The Small Habit That Shapes Big Outcomes

Written by Jennifer Kennedy 

As we move through December, infection prevention and control become a priority for every organization delivering care in the home. Respiratory season is in full swing, families are gathering, and vulnerable patients rely on providers to reduce risk wherever possible. Hand hygiene remains one of the most effective tools we have. It is simple, low-cost, and deeply connected to the trust families place in us every day.  

Cold, flu, and COVID-19 tend to surge during the fall and winter months (October through mid-May), with peaks usually in December–February. COVID-19 and RSV often peak in late December to early January, while flu peaks vary but are most common between December and February.  December and January are the highest-risk months when flu, COVID-19, and RSV often surge together, straining hospitals and increasing referrals to post-acute care providers, including home health.

Infection control and prevention is a federal regulatory requirement for home health and hospice providers. This past year brought encouraging progress. Hospice organizations saw a long-standing infection control deficiency removed from the top ten list, a sign that teams across the field are strengthening their practices and building more reliable daily habits. That improvement reflects the hard work of clinicians, aides, and leaders who are committed to safer care. It is worth celebrating. It also reminds us that progress creates momentum, and momentum invites us to go even further.  However, home health providers still had two separate infection control related deficiencies in their top 10 list, so improvement is definitely needed.

In home-based care, the environment is constantly changing, and. visiting clinicians navigate care across living spaces that differ from home to home. That variability is precisely why hand hygiene is so important. It is the steady behavior that strengthens everything else we do, and it is one of the easiest ways to protect both patients and staff during the highest-risk months of the year.

What Effective Hand Hygiene Helps Prevent

Experts know hand hygiene is not just a regulatory expectation. It is a control measure that interrupts pathways that would otherwise compromise patient safety, symptom management, and clinical stability. High compliance helps prevent:

1. Respiratory virus transmission: Influenza, RSV, and SARS-CoV-2 remain significant risks for hospice and home health patients. Effective hand hygiene reduces the transfer of viral particles from surfaces and equipment to mucous membranes, preventing respiratory decline in patients who cannot tolerate setbacks.
2. Gastrointestinal infections: Norovirus and other enteric illnesses can quickly destabilize frail patients. Dehydration worsens symptom burden and disrupts medication absorption. Especially for end-of-life patients, these complications create unnecessary suffering.
3. Secondary bacterial infections: Winter respiratory viruses often pave the way for bacterial pneumonia. Poor hand hygiene increases the spread of organisms such as Staphylococcus aureus, which can lead to avoidable antibiotic use and increased discomfort.
4. Cross-contamination between homes: Clinicians serve multiple households daily. Without consistent hand hygiene between visits, microbes travel with them from one environment to another, exposing otherwise stable patients to new risks.
5. Workforce illness and operational disruptions: Illness within staff teams leads to missed visits, delayed care, and increased strain on remaining clinicians. During the respiratory season, protecting your workforce is integral to maintaining continuity of care.
6. Wound complications and device-related infections: For patients with chronic wounds, IV access, or catheters, even minor lapses in hand hygiene can lead to contamination that slows healing or triggers more intensive interventions.

These risks impact symptom control and overall patient well-being..

What Lapses Can Make Worse

Inadequate hand hygiene is not a minor oversight; it is a significant issue. It can exacerbate conditions that are already fragile.

Lapses can worsen:
• respiratory distress in patients with pulmonary or cardiac disease
• gastrointestinal instability that disrupts medication schedules
• wound deterioration and pain
• chances of unplanned hospital use
• household transmission to family caregivers
• staff scheduling shortages that impact continuity and satisfaction

Every one of these outcomes affects the patient’s experience and the organization’s operational capacity.

Strengthening Hand Hygiene Across Your Team

Improvement in infection prevention is never the result of a single discipline or a single reminder. It is the result of a team that shares expectations, feels supported, and understands how daily behavior ties to patient outcomes.

Equip clinicians with what they need

Reliable hand hygiene starts with access. Go-bags stocked with sanitizer, readily available soap and water, and simple, field-tested workflows make it easier for clinicians to maintain consistent habits.

Embed expectations into real-world workflows

Home-based care looks different from one visit to the next. Agencies often succeed when they tailor WHO’s Five Moments of Hand Hygiene into home-care specific scenarios and use huddles, case conferences, and supportive supervision to reinforce behaviors.

Use visibility and recognition to strengthen culture

People practice what they see. Visible leadership support, shared success stories, and recognition of strong habits help cement hand hygiene as a cultural norm, not a compliance checkbox.

Invite staff to shape solutions

Your clinicians know where the friction points are. Asking for their ideas creates practical, innovation-friendly solutions that fit your organization’s model. CHAP’s non-prescriptive standards make this possible by giving providers the flexibility to build systems that actually work in the home environment.

A Field Moving in the Right Direction

Removing hospice infection control from the top ten deficiency list reflects real progress across the field. Providers are strengthening their systems, investing in training, and supporting teams with improved tools and clear expectations. It is meaningful growth, demonstrating what is possible when clinicians and leaders collaborate.

December is a perfect moment to reinforce what is already working and recommit to the basics that keep patients safe and teams strong. Hand hygiene may be a simple behavior, but its impact touches every corner of care. When it becomes consistent, reliable, and supported through a strong culture, providers are better equipped to protect patients, improve outcomes, and deliver exceptional care in every home they enter.