Infection prevention quality indicators in aged care: ready for a national approach
N. J. Bennett A B D , J. M. Bradford A , A. L. Bull A and L. J. Worth A CA Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute, Melbourne, Vic. 3000, Australia. Email: Jennifer.Bradford@mh.org.au; Ann.Bull@mh.org.au; Leon.Worth@mh.org.au
B National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia.
C Department of Medicine, The University of Melbourne, Parkville, Vic. 3010, Australia.
D Corresponding author. Email: Noleen.Bennett@mh.org.au
Australian Health Review 43(4) 396-398 https://doi.org/10.1071/AH18052
Submitted: 2 January 2018 Accepted: 4 June 2018 Published: 21 August 2018
Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND
Abstract
Accreditation standards for Australian aged care homes include the requirement for programs to ensure infections are controlled. Effective infection prevention programs are supported by surveillance data providing the impetus for quality improvement and facilitating evaluation of interventions at the facility level. In 2016, infection control professionals employed in Victorian public-sector residential aged care services were surveyed to examine the nature and resourcing of local infection prevention programs and monitoring activities. Overall, 164 services participated (90% response rate). A high proportion (84%) reported executive support for infection surveillance, with mean allocation of 12 h per fortnight per facility for infection prevention activities. Current surveillance activities included monitoring of infections and antimicrobial use (90%), influenza vaccination compliance for staff (96%) and residents (76%) and monitoring of infection due to significant organisms (84%). A successful statewide program including eight quality indicators has subsequently been implemented in Victoria. We suggest that a national focus could strengthen this framework, ensuring a uniform strategy with enhanced benchmarking capacity. Stakeholder engagement and refinement of appropriate indicators for monitoring quality improvement in public, not-for-profit and private sectors within aged care is required.
Additional keywords: aged care, infection prevention, surveillance.
References
[1] Aged Care Standards and Accreditation Agency. Guidance on the draft aged care quality standards. 2017. Available at: https://www.aacqa.gov.au/providers/news-and-resources/aged-care-quality-standards [verified 19 July 2018].[2] Wyatt K. Aged care influenza reviews released. [Media release] 2017. Available at: http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2017-wyatt117.htm [verified 20 March 2018].
[3] Cruickshank M, Ferguson J, editors. Reducing harm to patients from health care associated infection: the role of surveillance. Syndey: Australian Commission on Safety and Quality in Health Care; 2008.
[4] Chadwick LM, MacPhail A, Ibrahim JE, McAuliffe L, Koch S, Wells Y. Senior staff perspectives of a quality indicator program in public sector residential aged care services: a qualitative cross-sectional study in Victoria, Australia. Aust Health Rev 2016; 40 54–62.
| Senior staff perspectives of a quality indicator program in public sector residential aged care services: a qualitative cross-sectional study in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar |
[5] Fleming A. Stewardship in long term care facilities. In: Nathwani D, editor. Antimicrobial stewardship from principles to practice. Birmingham: British Society for Antimicrobial Chemotherapy; 2018. p. 190.
[6] Centers for Disease Control and Prevention National Healthcare Safety Network. Tracking infections in long-term care facilities. 2017. Available at: https://www.cdc.gov/nhsn/ltc/index.html [verified 22 March 2018].
[7] O’Reilly M, Courtney M, Edwards H, Hassall S. Clinical outcomes in residential care: setting benchmarks for quality. Australas J Ageing 2011; 30 63–9.
| Clinical outcomes in residential care: setting benchmarks for quality.Crossref | GoogleScholarGoogle Scholar |
[8] Stuart RL, Marshall C, Orr E, Bennett N, Athan E, Friedman D, Reilly M, Members of Residential Aged Care Research Interest Group Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities. Intern Med J 2015; 45 576–80.
| Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities.Crossref | GoogleScholarGoogle Scholar |
[9] Russo PL, Bull A, Bennett N, Boardman C, Burrell S, Motley J, Berry K, Friedman ND, Richards M. The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre. Am J Infect Control 2006; 34 430–6.
| The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre.Crossref | GoogleScholarGoogle Scholar |
[10] Johnson SA, Bennett NJ, Bull AL, Richards MJ, Worth LJ. Influenza vaccination uptake among Victorian healthcare workers: evaluating the success of a statewide program. Aust N Z J Public Health 2016; 40 281–3.
| Influenza vaccination uptake among Victorian healthcare workers: evaluating the success of a statewide program.Crossref | GoogleScholarGoogle Scholar |
[11] Australian Government Department of Health. Australian influenza surveillance report and activity updates. 2017. Available at: http://www.health.gov.au/flureport#current [verified 22 March 2018].
[12] Australian Commission on Safety and Quality in Health Care. 2016 Aged care national antimicrobial prescribing survey report. 2017 Available at: https://irp-cdn.multiscreensite.com/d820f98f/files/uploaded/acNAPS2016.pdf [verified 22 March 2018].
[13] Australian Aged Care Quality Agency. Infection control – do you have it under control? 2017. Available at: https://www.aacqa.gov.au/providers/education/the-standard/october-2017/infection-control-2013-do-you-have-it-under-control [verified 10 July 2018].
