Highlights
- •A cross-sectional study of 158 Australian residential and aged care facilities (RACFs).
- •Majority of RACFs have an infection control program and an employee with infection prevention and control responsibilities.
- •Support for RACF staff who are responsible for infection prevention and control could be enhanced.
Abstract
Background
Individuals in residential and aged care facilities (RACFs) are at risk of developing
health care-associated infections (HAIs) due to factors such as age-related changes
in physiology, immunity, comorbid illness and functional disability. The recent establishment
of an Australian Royal Commission into the Quality of Residential and Aged Care Services
highlights the challenges of providing care in this sector. This national study identified
infection prevention and control (IPC) services, practice and priorities in Australian
RACFs.
Methods
A cross-sectional study of 158 Australian RACFs comprising a 42-question survey incorporating
five key domains relating to IPC namely governance, education, practice, surveillance,
competency and capability was undertaken in 2018.
Results
Of the 131 respondents, the majority 92.4% of respondents reported having a documented
IPC program, 22.9% (n = 30) operated with a dedicated infection control committee
The majority of RACFs reported lacking specialist and qualified experienced IPC professionals
(n = 67). The majority of RACFs (90.1%, n = 118) reported the existence of a designated
employee with IPC responsibilities. Of these 118 staff members with IPC responsibilities,
42.5% had a qualification in IPC. The reported average funded hours per month for
IPC professional or an external provider of IPC activities was 14 (95% CI 9.6–18.9 h).
Conclusion
The overwhelming majority of RACFs deliver IPC services and report doing so in ways
that meet the needs of their own specific contexts in the absence of the lack of formal
guidelines when compared to the hospital sector. Quality residential and aged care
free from HAIs requires formal structure and organization strategies.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Infection, Disease & HealthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Graves N. Halton K. Robertus L. Costs of healthcare associated infection. Australian Commission on Safety and Quality in Healthcare, Sydney2008
- The burden of healthcare-associated infection in Australian hospitals: a systematic review of the literature.Infect Dis Health. 2017; 22: 117-128
- Cruickshank M. Ferguson J. Reducing harm to patients from healthcare associated infections: an Australian infection prevention and control model for acute hospitals. Australian Commission on Safety and Quality in Heatlh Care, Sydney2009
- Australian guidelines for the prevention and control of infection in healthcare.National Health and Medical Research Council, Canberra2010
- Prevention and control of infection in residential and community aged care.National Health and Medical Resource Council, Canberra2014
- Residential care.Australian Government, 2019 ([cited 2019 6th April]. Available from:)
- A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial.JAMA Int Med. 2015; 175: 714-723
- Understanding infection prevention and control in nursing homes: a qualitative study.J Geriatr Nurs. 2015; 36: 267-272
- Multidrug-resistant organism infections in US nursing homes: a national study of prevalence, onset, and transmission across care settings, October 1, 2010-December 31, 2011.Infect Control Hosp Epidemiol. 2014; 35: S48-S55
- Healthcare-associated pathogens and nursing home policies and practices: results from a national survey.Infect Control Hosp Epidemiol. 2015; 36: 759-766
- Infection rates in residential aged care facilities, Grampians region, Victoria, Australia.Healthc Infect. 2011; 16: 116-120
- Antibiotic use and misuse in residential aged care facilities.Intern Med J. 2012; 42: 1145-1149
- Surveillance of infection burden in residential aged care facilities.Med J Aust. 2012; 196: 327-331
- Prevalence of antimicrobial-resistant organisms in residential aged care facilities.Med J Aust. 2011; 195: 530-533
- Prevalence of infections and antimicrobial prescribing in Australian aged care facilities: evaluation of modifiable and nonmodifiable determinants.Am J Infect Control. 2018; 46: 1148-1153
- Review of infection control practices in residential aged care.Australian Government, Canberra2018
- Documentation, composition and organisation of infection control programs and plans in Australian healthcare systems: a pilot study.Infect Dis Health. 2016; 21: 51-61
- Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature.BMJ Quality & Safety, 2012
- Roles, responsibilities and scope of practice: describing the state of play for infection control professionals in Australia and New Zealand.Healthc Infect. 2015; 20: 29-35
- Time spent by infection control professionals undertaking healthcare associated infection surveillance: a multi-centred cross sectional study.Infect Dis Health. 2016; 21: 36-40
- Hospital infection control units: staffing, costs, and priorities.Am J Infect Control. 2015; 43: 612-616
- A national stakeholder review of Australian infection control programs: the scope of practice of the infection control professional.Australian Commission on Safety and Quality in Health Care, Sydney2008
- Staffing requirements for infection control programs in US health care facilities: Delphi project.Am J Infect Control. 2002; 30: 321-333
- Assessing the status of infection control programs in small rural hospitals in the western United States.Am J Infect Control. 2004; 32: 255-261
- Staffing and structure of infection prevention and control programs.Am J Infect Control. 2009; 37: 351-357
- State of infection prevention in US Hospitals enrolled in NHSN.Am J Infect Control. 2014; 42: 94-99
- Resourcing hospital infection prevention and control units in Australia: a discussion paper.Infect Dis Health. 2017; 22: 83-88
- Variation in health care-associated infection surveillance practices in Australia.Am J Infect Control. 2015; 43: 773-775
- Exploring the context for effective clinical governance in infection control.Am J Infect Control. 2017; 45: 278-283
- WordArt.com. 2019 ([cited 2019 2nd March]. Available from:)
- Redressing quality and safety in aged care: Australian Hospital and Health Care.2018 ([cited 2019 17th March]. Available from:)
- Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities.Intern Med J. 2015; 45: 576-580
- Infection prevention quality indicators in aged care: ready for a national approach.Aust Health Rev. 2018 Aug; ([Epub ahead of print])
- Safety and quality improvement guide standard 3: preventing and controlling healthcare associated infections (October 2012).Australian Commission on Safety and Quality in Health Care, Sydney2012
- Role of professional organizations in advocating for the nursing profession.Online J Issues Nurs. 2012; 17
- Health professional networks as a vector for improving healthcare quality and safety: a systematic review.BMJ Qual Saf. 2012; 21: 239-249
- Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections.J Hosp Infect. 2006; 64: 16-22
- Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina.Am J Infect Control. 2003; 31: 405-409
Article info
Publication history
Published online: July 03, 2019
Accepted:
June 11,
2019
Received in revised form:
June 5,
2019
Received:
March 31,
2019
Identification
Copyright
© 2019 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
