Feasibility of National Surveillance of Health-Care-Associated Infections in Home-Care Settings

Lilia P. Manangan, Michele L. Pearson, Jerome I. Tokars, Elaine Miller, William R. Jarvis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA


Emerging Infectious Diseases. 2002;8(3) 

In This Article

Abstract and Introduction

This article examines the rationale and strategies for surveillance of health-care-associated infections in home-care settings, the challenges of nonhospital-based surveillance, and the feasibility of developing a national surveillance system.

Over the past 2 decades, the delivery of health care in the United States has shifted increasingly from hospitals to patients' homes[1,2,3]. Nearly eight million people in the United States received medical care at home in 1996[4], and an estimated 774,113 (10%) of these patients had at least one indwelling medical device[5]. Use of a medical device is the greatest predictor (exogenous) of health-care-associated infection.

Home care is often provided by family members who have little or no formal health-care training, which may place patients at increased risk of health-care-associated infections not typically seen in hospitals. In the home-care setting, patients with open wounds or central venous catheters may undertake activities of daily living (e.g., bathing, exercising, gardening, and playing with pets) that may increase the risk of infections.


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