Outbreak Investigation, Public Health and Health Policy
Oral Presentation
Monika Pogorzelska-Maziarz, PhD, MPH, CIC
Assistant Professor
Jefferson College of Nursing
Philadephia, Pennsylvania
No financial relationships or conflicts of interest
Ashley Chastain, DrPH, MPH
Project Manager
Columbia University School of Nursing
New York, New York
No financial relationships or conflicts of interest
Background: Home healthcare (HHC) is becoming a leading source of post-acute services. Currently, most HHC patients are 65 years of age and older and have multiple chronic conditions, thereby increasing their risk of infections and rehospitalizations. With a nationally-representative survey, we aimed to better understand the current state of infection prevention and control (IPC) at HHC agencies.
Methods: A national survey, directed at administrators and clinical managers, was conducted from October 2018 to November 2019. Agencies were recruited from a national HHC conference, and a national random sample of 1,505 agencies stratified by census region, ownership status and rural/urban location. Questions were asked about IPC staffing, IPC compliance and training, and current IPC policies and procedures. Descriptive statistics were computed using Stata 13.
Results: 575 HHC agencies (35% response rate) responded; 63% had for-profit ownership. At responding agencies, 35.4 % of staff members in charge of IPC had received no specific IPC training, and 5.6% reported that they currently did not have a staff member in charge of IPC.
Over 60% of agencies provided staff training on IPC topics either annually or at new employee orientation. 82.3% reported measuring adherence to hand hygiene policies; policy adherence was measured by shadowing (84.9%) and knowledge assessments (71.8%).
Most HHC agencies (87.6%) reported collecting and reviewing infection data to identify trends. Overall, only 31% of agencies required staff influenza vaccination; however, a majority (61.4%) offered free influenza vaccinations to their staff. During the past influenza season, 62.7% of agencies had 75% or more of their employees vaccinated for influenza, and 9% reported not tracking that data.
Conclusions: This national study examining the current state of IPC in HHC can be used as a benchmark for quality improvement initiatives. Particularly, we learned that staff training around IPC and policies and procedures related to staff vaccination are currently inadequate.