Developing Quality Indicators of Hygiene and Infection Control in Home Care Nursing for Older Adults (1^st report) Developing Process of Quality Indicators

Abstract

As the number of older adults who have difficulties in maintaining their hygiene due to impaired ADL, or who are in compromised conditions or have infectious diseases, will increase, it is necessary for home care nurses to maintain their clients'hygiene and to take appropriate infection control procedures. The authors determined the best care practice of hygiene and infection control in home care nursing, as one of the important area of older adults'home care, and then based on these best practices, we developed indicators to evaluate quality of home care nursing with reference to practice they provide. Quality indicators were developed through following processes; an item pool of quality indicator candidates was created from review of past literatures and then they were examined by the expert panel that was consisted of the specialists of infection control and home care nursing of older adults. Quality indicators of body hygiene and oral hygiene were developed separately, as oral hygiene is considered to be unfamiliar in home care nursing in spite of its importance. Indicators concerned with performing standard precaution, securing sterilized materials and playing a role of interprofesisonal coordinator were included in quality indicators for infection control, considering the state of infection control in home care, such as lack of microbiological information, costs for sterilized materials and participation of plural care professionals. Additionally, description that home care nurses show the procedures for clients and their caregivers were also included in quality indicators since hygiene and infection control procedure are often performed by clients themselves and their caregivers. As a result, 16 quality indicators for body hygiene, 14 for oral hygiene and 18 for infection control were selected respectively