Home Care Infection Prevention & Control Program, 2018 Edition

Mary McGoldrick, MS, RN, CRNI®

Home Care Infection Prevention and Control Program

This comprehensive, evidenced-based infection prevention and control program includes policies and procedures, forms and checklists that:

  • Address care provided to home health and hospice patients in the home, as well as hospice care provided in an inpatient hospice unit and residential hospice facility and meet:
    • Accrediting body standards (i.e., The Joint Commission [TJC], Community Health Accreditation Partner [CHAP], and the Accreditation Commission for Home Care [ACHC]);
    • Federal regulations (e.g., CMS Emergency Management, Occupational Safety and Health Administration [OSHA], Medicare Home Health and Hospice Conditions of Participation [CoPs]); and
    • Centers for Disease Control and Prevention (CDC) and other professional, evidenced-based guidelines.

By purchasing and adopting the content within the Home Care Infection Prevention and Control Program manual, you will:

  • Save hours of time from doing research, reading new evidenced-based guidelines, and interpreting regulatory and accrediting body requirements and writing policies and developing forms.
  • Have a complete template to develop and implement an infection prevention and control program, specifically designed for care in the home and hospice facility.
  • Have peace of mind knowing that the author of the program is credible as a source of current information and is the co-author of the APIC-endorsed books on Infection Control in Home Care and Hospice and former Joint Commission surveyor
  • Receive updates annually to meet the home health and hospice Medicare CoPs and keep your patient care practices current to improve outcomes.

Preview the Table of Contents and the Conditions of Purchase.

List Price: $475.00
Product: #IC1017
ISBN: 978-0-9974050-0-2
Pages: 526
3 Ring Binder: 11.665" L x 3.224" W x 11.432" H
CD-ROM with the text in My PolicyMaker© software for easy customization.

Updated Annually: Preview a Summary of Changes from the 2017 to the 2018 Edition of the Home Care Infection Prevention and Control Program manual.

 

 

The twelve sections of the Home Care Infection Prevention and Control Program, 2018 include:

Infection Prevention and Control Plan

A written Infection Prevention and Control Plan outlines the structure and framework for the infection prevention and control program, and is required by The Joint Commission. This Infection Prevention and Control Plan includes:

  1. Infection Prevention and Control Program: Goals, Objectives, Strategies

  2. Infection Prevention and Control Risk Assessment

  3. Strategies to Minimize, Reduce, or Eliminate the Prioritized Risks

  4. The Structure and Resources for the Infection Prevention and Control Program

  5. References for the evidenced-based guidelines and resources used to design this infection prevention and control program manual.



Quality Assessment and Performance Improvement

In the Medicare Home Health and Hospice Conditions of Participation (CoPs), a Quality Assessment and Performance Improvement (QAPI) program is required to identify, collect, aggregate and analyze performance data on its infection prevention and control program. The QAPI section includes:

  1. Quality Assessment and Performance Improvement Program: QAPI plan with a focus on infection prevention and control

  2. Infection Prevention and Control Program Evaluation Activities

  3. Infection Prevention and Control Program Targeted Goals

  4. QAPI: Infection Prevention and Control Program Data Collection Matrix

  5. Home Care Infection Prevention and Control Risk Assessment Tool: To assist in determining the priorities for data collection

  6. Infection Prevention and Control Skilles Review Data Summary 

  7. Influenza Vaccination Summary: 2017-2018 Influenza Season

  8. Occupational Illness/Injury Data Summary

  9. Infection Prevention and Control Program Targeted Goals Evaluation



Surveillance, Identification and Reporting of Infections

Accrediting body standards and the QAPI Condition in the Medicare CoPs require the monitoring and measuring of home care-onset healthcare-associated infections. The Surveillance, Identification and Reporting of Infections section provides a ready-to-implement framework to collect numerator and denominator data. In addition, the methodology used and the "how to" instructions on collecting and aggregating the data will assist management in determining if a patient's infection would be considered having a home care-onset, and in calculating the organization's infection rate(s). The Surveillance, Identification and Reporting of Infections section includes:

  1. Surveillance Activities

  2. Identifying a Home Care-onset Infection

  3. Calculating the Metrics for a Home Care-onset Infection Incidence Rate

  4. Collecting Denominator Data for Device-associated Infections

  5. Conducting Surveillance Activities for a Urinary Tract Infection

  6. Calculating the Metrics for a Urinary Tract Infection

  7. Conducting Surveillance Activities for a Central Line-associated Bloodstream Infection

  8. Calculating the Metrics for a Central Line-associated Bloodstream Infection

  9. Conducting Surveillance Activities for a Skin and Soft Tissue Infection

  10. Calculating the Metrics for a Skin and Soft Tissue Infection

  11. Outbreak Surveillance Activities

  12. Collecting, Aggregating and Analyzing Surveillance Data

  13. Criteria for Internal Reporting of Infections

  14. Criteria for External Reporting of Infections

  15. Protocol for Contacting Public Health Agencies

  16. Resources for Site-specific Infection Criterion, Measures to Calculate a Home Care-onset Infection, Surveillance worksheets and reports, Line lists, Transfer Summary, Incidence Logs, and Reportable Web Sites.


Patient and Staff Education

In the Education Standard in the Medicare Conditions of Participation (CoPs), infection control education to staff, patients, and caregiver(s). The first part of the Education section addresses patient education and includes:

  1. Principles of Infection Prevention and Control Education

  2. Infusion Therapy in the Home

  3. Storage and Disposal of Home-generated Medical Waste

  4. Preventing the Spread of Clostridium difficile

  5. Preventing a Home Care-onset Urinary Tract Infection

  6. General Infection Prevention and Control Strategies

  7. Preventing a Home Care-onset Infection During Patient Care

  8. Preventing a Home Care-onset Infection During Enteral Therapy

The second part of the Education section addresses staff education and includes:

  1. Infection Prevention and Control Strategies

  2. Hand Hygiene

  3. Bloodborne Pathogens

  4. Medical Waste and Sharps

  5. Cleaning Chemicals

  6. M. tuberculosis and Airborne Pathogens

  7. Preventing  a Central Line-associated Bloodstream Infection

  8. Antimicrobial Stewardship

  9. Preventing the Spread of Antibiotic-resistant Organisms

  10. Preventing the Spread of Clostridium difficile

  11. Preventing a Mosquito-borne Illnesses

  12. Influenza Vaccination

  13. Pandemic Preparedness Response Training

  14. Preventing an Animal Bite when Making Home Visits

  15. Aide Training Program

  16. Aide Competence Assessment in Infection Prevention and Control

  17. Staff Competence Assessment in Infection Prevention and Control

  18. Hand Hygiene: Demonstrating Staff’s Competence and Competence

  19. Infection Prevention and Control Skills Review

  20. Hand Hygiene Knowledge Assessment with Answer Key

In addition, there is a comprehensive infection prevention and control skills review (competence assessment) form to evaluate the staff’s performance to see if they can put their infection prevention knowledge into practice. You can also test your staff’s critical thinking skills by having them take the Hand Hygiene Knowledge Assessment test.



Occupational Health Program

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing and controlling the transmission of pathogenic organisms to or via the staff that have patient contact is required. In addition, the Occupational Health and Safety Administration (OSHA) requires a written plan for the screening and managing the health of its staff. The Joint Commission, as well as many states, also require an influenza vaccination program. The QAPI Condition in the Medicare CoPs requires the monitoring and measuring of staff infections.  The Occupational Health Program section contains everything needed to screen and manage the health of your staff and includes:

  1. Health Screening

  2. Hepatitis B Vaccination

  3. Administering the Hepatitis B Vaccine

  4. Influenza Vaccination Program

  5. Influenza Vaccination Acceptance

  6. Administering the Influenza Vaccine

  7. Influenza Vaccination Declination

  8. Influenza Vaccination Rate Methodology

  9. Calculating the Influenza Vaccination Rate

  10. Influenza Vaccination Program Evaluation

  11. Testing for M. tuberculosis Infection

  12. Administering and Interpreting the Tuberculin Skin Test

  13. Serial TB Screening

  14. Staff Members with a Newly Recognized Positive Test Result for M. tuberculosis Infection or Signs or Symptoms of TB Disease

  15. Respirator Medical Questionnaire and Examination

  16. Occupational Exposure to M. tuberculosis

  17. Occupational Exposure to Blood and Body Fluids

  18. Follow-Up of Staff Exposed to Known or Suspected Human Immunodeficiency Virus (HIV) - Positive Sources and Postexposure Prophylaxis (PEP)

  19. Evaluating and Managing Staff with a Possible Occupational Exposure to Zika Virus

  20. Occupational Latex Allergies

  21. Actions to Take after an Animal Bite in the Home

  22. Work Restrictions

  23. Occupational Health Surveillance Activities

  24. Health Screening form

  25. Hepatitis B Vaccination Acceptance/Declination form

  26. Influenza Vaccination Acceptance/Declination form

  27. Immunization and TB Screening form

  28. Tuberculin Skin Test Record

  29. Tuberculosis Symptom Screen Questionnaire

  30. Respirator Medical Evaluation and Questionnaire

  31. Verification of Qualitative Fit Test (QLFT) form

  32. Observation Checklist for Placing a Tuberculin Skin Test

  33. Observation Checklist for Reading a Tuberculin Skin Test

  34. Work Restrictions for Staff Exposed to or Infected with Certain Diseases and Conditions

  35. Work Restrictions for Staff Exposed to or Infected with Certain Vaccine Preventable Diseases and Conditions

  36. Outcome Measures: Occupational Health Surveillance

  37. Occupational Illness/Injury Log form



Hand Hygiene

In Standard (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing and controlling the transmission of pathogenic organisms via the staff’s hands is he cornerstone to a solid infection prevention and control program. The Hand Hygiene section has policies based on both the CDC and WHO’s Hand Hygiene Guidelines, with one set removed based on the organization’s preferences, and includes:

  1. Hand Hygiene Plan

  2. Indications for Hand Hygiene

  3. Hand Hygiene Using an Alcohol-based Hand Hygiene Product

  4. Hand Hygiene Using Soap and Water

  5. Hand Hygiene Products

  6. Hand Hygiene Supplies

  7. Other Hand Hygiene Considerations

  8. Hand Care Program

  9. Alcohol-based Hand Hygiene Product Storage

  10. CDC vs. WHO Hand Hygiene Guideline Comparison



Cleaning and Disinfection

In §484.70 (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing and controlling the transmission of pathogenic organisms is required. The Cleaning and Disinfection includes how to sanitize, clean and disinfect equipment and supplies, and also how to manage the equipment and supplies both in the home and in the staff’s vehicle. The Cleaning and Disinfection section includes:

  1. Principles of Cleaning and Disinfection

  2. Soft Surface Sanitizing

  3. Medical Equipment: Noncritical Items

  4. Vital Sign Equipment

  5. Electronic Medical Equipment Used by Patients

  6. Portable Electronic Devices: Laptop Computer, Tablet, and Peripherals

  7. Bag Technique

  8. Decontaminating and Cleaning the Nursing Bag

  9. Core and Supplementary Contents in the Home Care Nursing Bag

  10. Children’s Toys and Rehabilitation Equipment

  11. Medical Bed Mattress Cover

  12. Cleaning and Storing a Bath Basin

  13. Medical Equipment:  Semicritical Items

  14. Point-of-Care Device: Prothrombin Monitoring Device

  15. Medical Equipment: Critical Items

  16. Linen Handling, Storage, and Cleaning

  17. Cleaning Spills of Non-regulated Medical Waste

  18. Cleaning Spills of Medical Waste on a Hard, Non-porous Surface

  19. Cleaning Spills on a Porous Surface

  20. Cleaning Environmental Surfaces

  21. Storing Patient Care Supplies in a Vehicle

  22. Inspecting and Maintaining Patient Care Supplies Stored in a Vehicle

  23. Medical Equipment and Supply Storage

  24. Staff Member Attire

  25. Labeling a Secondary Cleaning Product Container

  26. Refrigerator Temperature Monitoring

  27. Refrigerator Cleaning

  28. Medication and Vaccine Refrigerator Temperature Log

  29. Food Refrigerator Temperature Log

  30. Refrigerator/Freezer Troubleshooting Record

  31. Equipment and Supplies Storage: Vehicle Inspection Checklist



Patient Care Practices

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing breached in infection prevention practices and controlling the transmission of organisms during patient care is required. The Patient Care Practices section includes clinical procedures on indwelling devices and procedures that place the patient at highest risk for a home care-onset infection. Specimen collection procedures to accurately identify an infection (and prevent the unnecessary use of antibiotics), how to prevent the transmission of bed bugs, and safely manage pets is also addressed. The Patient Care Practices section includes:

  1. Sterile Technique

  2. Aseptic Technique

  3. Wound Care

  4. Irrigation Solution Storage and Use

  5. Access Device and Phlebotomy: Skin Antisepsis

  6. Venous Access Device: Changing the Dressing

  7. Needleless Connector Disinfection Technique

  8. Needleless Connector Disinfection Technique: Disinfection Cap

  9. Needleless Connector: Indications and Frequency for Changing

  10. Needleless Connector: Clamping and Disconnecting Sequence

  11. Venous Access Device: Flushing and Locking

  12. Central Venous Access Device: Infection Prevention Strategies

  13. Central Venous Access Device: Evaluation and Criteria for Removal

  14. Removing a Midline or Non-tunneled Central Venous Catheter

  15. Peripheral Venous Access Device: Infection Prevention Strategies

  16. Subcutaneous Access Device: Infection Prevention Strategies

  17. Infusion Therapy Equipment and Supplies

  18. Collecting Blood for Culture and Other Tests

  19. Single and Multi-dose Vials and Containers

  20. IV Push Medication Preparation and Administration

  21. Patient Vaccination: Influenza and Pneumococcal Vaccines

  22. Medication and Vaccine Storage

  23. Medication Storage During Transport to the Home

  24. Refrigerated Vaccine Storage During Transport

  25. Medication Storage in the Patient’s Home

  26. Point-of-Care Device: Blood Glucose Meter

  27. Preventing Ventilator-associated Pneumonia: Oral Care

  28. Enteral Therapy

  29. Urinary Tract Care

  30. Collecting and Transporting a Urine Specimen

  31. Collecting and Transporting a Stool Specimen

  32. Collecting and Transporting a Rectal Swab

  33. Collecting and Transporting a Nasopharyngeal Swab

  34. Animal-assisted Activities

  35. Care and Handling of Animals in a Hospice Care Facility

  36. Reducing the Risk of Transporting Bed Bugs and Other Pests



Isolation Precautions

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing and controlling the transmission of pathogenic organisms is essential. The Isolation Precautions section includes a Pandemic Preparedness Plan and Plan for managing an influx of infectious patients as required by the CMS Emergency Management regulations and a Plan for Managing an Influx of Infectious Patients as required by TJC, if applicable. The Isolation Precaution policies also address emerging pathogens in home care, such as MDROs, Zika Virus Disease, C. difficile. There is also an algorithm for staff to use to determine when Standard versus Contact Isolation Precautions should be implemented in the home setting. The Isolation Precautions section includes:

  1. Standard Precautions

  2. Transmission-Based Isolation Precautions

  3. Airborne Precautions

  4. Droplet Precautions

  5. Contact Precautions

  6. Caring for a Patient with a Multidrug-Resistant Organism

  7. Caring for a Patient with a Clostridium difficile Infection

  8. Caring for a Patient with Zika Virus Disease

  9. Management of the Individual in the Home Suspected of Having Exposure to the Ebola Virus

  10. Caring for a Patient with Confirmed or Suspected Pandemic Influenza or Emerging Pathogen

  11. Pandemic Preparedness Plan and Managing an Influx of Infectious Patients

  12. Sequence for Putting on Personal Protective Equipment

  13. Sequence for Removing Personal Protective Equipment: Option One

  14. Sequence for Removing Personal Protective Equipment: Option Two

  15. Management of MDROs in the Home and Facility-based Hospice Setting

  16. When to Implement Standard Precautions vs. Contact Precautions for a Patient Infected or Colonized with a Multidrug-Resistant Organism

  17. Pandemic Preparedness Self-Assessment

  18. Category A Bioterrorism Agents

  19. Recommended Isolation Precautions for Selected Infections and Conditions



Medical Waste Management Plan

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), agencies preventing and controlling the transmission of pathogenic organisms via regulated medical waste is required. In addition, the Occupational Health and Safety Administration (OSHA) requires a written plan for the protecting its staff against exposure to regulated medical waste. The content in the Medical Waste Management meets the federal OSHA requirements and includes how to manage regulated medical waste in the home, during transport from the home, and in the office. The content in the Medical Waste Management includes:

  1. Categories of Waste

  2. Regulated Medical Waste Generated by Staff

  3. Disposal and Transport of Medical Waste Generated by Staff

  4. Sharps Waste Generated by Staff

  5. Sharps Waste Management

  6. Disposal and Transport of Sharps Generated by Staff

  7. Medical Waste Storage Area

  8. On-Site Medical Waste and Sharps Storage Container



Bloodborne Pathogen Exposure Control Plan

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), agencies preventing and controlling the occupational transmission of bloodborne pathogens is required. In addition, the Occupational Health and Safety Administration (OSHA) requires a written Bloodborne Pathogen Exposure Control Plan. The content in the Bloodborne Pathogen Exposure Control Plan meets the federal OSHA requirements and includes:

  1. Administration

  2. Exposure Determination

  3. Engineering and Work Practices Controls

  4. Personal Protective Equipment

  5. Recordkeeping

  6. Bloodborne Pathogen Exposure Control Plan Evaluation

  7. Sharps and Safety Device Evaluation form

  8. Blood and Body Fluid Exposure form

  9. Sharps Injury Log

  10. Source Patient Blood Test Consent/Declination form



Respiratory Protection Plan

In (a) Standard: Prevention and (b) Standard: Control in the Medicare Conditions of Participation (CoPs), preventing and controlling the transmission of M. tuberculosis is required. In addition, the Occupational Health and Safety Administration (OSHA) requires organizations with risk to have a written Respiratory Protection Plan. The content in the Respiratory Protection Plan meets the federal OSHA requirements and includes:

  1. Administration

  2. Exposure Determination

  3. TB Risk Assessment Activities

  4. TB Risk Classification

  5. TB Screening Program

  6. Patient Identification and Management

  7. Particulate Filtering Facepiece Respirator

  8. Fit Testing

  9. How to Perform Qualitative Fit Testing

  10. User Seal Check

  11. Recordkeeping

  12. Respiratory Protection Program Evaluation

  13. TB Risk Assessment Tool

For more information, preview the comprehensive Table of Contents to the Home Care Infection Prevention and Control Program, 2018