Construction of risk management for infection control in home care settings

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To find an actual situation of infection in home care settings and to consider a provision against it, three studies(1〜3) were performed in this research. 1. Questionnaire against three kinds of home-visit services; home-visit nursing (134 visiting nurse service stations at Tokyo in the year of 2004, 523 stations in areas out of Tokyo in 2005), home-helper service (344 visiting care service stations in 2006) and 1208 visit -bath services. (1) Existence of patients with infection: In cases of 55% of visiting nurse service stations, 30% of visiting care service stations and 60% of visit-bath services, care-workers were giving care to patients with infectious diseases. Hepatitis, both type B and type C were most frequently existed in visiting nurse service stations.(2) Infection control strategies of standard precautions under CDC : There were reasonable replies by every service. But there was no relationship between existence of infected patients and performed strategies. (3) Health care for care-worker: About 80% of stations recommended vaccination, and 95% of them did recommend Influenza vaccine. 2. Experiment for practical use of waterless, rubbing antiseptics: Spreading volume of antiseptics which is on the market was variable and for to get effective result to hand washing, some of the products had not suitable characteristics of their container. 3. Visit to Texas, USA, to learn infection control system in home care settings: There were indispensable and systematic educations to personnel in home visit system.Infection is one of the important barriers against quality of medicine and patient's QOL Effective strategy of education on infection control in home-visit service should be designed by the administration in near future.