Abstract：
OBJECTIVE:To describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. DESIGN:Observational study of nurse hand hygiene practices. SETTING:and Participants: Licensed practical/vocational and registered nurses were observed in the homes of patients being served by a large nonprofit HHC agency. METHODS:Two researchers observed 400 home care visits conducted by 50 nurses. The World Health Organization's "5 Moments for Hand Hygiene" validated observation tool was used to record opportunities and actual practices of hand hygiene, with 3 additional opportunities specific to the HHC setting. Patient assessment data available in the agency electronic health record and a nurse demographic questionnaire were also collected to describe patients and nurse participants. RESULTS:A total of 2014 opportunities were observed. On arrival in the home was the most frequent opportunity (n = 384), the least frequent was after touching a patient's surroundings (n = 43). The average hand hygiene adherence rate was 45.6% after adjusting for clustering at the nurse level. Adherence was highest after contact with body fluid (65.1%) and lowest after touching a patient (29.5%). The number of hand hygiene opportunities was higher when patients being served were at increased risk of an infection-related emergency department visit or hospitalization and when the home environment was observed to be "dirty." No nurse or patient demographic characteristics were associated with the rate of nurse hand hygiene adherence. CONCLUSIONS AND IMPLICATIONS:Hand hygiene adherence in HHC is suboptimal, with rates mirroring those reported in hospital and outpatient settings. The connection between poor hand hygiene and infection transmission has been well studied, and it has received widespread attention with the outbreak of SARS-CoV-2. Agencies can use results found in this study to better inform quality improvement initiatives.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
McDonald MV,Brickner C,Russell D,Dowding D,Larson EL,Trifilio M,Bick IY,Sridharan S,Song J,Adams V,Woo K,Shang Jdoi
10.1016/j.jamda.2020.07.031subject
Has Abstractpub_date
2020-09-15 00:00:00eissn
1525-8610issn
1538-9375pii
S1525-8610(20)30656-3pub_type
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journal_title：Journal of the American Medical Directors Association
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journal_title：Journal of the American Medical Directors Association
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pub_type： 杂志文章
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pub_type： 杂志文章,随机对照试验
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.10.009
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.02.008
更新日期：2013-10-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究,随机对照试验
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abstract：INTRODUCTION:Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. METHOD...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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pub_type： 杂志文章,meta分析,评审
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2020-04-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2020-06-01 00:00:00
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更新日期：2020-11-19 00:00:00
abstract：OBJECTIVES:Examine the association between completion of an outpatient visit with a physician or advanced practice provider (PCP) within 7 days of discharge from a short skilled nursing facility (SNF) stay and 30-day readmission and determine if functional status at discharge moderates visit effectiveness. DESIGN:Retr...
journal_title：Journal of the American Medical Directors Association
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pub_type： 杂志文章
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journal_title：Journal of the American Medical Directors Association
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更新日期：2014-01-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.04.010
更新日期：2012-07-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2014-01-01 00:00:00
