Evaluating National Healthcare Safety Network of Healthcare-associated Infection Events in Home Health Care Open Access

Linville, Millie (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/v692t6413?locale=en


An increase in the use of home health care (HHC) as an alternative to the traditional healthcare setting is spurred by innovative technologies that allow for improved quality of care at home and a need to cut costs. Although the home setting separates patients from many of the risks of infection exposure as compared to a facility-based setting, it is also uncontrolled and has a host of factors that have posed barriers to effective infection prevention and surveillance. As HHC becomes more commonplace, healthcare-associated infection (HAI) surveillance systems will also need to track and monitor infection prevalence and the impact of intervention efforts in this growing healthcare setting. With approximately 5 million people receiving health care at home, there is a need to gain a more complete picture of the true burden of HAI affecting patients. The purpose of this thesis project was to confirm the hypothesis that National Healthcare Safety Network (NHSN) surveillance does not include HAI data from the HHC setting and determine if the literature describes possible data sources to create a more complete picture of HAI burden. To achieve the goals of this thesis, a program evaluation and literature review were conducted. The program evaluation and literature review confirm that HAI data from the HHC setting is not currently reported to the NHSN or used in HAI surveillance reporting. The literature called for the need for national or nationally-coordinated surveillance efforts, but none currently exist. The variability in how home health agencies define and identify infections makes it difficult to estimate the incidence and prevalence of HAI across HHC sites and establishing a baseline by site of infection is currently not possible. Investigators have pointed to Medicare Outcome and Assessment Information Set (OASIS) data as a possible data source with a validated data collection process to integrate HAI reporting from home healthcare agencies. Reviewing specific data elements of the OASIS data set, there does appear to be a viable option to enhance HAI surveillance with data on infection events attributable to the HHC setting.

Table of Contents

Chapter 1: Introduction

Chapter 2: Methodology

Chapter 3: Findings

Chapter 4: Discussion

Chapter 5: Executive Summary


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