Infection Prevention for Out-Patients and Patients in In-Home Care Settings
While most people are generally happy to be treated outside of hospitals, there is growing concern about the need to better educate out-patients on infection prevention and control.
Best practice for infection prevention and control exists. However, a recent report by the Australian Commission on Safety and Quality in Healthcare has highlighted gaps between what is accepted to be best practice and what is actively delivered for patients in their own homes.
The report noted several concerns, including that home hygiene is far from optimal, preventable infections still occur in Australia where they should not, and antimicrobial resistance is on the rise.
Every year 180 000 patients suffer healthcare-associated infections, resulting in increased patient morbidity, diminished quality of life, and extended antibiotic usage.
Healthcare-associated infections have also resulted in spiralling costs for the health system. A case study found that across just 126 surgical sites, the cost had ballooned to over $5 million.
A rising need for out-patient/in-home care, spurred on by COVID-19, has highlighted the importance of infection prevention rigour and safe home hygiene practices.
Out-patient/in-home care can introduce new risks such as pets, shared washing and eating facilities, and reduced medical surveillance. In hospitals, these risks are tightly managed by clinics, but in the home, there are fewer safeguards.
Some experts have found that patients face ‘information overload’ when discharged from hospital care. Patients can also be confused further by conflicting online information.
A common conflict of information arising from patients attempting to combat information overload by conducting their own research is the ‘hygiene hypothesis.’
The hygiene hypothesis dictates that over-sterilisation is possible, and instead, one should allow a certain number of bacteria to build immunity.
While the hygiene hypothesis is technically valid to an extent, it is critical that patients understand that the most effective and safest method of infection prevention is through best practice infection prevention procedures and effective products.
Our systematic response needs to be twofold.
We must first address the immediate risk to out-patients and patients in in-home care by introducing better infection prevention products and procedures.
We must then address behaviours around infection prevention.
For better infection prevention products and procedures for out-patients and patients in in-home care to become standard, further education of patients and clinical professionals alike is required.
For behaviours around infection prevention to change for the better, the World Health Organisationrecommends multimodal strategies as the best route of action.
Multimodal strategies suggested by the World Health Organisation include active surveillance and ongoing evidence-based education.
These strategies are valued for their emphasis on knowledge and surveillance, which are critical to infection prevention and control.