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The Association for Professionals in Infection Control and Epidemiology (APIC) has developed a draft set of infection definitions for home care settings. Published in the association’s peer-reviewed journal, the guidelines may be helpful in clarifying what is and isn’t an infection in the difficult area of home health care.1
Home health agencies must establish definitions of infection for the purpose of surveillance before initiating a surveillance program, the guidelines state. Definitions should be consistently used in the collection, analysis, and reporting of infection data.
"In any surveillance system, one of the early steps is to establish definitions that you will continually rely upon," says Freda Embry, RN, BSN, one of the authors of the definitions as a member of the APIC Homecare Membership Section. "Then, once you have done that, if you do your surveillance consistently and uniformly, then you should be able to trust that any future increases or decreases are real, and not an artifact of changing a definition or a method."
The criteria for infection in the proposed definitions acknowledge that laboratory and other diagnostic tests are performed less frequently in home health care. Instead, clinical observations by home health care providers are often relied on to assess changes in the patient’s status.
"The definitions were designed to be based on clinical observations to the degree possible," she says. "A major objective was to design a set of definitions that would be beneficial and helpful to the reality of the workplace."
1. Embry FC, Chinnes LF. Draft definitions for surveillance of infections in home health care. Am J Infect Control 2000; 28; 449-453.