INFECTION CONTROL
Infection control
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in aged care Sean Rooney, Chief Executive Officer, Leading Age Services Australia (LASA)
I
n recent times we have increased protections for older Australians in aged care, with the Infection Prevention and Control (IPC) leads in aged-care homes, high-rate vaccinations for residents and mandatory immunisation for staff. The Australian Institute of Health and Welfare has reported on the direct and indirect health effects of the pandemic across the country, covering the 12 months since April 2020. People living in residential aged-care facilities made up 75% of Australian deaths from COVID-19, despite only making up 7% of the total cases. Until the beginning of December, there were 671 older people who died from COVID-19 in aged-care homes and they were at least 24% in the 85- to 89-year age group and 34% in those aged 90 and over. As COVID-19 infections played out across our communities in 2020, we all learnt it was nothing like a gastro or influenza outbreak. Sadly, there were deaths in Dorothy Henderson Lodge and Newmarch House in Sydney and when COVID-19 appeared in homes in Melbourne, it hit with speed 60
HOSPITAL + HEALTHCARE
across multiples of homes across a very short period. All at a time when personal protective equipment (PPE) was unavailable or highly priced.
Some aged-care providers have sourced their own teams to assist with polymerase chain reaction or RAT testing and now conduct their own contact tracing.
People in general — aged-care teams, governments and sector specialists — were all still learning how this virus was spreading; we were building the plane as it was taking off.
At the end of 2020, the Royal Commission released a special report on COVID-19, calling for an ‘infection control champion’ in every aged-care facility in Australia.
Should we wear masks, should case zero be sent to a hospital or remain in a specific area of a non-purpose built nursing home? When facilities notified public health authorities of a positive case, some waited four days for testing of staff and residents. Now we have more understanding of the virus, enhanced Outbreak Management Plans based on lessons learned, trained IPC leads and trained teams of aged-care staff and the use of rapid antigen testing (RAT) in some settings. We also understand the importance of donning and doffing PPE safely, plus the other controls of new respiratory etiquette, wearing face masks, physical distancing and improving hand hygiene. SPRING 2021
The federal government accepted the recommendation and provided funding of $217.6 million to residential aged-care providers and required all sites to engage an infection prevention control (IPC) lead. Depending on the individual, the focus on online coursework was also challenging. The course was designed to be completed in 80 hours and the targeted IPC training included delivery in a face-to-face format. Training delivery is sensitive to the agedcare setting, the workforce composition, language proficiency, background education, demographics and flexible to be replicated in rural and regional locations. The older age groups were among the most vulnerable during the pandemic and that remains the case, although the vaccinations will have given them added protection.
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