Background
Home health care (HHC) has been the fastest growing health care sector for the past
3 decades. The uncontrolled home environment, increased use of indwelling devices,
and the complexity of illnesses among HHC patients lead to increased risk for infections.
Methods
A systematic review of studies evaluating infection prevalence and risk factors among
adult patients who received HHC services was conducted and guided by the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses. Literature was searched
using Medline, PubMed, and the Cumulative Index to Nursing and Allied Health as well
as hand searching. Two reviewers independently assessed study quality using validated
quality assessment checklists.
Results
Twenty-five studies met the inclusion criteria and were reviewed. The infection rates
and identified risk factors for infections varied dramatically between studies. In
general, patients receiving home parental nutrition treatments had higher infection
rates than patients receiving home infusion therapy. The identified risk factors were
limited by small sample sizes and other methodologic flaws.
Conclusions
Establishing a surveillance system for HHC infections, identifying patients at high
risk for infections, tailoring HHC and patient education based on patient living conditions,
and facilitating communication between different health care facilities will enhance
infection control in HHC settings. Future studies should use a nationally representative
sample and multivariate analysis for the identification of risk factors for infections.
Key Words
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Article info
Publication history
Published online: March 24, 2014
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
