Infection control in the community

Significance of Ongoing Training and Professional Development in Optimizing Healthcare-associated Infection Prevention and Control

The employees who work in infection prevention and control (IPC) are very important in the field of health-care because they are committed to protecting patients, staff, and visitors from the risk of acquiring infections while in the hospital. The complexity of infection control in hospitals is alwaysgrowing in tandem with the rapid developments that are being made in medical technology andpractices. IPC personnel are required to maintain vigilance and continually improve their monitoringof the entire health-care process due to the ongoing development of IPC guidelines and regulations, the fluctuating infection risks, and the emergence of new infectious diseases. As a result, individuals involved in the prevention and control of infections in health-care settings absolutely need to participate in continual training and professional development. This reviewemphasizes the need of relevant professionals to engage in ongoing training and professional development to maintain their skills in the area of healthcare-associated infection control and prevention. Personnel working in IPC may more effectively react to newly discovered health risks andmake certain that hospital infection (HI) management gets the appropriate attention if they have atimely and in-depth awareness of best practices. They are better able to maintain their composure, react correctly, and deliver the most effective infection control and prevention techniques for the health-care system, all while increasing awareness about the significance of effective HI management.

Barriers to infection prevention and control in patients' homes

While there is a lot of emphasis on the need for good infection prevention and control practices and acute care, the increasing complexity of patients being cared for in their own homes means that there is an increased risk for infection. Good practice is required by community nurses to minimise this risk. Patients' own homes can present particular challenges in complying with good practice and this article looks at some of the barriers to optimum infection prevention and control precautions in this setting.

Ensuring effective infection prevention and control in the community

Managing community-acquired infections remains an ongoing challenge for community nursing teams. The coronavirus disease 2019 (COVID-19) pandemic meant that community nurses had to ensure they were using evidence-based infection prevention and control measures to limit the effects of the pandemic and maintain patient safety. Community environments can be unpredictable, and compared with acute settings nurses will often lack the appropriate resources when visiting patients in their homes or in residential care. This article outlines effective infection prevention and control measures that nurses can implement in the community, such as the appropriate use of personal protective equipment, optimal hand hygiene, safe waste management and adherence to an aseptic technique.

Providing community intravenous therapy during the COVID-19 pandemic

Community intravenous therapy is well-established in most regions of the UK. Although there are national good practice recommendations detailing the service provision of outpatient parenteral antibiotic therapy (OPAT), examples of extended service delivery of other therapies are limited. This article describes the development of a community IV therapy service through integration with acute and primary care teams. IV therapies delivered in addition to antimicrobials safely outside of the hospital setting are also discussed with scope for future areas of development explored. The benefits of care closer to home for patients during the global COVID-19 pandemic are examined, as well as the potential for widening the whole gamut of practice for already established NHS community services through the development of integrated working in a local care organisation.

Implications of a US study on infection prevention and control in community settings in the UK

Healthcare-associated infections are a significant reason for readmission to hospital post-discharge to the community. In this paper, the authors describe some of the key findings from a programme of work conducted in a home care agency (community care organisation) in the US. A survey was conducted to explore home care nurses' knowledge, attitudes and beliefs around infection control (n=415); 400 nurse-patient visits were observed, and 50 nurses were interviewed about their infection control practices. Nurses reported high compliance with infection control practices. However, the overall average adherence rate to observed hand hygiene practices was 45.6%. Interview data provided valuable insights into specific challenges faced by nurses in a home care setting. This study provides insights that can be used to enhance infection control practice in community care in the UK.

Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: A qualitative interview study

BACKGROUND

There is an increase in the number of individuals who receive care at home. A significant proportion of these patients acquire infections during their care episode. Whilst there has been significant focus on strategies for infection prevention and control in acute care environments, there is a lack of research into infection prevention in a home care setting.

OBJECTIVES

To understand (1) if and how home care nurses identify patients at high risk of infection and (2) the strategies they use to mitigate that risk.

DESIGN

A qualitative descriptive study, using semi-structured interviews.

SETTING

A large not for profit home care agency located in the New York region of the United States.

PARTICIPANTS

Fifty nurses with a range of experience in home care nursing.

METHODS

Purposive and snowball sampling was used to recruit nurses from across the home care agency with varied years of work experience. Interviews were audio recorded and transcribed. The interviews explored how home care nurses evaluate their patients' risk of developing an infection and if/how they modify the plan of care based on that risk. Data were analysed using thematic analysis.

RESULTS

Three themes were derived from the data; assessing a patient's risk of infection, the risk assessment process, and strategies for mitigating infection risk. Factors identified by nurses as putting a patient at higher risk of infection included being older, having diabetes, inadequate nutrition; along with inadequate clinical information available at start of care. The patient's knowledge and understanding of infection prevention, and the availability and knowledge of caregivers were also important, as was the cleanliness of the home environment. Given the context of home care, where nurses have little control over the environment and care processes in-between visits, the main strategy for infection prevention was patient and caregiver education. Nurses also discussed the importance of their own infection prevention behaviours, and the ability to adjust a patient's plan of care according to their infection risk.

CONCLUSIONS

The study highlights the complexity of the risk assessment process in relation to infection. Existing guidelines for infection prevention and control do not adequately cover the home care environment and more research needs to determine which interventions (such as patient/caregiver education) would be most effective to prevent infections in the home care setting.

Infection prevention in care homes: the role of community nurses

Community nurses are often in the position of providing clinical services to residents in the care home sector. In doing so, they need to consider the factors that increase the risk of infection in these residents and how these might be addressed. They also need to be mindful of the collaborative approach required and any training needs of staff working there in relation to services they have provided.