Home healthcare (HHC) is becoming a leading source of post-acute services. Currently,
most HHC patients 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.
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.
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.
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