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Organisation and governance of infection prevention and control in Australian residential aged care facilities: A national survey

  • Brett G. Mitchell
    Correspondence
    Corresponding author. Avondale College, 185 Fox Valley Road, Wahroonga, NSW, 2076, Australia.
    Affiliations
    Discipline of Nursing, Avondale College of Higher Education, Wahroonga, NSW, Australia

    School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia
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  • Ramon Z. Shaban
    Affiliations
    Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown. NSW, Australia

    Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia

    Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
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  • Deborough MacBeth
    Affiliations
    Department of Infection Prevent and Control, Gold Coast Hospital and Health Service, Gold Coast, QLD, Australia
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  • Philp Russo
    Affiliations
    Department of Nursing Research, Cabrini Institute, Malvern, Victoria, Australia

    Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia

    Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, NSW, Australia
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      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

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