[A survey of infection control among community home care service providers].
OBJECTIVE
This study aimed to explore the current situation of infection control by community home care providers.


METHODS
We investigated an area managed by one of 6 municipal social welfare offices in Fukushima. Two questionnaires were sent to all home care agencies providing home help services, visiting bathing care and visit-nursing: one to the 82 chiefs of the agencies (response rate of 90.2%) and the other to 1024 health care workers working for them (57.2%). The questionnaire covered health checkups of employees, maintenance and management of devices, infection control education and manuals, and hand hygiene.


RESULTS
1. Medical checkups were organized once a year or more at 94.6% of the agencies and employee participation of once a year or more was 87.6%. 2. Regarding the management of health care devices, personnel were assigned and a registration system was introduced at 43.2% and 20.8% of the agencies, respectively. Most agencies (94.6%) provided disposable gloves and 82.6% of the employees used them when handling body fluids or excretions. However, not many agencies provided hand-washing equipment (43.2%) and paper towels (39.2%). 3. Infection control educational programs were organized at 40.3% of the agencies and attended by 30.2% of the employees. Among the agencies without such programs, 76.2% gave employees' time constraint as a reason for not giving training. On the other hand, 78.5% of non-attendants of the program answered that they were not given a chance to participate. 4. Infection control manuals were available at 68.9% of the agencies, but only 69.4% of their employees were aware of them and only 44.3% utilized them. Agencies were aware of the situation and only 42.9% answered that their manuals were fully utilized. Among the agencies currently without manuals, 47.8% are developing manuals. 5. When and how to wash hands and how to use towels in home care settings were specified in 73.0%, 78.4% and 35.1% of the agencies, respectively. As high as 92.0% of employees washed their hands after caring for clients and 74.6% after handling body fluids or excretions, but 52.2% did so before caring. It was noted that although 82.7% of the employees washed their hands with water and soap (and antiseptic agents), only 7.5% used paper towels to dry their hands.


CONCLUSIONS
The chiefs of home care providers should be required to develop and implement better infection control strategies with the support of local governmental agencies.
Nakano
Kyoko
K
Department of Public Health, Fukushima Medical University School of Medicine.
Ono
Kiyoko
K
Yasumura
Seiji
S
D017028:Caregivers / Q000193:education; D003153:Community Health Services; D018574:Home Care Agencies; D017053:Infection Control / Q000379:methods*; D011795:Surveys and Questionnaires