Improving hand hygiene, staff training and  antimicrobial stewardship are among strategies to prevent aged care residents going to hospital because of infections, a Monash University study shows.

The study undertaken by Monash University’s Centre for Medicine Use and Safety explored the root causes of the infections as part of its investigation into strategies to prevent infection-related hospitalisations from residential aged care.

The research, published in the International Journal for Environmental Research and Public Health in May, involved a review of 49 consecutive infection-related hospitalisations of residents at six Resthaven aged care facilities.

The most common type of infection leading to hospitalisation was respiratory (59 per cent) followed urinary (29 per cent) and skin (10 per cent).

The study found that strategies to prevent infections occurring in the first place can help avoid potentially unnecessary hospitalisations.

They include vaccinations, promoting hand hygiene and staff education, and treating infections early, such as administering appropriate antimicrobials.

Project senior researcher Professor Simon Bell said infections were the leading cause of hospitalisations from residential aged care.

Simon Bell

“Residents of aged care services often live in close proximity to one another and they have co-morbidities that might of course increase the risk of infection,” Professor Bell told Australian Ageing Agenda.

Previous research found that about 25 per cent of hospitalisations in Australian aged care facilities were infection related, he said.

“We also know that from the international literature that estimates range from about 13-67 per cent of hospitalisations are potentially preventable,” said Professor Bell, director of the Centre for Medicine Use and Safety.

Potential root causes of infections include a resident’s vaccination status or medications that may increase infection risk, he said.

“If people need to take those medicines in the cases where it can’t be avoided, then there needs to be appropriate monitoring to minimise the risk of infection, or to identify and to monitor that risk,” Professor Bell said.

Increasing awareness and access to evidence-based resources for managing infections, such as therapeutic guidelines are also important, he said.

Other strategies to prevent infection-related hospitalisations include employing pharmacists on aged care teams to help ensure appropriate antimicrobial use, ensuring there are clinical pathways for staff to respond to specific infections and having telehealth services to review and inform the decision to initiate hospital transfers.

Professor Bell said many of the strategies can be implemented by aged care providers at a relatively low cost, including ensuring there is access to evidence-based resources for managing infections.

View the study Root Cause Analysis to Identify Medication and Non-Medication Strategies to Prevent Infection-Related Hospitalizations from Australian Residential Aged Care Services here.

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