Avoiding Infection Control Errors in Home Care
By: Becky Tolson, RN, BS
Manager, Survey Operations
Posted: August 5, 2025
In facility-based healthcare organizations, infection control is proactively managed throughout the environment. Providers of home care services address infection prevention through example and education with the goal of minimizing infection risk while carrying their equipment and supplies into a range of locations.
During an ACHC Home Care Accreditation survey, infection control is a crucial area of focus. Surveyors assess the agency’s written policies and procedures and then shadow clinicians on patient home visits to observe implementation of the practices that prevent infections and reduce risk. Depending on severity, errors (infection control breaches) may be reportable to state public health authorities, and these issues have been among cited survey deficiencies. Understanding where agencies may fall short and actively addressing issues is essential for compliance and quality care.
Infection control breaches are common in:
- Hand hygiene: Hand hygiene must occur before and after patient contact and after touching potentially contaminated surfaces. Inconsistent availability of appropriate hand washing supplies can also lead to citations. Examples include using a patient’s bar soap and cloth bath towel rather than liquid soap and paper towels or alcohol-based hand sanitizer.
- Personal protective equipment (PPE): Surveyors expect the use of PPE to align with agency policy and patient care needs. Common errors include failure to wear gloves (e.g., during wound care), absence of masks during respiratory procedures, or incorrect donning and doffing of PPE.
- Bag technique: How clinicians manage their bag of supplies and equipment relates directly to infection prevention. If staff cannot correctly demonstrate practices such as appropriate bag placement, use of necessary barriers, and disinfection of multiuse items like blood pressure cuffs, stethoscopes, and thermometers, survey deficiencies may be the result.
- Wound care: This high-risk service receives significant attention during surveys. Surveyors will observe dressing changes and review documentation. Incorrect or missed dressing changes, improper technique for wound care, and expired supplies can all trigger citations.
- Sharps: Safe injection practices for single-use items, disposal of sharps in approved containers, and relevant safety education for patients when sharps are used in the home are all important elements to minimize infection risk.
Four tips to ensure continuous compliance
1. Review your policies and procedures.
Verify that your infection control policies are up to date, reflecting the latest industry guidance, and comprehensive, addressing the scope of services you provide. Ensure that your staff has access to the policies and can demonstrate compliance through actual field practice.
2. Train your staff.
Provide infection control training at orientation and at least annually. Document the training for each individual staff member.
3. Stock needed supplies.
Provide clinicians with the proper PPE, hand washing materials, disinfectants, and sharps containers. Surveyors may ask to see your office supply or staff members’ car stocks.
4. Use mock surveys.
Direct observation of clinicians in the field or through simulated home visits in the office provide opportunities to verify compliant hand hygiene, PPE use, bag technique, wound care, and sharps handling. Provide immediate feedback and reinforce correct techniques.
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