June 10, 2014
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Home health care poses infection risks

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Among patients with home health care, receiving parenteral nutrition and using urinary catheters were two important risk factors leading to infections, researchers reported in the American Journal of Infection Control.

“The infection risk for patients receiving care at home is high because they often aren’t being looked after by individuals with the same infection control experience that would occur in a hospital setting,” Jingjing Shang, PhD, assistant professor at Columbia University School of Nursing, said in a press release. “Nurses who care for patients in their homes need to teach patients and their families how to prevent infections, and nurses need to make sure that they tailor this education to a level that’s easy for people without formal medical training to understand.”

Shang and colleagues conducted a systematic review of studies looking at infection risk among patients receiving home health care. They identified 25 studies to include in the review and evaluated infection rates and risk factors of infections.

Across the 25 studies, different definitions were used to determine infection rates, but the most commonly used definition was number of infections per device days. The highest rate reported was 10.04 for central line-associated bloodstream infections (CLABSIs) in a study of 31 patients receiving parenteral nutrition, followed by a rate of 8.4 per 1,000 catheter days for catheter-associated urinary tract infections (CAUTIs) among 44 patients with long-term indwelling urinary catheters.

Fourteen of the studies evaluated risk factors for patients receiving home health care, reporting a variety of risk factors that were not consistent across the studies.

“Patients shouldn’t have to choose between safety and receiving care in the comfort of their own homes,” Shang said. “The stakes are already high, and they’re getting higher all the time, as our population keeps aging and more and more patients receive care outside of an institutional setting.”

An estimated 12 million Americans receive care from home health care providers in the year, and 69% are older than 65 years, according to the report. In 2009, more than $72 billion was spent on home health care.

Disclosure: Shang and colleagues report no relevant financial disclosures.