The challenge of infection control in patients' homes
Infection control is the responsibility of all nurses, but, traditionally, it has been seen as a priority only in hospitals. Infection control does not stop when a patient is discharged home, but should be practiced wherever clinical care takes place. Community nurses face a unique challenge as they work in patients' homes, and they must manage infection control in that unique environment. This article looks at practical ways to maintain infection control in patients' homes. It covers hand hygiene and personal protective equipment (PPE), including the five moments of hand hygiene, appropriate hand hygiene, the use of all PPE and when gloves are required and when they are not. It also discusses managing clinical equipment, both that taken into the home and that left with a patient, including decontamination, safe storage of sharps and waste management. It touches upon what can be done in a patient's home to reduce the risk of contamination, as well as infectious disease management, including specimens and wound infection management. Lastly, it talks about cross-infection and why staff health is also important.
Infection control must be an important part of all nursing care; it does not stop at the hospital/clinic door. Unfortunately, community nurses face unique challenges working in patients' homes, because they have little control over the environment they work in and need to be innovative. This article discusses the common issues faced by community nurses around infection control and offers practical advice, based on the authors' own practices. Good infection control practices in the community will aid patient safety and improve patient care and can, ultimately, help prevent hospital admissions.
Effective hand hygiene remains one of the cornerstones of good infection control. Since its conception in 1979, the, originally six-, now seven-stage, handwashing technique (World Health Organization (WHO), 2009) has proved very effective at decontaminating hands, whether used with soap and water or decontaminating hand rubs. It has been taught widely in healthcare and supported with many campaigns (Ayliffe et al, 2000). However, an equally important element is knowing when to decontaminate hands. The Five Moments of Hand Hygiene (WHO, 2009) is an effective tool to assess when to decontaminate hands. These are detailed as:
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