NHIA Addresses Recent Home Infusion Therapy Study

In response to a recent article by Infection Control Today^® (ICT^®), National Home Infusion Association (NHIA) reached out to ICT^® to the topic. The article and interview titled “Home Infusion Therapy: Limited Study Shows Lack of Formal Infection-Surveillance Training,” discussed the issues that Home-infusion therapy (HIT) staff have with lack of surveillance, education, and barriers to training in central line-associated bloodstream infection (CLABSI) surveillance. 

This interview was with Sara Keller, MD, MSHP, MPH, with Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health, and lead author of this study, “The Need to Expand the Infection Prevention Workforce in Home Infusion Therapy” published in the American Journal of Infection Control. This study is part of a broader study on CLABSI surveillance.

To further understand NHIA’s thoughts on the interview and accompanying article, ICT^® spoke to Connie Sullivan, BSPharm, CEO of NHIA.

When asked about her concerns with the study, Sullivan said that the “limited study is not representative of the home infusion industry and misrepresents the industry based on the data.”

Sullivan also told ICT^® that she was concerned that the study's results were skewed because it was limited. “I think that if you talk to a field nurse, and this is one of the things that we don't know who she spoke to, specifically in these organizations. It's hard to address the lack of training specifically for those individuals because we don't know if this is a field nurse [who] also has some additional responsibilities of looking at the quality improvement data this, a pharmacist is this someone who exclusively works in the quality improvement arm and, their whole job is just to aggregate data and report back on what their infection rates are. Without having any transparency into what questions she asked, I think that's also something we [NHIA] wanted to know; she described these as semi-structured interviews. I think that again, looking at the methodology that she used for the study, not only is it just qualitative, she's snowball sampling, which is “Hey, do you know anyone else I can talk to?” We're all very prone to bias.”

Sullivan did note things that NHIA and Keller agreed on. “It's much harder to confirm a cloud see in the home setting. You're not always going to be able to get a culture. You're not always going to be able to send a patient in. So our definition reflex, our environment, and that is, again, where we keep emphasizing, if you're looking for the same exact thing you do in a hospital and home infusion, you are likely not going to find it just because the environment demands different approaches, different understanding. We feel like a preventative approach is a much more effective approach. Not to say surveillance wouldn't be a great thing and should be done. But we do feel like it is done. It's done differently.

Sullivan continued: "These are not large providers, and in a lot of cases, these are smaller, pharmacy-based operations. They don't always have the resources to have dedicated people just to do these types of things. Most of these people are going to have other responsibilities in the organization, but they're required by their accreditation or conversations to monitor for catheter infections. And they do.”