infection control and applied epidemiology. St. Louis: Mosby; 1996. p. 90-1-90-11.
  22. Rhinehart  E, Friedman  M. Infection control in home care. Gaithersburg (MD): Aspen Publishers, Inc.; 1999.
  23. Garner  J, Jarvis  WR, Emori  TG, Horan  T, Hughes  J. CDC definitions for nosocomial infections. Am J Infect Control. 1988;16:2840. DOIPubMedGoogle Scholar
  24. Emori  TG, Culver  D, Horan  T. National Nosocomial Infections Surveillance System (NNIS): description of surveillance methods. Am J Infect Control. 1991;19:1935. DOIPubMedGoogle Scholar
  25. Home Care Membership Section  APIC. Draft definitions for surveillance of infections in home health care. Am J Infect Control. 2000;28:44953. DOIPubMedGoogle Scholar
  26. Lee  T, Baker  O, Lee  J, Scheckler  W, Steele  L, Laxton  C. Recommended practices for surveillance. Am J Infect Control. 1998;26:27788. DOIPubMedGoogle Scholar
  27. Pearson  M. Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol. 1996;17:43873. DOIPubMedGoogle Scholar
  28. Wong  ES. Guideline for prevention of urinary tract infection. Am J Infect Control. 1983;11:2831. DOIPubMedGoogle Scholar
  29. Garner  J. Guideline for isolation precautions in hospitals. Am J Infect Control. 1996;17:5380.PubMedGoogle Scholar
  30. Centers for Disease Control and Prevention. Recommendations for preventing the spread of vancomycin resistance. Am J Infect Control. 1995;23:8794. DOIPubMedGoogle Scholar

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