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Review audits highlight skill gaps in infection control


Management and staff at two aged care organisations where 16 residents died during this year’s winter flu season lacked the skills and knowledge to respond to an outbreak, an audit by the Quality Agency has found.

The Minister for Aged Care Ken Wyatt ordered an agency review of the St John’s facilities in Wangaratta, Victoria and Uniting AgeWell Strathdevon in La Trobe, northwest Tasmania following the deadly influenza outbreak in August and September, which saw many residents and staff struck down with the illness.

The Quality Agency said both organisations did not implement an effective coordinated response to the outbreak and staff were unclear of their roles and responsibilities.

Skill and knowledge gaps impacted negatively on residents, the audit reports said.

Organisational and government infection control guidelines were also not consistently followed.

At St John’s some organisational policies and procedures to direct staff in response to a respiratory outbreak were not in line with Commonwealth and Victorian guidelines.

At Strathdevon, staff did not always have access to sufficient supplies of personal protective equipment to ensure infection control measures could be followed.

In addition to knowledge, skill and procedural gaps, staffing shortages also impacted on the ability of both organisations to effectively respond and contain the outbreak. This was often because staff had also contracted the flu and replacement staff could not always be found.

At Stathdevon, 76 per cent of residents had received the 2017 flu vaccine, however only 36 per cent of staff were vaccinated.

At St John’s retirement village nursing home, approximately 45 per cent of staff were vaccinated and 33 per cent of residents.

Early identification of flu symptoms and good communication with residents and families during the outbreak were also raised as concerns in the reports.

The review audits found St John’s Retirement Village Nursing Home had failed to meet 13 of the 44 expected outcomes and its hostel failed to meet 12 outcomes.

Uniting AgeWell Strathdevon failed to meet 5 of the 44 outcomes.

The CEO of Uniting AgeWell, Andrew Kinnersly, apologised for the failure to meet agency, resident and community expectations and said the organisation had taken steps to address the issues raised.

“I sincerely regret we did not meet the [accreditation] standards in all respects,” he said in a statement.

“Following a thorough review of operational management and practices at Strathdevon, Uniting AgeWell has taken decisive action to ensure identified gaps are immediately rectified.

“This includes the appointment of a nurse advisor to lead staff at the site, the appointment of additional clinical and cleaning staff, increased outbreak management education for all staff and strengthened communication and feedback mechanisms for residents and families,” said Mr Kinnersly.

Chairman of St John’s Village Bishop John Parkes said the organisation has established an infection control working group and introduced staffing changes including appointing a nurse advisor and nurse practitioner.

“While noting the unique circumstances arising from this year’s influenza outbreak, St John’s Village fully recognises the need to ensure that it has systems and procedures in place which can withstand such challenges. St John’s Village is therefore committed to rectifying gaps identified in the report as a matter of urgency.”

St John’s Village said it has reported its former acting care services manager to the Australian Health Practitioner Regulation Authority.

Industry-wide review

As AAA has reported, the Australian Aged Care Quality Agency is currently conducting a sector-wide survey of residential aged care services’ infection control practices and preparedness to respond to influenza and gastroenteritis outbreaks, including gathering data on vaccination rates and training.

Minister Wyatt said based on the results, the agency will follow up with facilities that have “registered low vaccination rates or difficulties managing the 2017 flu season.”

The Quality Agency is also running staff seminars in every jurisdiction to strengthen quality monitoring around infection control and increase staff and resident vaccinations, he said.

Targeted aged care communication and education materials will be developed for the 2018 influenza season to further promote staff influenza vaccination.

“I am closely monitoring developments, and ensuring all government-funded aged care facilities are prepared for infectious outbreaks, especially influenza, is a top priority,” said Minister Wyatt.

Australia’s chief medical officer Professor Brendan Murphy is currently examining ways to boost vaccination rates among residential aged care workers including making the flu vaccination compulsory.

Australia experienced an increase in the number of flu-related deaths in 2017 and the effectiveness of the seasonal flu vaccine has been estimated to have been low.

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2 Responses to Review audits highlight skill gaps in infection control

  1. Care worker November 19, 2017 at 8:24 am #

    I think you will find that all aged care facilities lack the replacement staff when more than two staff are ill and away at any one time.
    This puts an extreme work load on the remaining staff of lockdown ,extra time taken with the implementation of PPE and additional infection control rehydration and a heightened level of care for their clients, staff also take on more shifts to cover sick workers putting themselves at risk of burnout and illness. which usually happens exasibating the problem . it is not unusual for 2 staff to look after 30 to 40 clients during an outbreak.
    And I was told that we are not able to use agency staff to replace sick staff as they are at risk then of spreading infection to the outside and other facilities.
    What is the solution ,

  2. Anonymous November 21, 2017 at 10:26 am #

    Hmm, Nursing homes became … Care facilities. You took the nursing out of Aged Care to reduce costs! the Industry didn’t see the need for the skills and now you identify a skills gap! How much did that audit and report cost to demeonstrate the obvious. No mimimum standards, no staffing level requirements…. don’t blame the care workers, in fact don’t even mention the care workers – you need to audit the people making the decisions.

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