Category Archives: Aged care

Outside the box: Infection prevention beyond the hospital walls

The recent article published in the MJA by Agostino and colleagues from the Hunter New England area provided data that could be described as not so startling, but nevertheless alarming. Their study aimed to identify groups at risk of MRSA infection, as well as the proportion of patients with MRSA but no history of recent hospitalisation (previous 12 months).

In their large cohort, they found that “young people, Indigenous Australians, and residents of aged care facilities, are disproportionally affected by CA-MRSA infections”.

Two comments in their Discussion caught my eye. The authors call for:

  • the focus of control measures to move from the healthcare setting to the community
  • national surveillance of MRSAphotodune-598972-think-outside-the-box-xl

The results of this study are not so startling because the findings are consistent with previous studies, alarming because this is another piece of evidence highlighting the deficits of our local knowledge.

This brings me to my next point. I am excited to be part of a team conducting a large study exploring infection prevention in Australian residential and aged care facilities. Led by Prof Brett Mitchell, together with Prof Ramon Shaban and Dr Deborough MacBeth, we aim to mimic a recent program of work  that generated so much rich information about infection prevention in our hospital facilities. Here are links to a sample of some of papers from this work:

This cross sectional study aims to explore governance, education, practice, surveillance and competency and capability – five key domains relating to infection prevention and control. All aged care homes in Australia are in the process of being contacted.

The findings of this study will be significant, they will:

  • further support ACIPC to refine the role and scope of practice of ICPs and better target education strategies,
  • inform decision-makers faced with accessing and planning infection control resources in settings outside hospitals.
  • guide future research priorities in this area
  • understand priorities and gaps in infection control services

If you receive an invitation to participate, I strongly encourage you to do so.

We look forward to sharing our findings with you during 2018.

Phil

What do we know about antimicrobial use in Australian residential aged care facilities?

The National Centre for Antimicrobial Stewardship (NCAS) is a multidisciplinary collaborative funded by the NHMRC with a strong track record of innovation and Capturesuccessful translation into clinical practice. We asked Dr Noleen Bennett from NCAS to write about a national antimicobial prescribing survey in aged care. It has brought up some interesting findings.

Thanks for Noleen for this blog – Phil, Brett and Ramon.

_________________________________________________________________

The short answer is we know antimicrobial use in Australian residential aged care facilities (RACFs) needs to be improved. The unacceptable risk otherwise is the emergence of multi drug resistant infections and other adverse consequences in this vulnerable population.

In 2015, 186 RACFs participated in the pilot Aged Care National Antimicrobial Prescribing Survey. Key areas for improvement were identified and included:

  • inadequate documentation
    • 31.6% of prescriptions did not have an indication justifying their use
    • 65.0% of prescriptions did not have a review or stop date documented.
  • the use of antimicrobials for unspecified skin infections
    • 17.5% of antimicrobials were being used for unspecified skin infections.
  • prolonged duration of prescriptions.
    • 31.4% of prescriptions had been prescribed for longer than six months.

All Australian RACFs and multi-purpose services are now strongly encouraged each year to participate in acNAPS. Participation assists in ensuring compliance with national guidelines and targeting local and national actions to support appropriate antimicrobial use.

For further information, the friendly NAPS team can be contacted via email support@nasp.org.au or phone (03) 9342 9415. The data collection period for the 2016 acNAPS has been extended. Data can now be collected and entered prior to Friday 9th September.

Declaration: Dr Noleen Bennett is employed at the National Centre for Antimicrobial Stewardship and is the Project Officer for the Aged Care National Antimicrobial Prescribing Survey

_____________________________

Brett: For those interested in other Australian data in residential and aged care (infection and antimicrobials related) here are some links to articles. (This is not an exhaustive list)