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

Challenges to Developing a National Surveillance System

Home-care surveillance poses several unique challenges, including lack of nationally accepted standard definitions and surveillance methods, loss of patient follow-up, lack of trained infection control personnel in home-care settings, difficulty in capturing clinical and laboratory data, and difficulty in obtaining numerator and denominator data.

A cornerstone of surveillance in any setting is development of standardized definitions and methods. Individual home-care agencies have developed surveillance definitions for their own use[17,18,19,20], but national definitions of infections in home care do not exist. The draft APIC definitions of home health-care-associated infections have yet to be accepted and implemented nationally. These definitions should be tested to determine their practicality or applicability, given the limited use of laboratory diagnostics in home care. In addition, standard methods of case finding, recording, and calculating rates are also essential. If national benchmark rates are to be established to permit inter- and intra-agency comparisons, consensus definitions of home health-care-associated infections, such as those published by APIC, will have to be implemented.


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