Understanding Infection Control
From a safety and quality perspective, infection control is one of the most important — and least understood — concerns of the HME industry. It isn't even mentioned in CMS' supplier quality standards, yet the industry's accreditation organizations will rightfully push infection control practices to the forefront for each HME organization.
Several steps must be taken to be accreditation-worthy. Step one is better understanding how infections occur.
There are things about the science of infection control that are important and universal. We know how most infections are spread. We know that some people are more susceptible to infections than others. Finally, we know how to reduce the risk, or, in some cases, prevent infections from spreading.
High school biology taught us about the infection triangle. The three things that need to be linked together to create an infection are the infectious microorganism (germ), the susceptible host (patient or HME personnel) and transmission (spread of the germ) to a susceptible host.
All of these things must be present for an infection to occur.
Routes of Transmission1
The transmission of the germ to the patient or HME employee can occur through one of five basic ways: direct contact, indirect contact, droplet, airborne or common vehicle transmission.
Direct Contact: Physical transfer of microorganisms (germs) to a susceptible host by body surface-to-body surface contact. Most often associated with blood-borne or sexual contact, this can also occur during patient care activities like turning or bathing. Acquiring or transmitting infections via this route would be a rare occurrence, since HME personnel typically have only brief, casual contact with patients and their environment.
Indirect Contact: Contact of a susceptible host with contaminated hands or object. This probably represents the most common transmission route for HME personnel. It can happen when they do not wash their hands between patient visits, or when contact is made with a contaminated personal item such as soiled clothing or bedding.
It can also occur when they come in contact with a contaminated common-use item such as a TV remote, writing pen, child's toy or eating utensil.
Droplet Contact: Nasal, oral, or conjunctival (membrane that lines the eyelids) mucosa comes in contact with relatively large droplets containing germs from an infected person that is close by, usually within three feet.