Risk factors for infection in home health care: Analysis of national Outcome and Assessment Information Set data.
Jingjing Shang, Jinjiao Wang, Victoria Adams and 1 others
PMID 32652615WHAT IT FOUND
In home health care, patients with recent hospitalizations, fragile illness, chair-fast status, catheters, oxygen, wounds, or caregivers needing training or unavailable were more likely to have hospital or emergency visits for respiratory, urinary, or wound infection.
Key findings
01Among 128,163 home health patients, 4,101 had hospital or emergency care for respiratory, urinary tract, or wound infection.
02Patients with multiple hospitalizations in the past 6 months, or with a serious progressive condition that may lead to death within a year, were at higher risk for all three infection types.
03Wound-site infection was linked to caregiver gaps in dressing changes: needing help, caregiver training, or no caregiver available.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The infection events were not lab-confirmed; they were based on a home health clinician's judgement of why the patient was hospitalized or went to the emergency department. The study only captured severe infections that led to hospitalization or emergency care, so it says nothing about milder infections during home health. The data were not collected for infection research; important factors such as income, home environment, education, health literacy, and exact infection incubation period were not measured. Caregiver availability and readiness were assessed only at admission, discharge, or 60-day reassessment, not continuously, and the measures were not infection-specific. The study is observational, so it cannot show that caregiver training, mobility treatment, or any other factor caused the infections.
The easy way to misread this
Do not conclude that caregiver training or physical therapy will prevent infections. This study only found associations in existing home health records, not tested interventions.