Infection control is integral to the safety and quality of any healthcare environment.
While home and community care settings do not necessarily present the same infection risks as acute care, they have their own unique set of challenges that must be considered by staff and organisations (VIC DoH 2011).
Protecting yourself and your clients from healthcare-associated infections requires a comprehensive understanding of infection control principles and how to apply them to a home environment.
Infection Risks Unique to Home Care
A client’s home may be a ‘workplace’, but it is also a private residence that is not subject to the same regulations as hospitals, aged care facilities and other healthcare environments. The layout and condition of the home, the equipment and the client themselves will vary depending on the location you are visiting.
Inevitably, it is difficult to predict the exact hazards you will encounter. Even if you make appropriate preparations and bring all the equipment you need, you may not know exactly what kind of environment you are working in until you arrive.
There are several unique challenges posed by home care environments:
Having to apply infection control protocols used in acute care and structured facilities to a home environment;
The client not having certain hygiene resources in their home, even those that are considered basic (e.g. soap);
Unpredictability (e.g. the client’s friend visiting unexpectedly);
Having to guide and educate clients (and all those that care for them regularly) about infection control;
Breaches in infection control protocol by the client or their family; and
Clients potentially bringing infections home with them after discharge from acute care, which can then be transmitted to staff and passed to other clients.
(Ventyv 2019; Moore 2019)
Basic Principles of Infection Control
Being able to successfully control and prevent infections relies on having a basic understanding of how infectious diseases spread. Ensure you understand:
Different types of pathogens;
How infections are transmitted (the chain of infection);
As with any healthcare setting, it is essential to always follow standard precautions when delivering home care services. Standard precautions are the minimum level of infection prevention and control that should be used for all clients, regardless of whether or not they appear unwell. Standard precautions operate under the assumption that every person is potentially infectious (NHMRC 2019).
Note: See the links above for more in-depth information about each component of standard precautions.
Transmission-based precautions are used in addition to standard precautions when a client is suspected or known to have a certain infectious illness, and standard precautions alone may be insufficient in preventing transmission. The exact strategies implemented will be individually tailored, depending on the infectious agent and its mode of transmission (NHMRC 2019).
Infection Hazards in the Home
Staff and clients may be exposed to biological hazards in the home through contact with contaminated surfaces, ingestion of pathogens or inhalation of infectious aerosol droplets (WA Gov 2019). This can occur during:
Health and personal care;
Cleaning of blood or bodily fluids;
Contact with contaminated or soiled items and equipment;
Handling clinical waste such as sharps;
Food handling and storage; and
Contact with pets and their excretions.
(QLD Gov 2018)
Minimising the Risk of Infection in the Home
In order to reduce the risk of infection transmission in the home, you should:
Always follow standard precautions;
Follow transmission-based precautions if a client is suspected or known to have an infectious illness;
Follow facility protocol if accidentally exposed to blood, body substances, sharps or infectious illnesses;
Bring hand hygiene equipment (e.g. alcohol-based hand rub) to homes in case handwashing facilities are not available;