Mitchell Brett G, Shaban Ramon Z, MacBeth Deborough, Russo Philp
Discipline of Nursing, Avondale College of Higher Education, Wahroonga, NSW, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown. NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia.
Infect Dis Health. 2019 Nov;24(4):187-193. doi: 10.1016/j.idh.2019.06.004. Epub 2019 Jul 3.
Individuals in residential and aged care facilities (RACFs) are at risk of developing health care-associated infections (HAIs) due to factors such as age-related changes in physiology, immunity, comorbid illness and functional disability. The recent establishment of an Australian Royal Commission into the Quality of Residential and Aged Care Services highlights the challenges of providing care in this sector. This national study identified infection prevention and control (IPC) services, practice and priorities in Australian RACFs.
A cross-sectional study of 158 Australian RACFs comprising a 42-question survey incorporating five key domains relating to IPC namely governance, education, practice, surveillance, competency and capability was undertaken in 2018.
Of the 131 respondents, the majority 92.4% of respondents reported having a documented IPC program, 22.9% (n = 30) operated with a dedicated infection control committee The majority of RACFs reported lacking specialist and qualified experienced IPC professionals (n = 67). The majority of RACFs (90.1%, n = 118) reported the existence of a designated employee with IPC responsibilities. Of these 118 staff members with IPC responsibilities, 42.5% had a qualification in IPC. The reported average funded hours per month for IPC professional or an external provider of IPC activities was 14 (95% CI 9.6-18.9 h).
The overwhelming majority of RACFs deliver IPC services and report doing so in ways that meet the needs of their own specific contexts in the absence of the lack of formal guidelines when compared to the hospital sector. Quality residential and aged care free from HAIs requires formal structure and organization strategies.
由于生理、免疫、共病及功能残疾等与年龄相关的变化等因素，入住寄宿及老年护理机构（RACF）的个体有发生医疗保健相关感染（HAI）的风险。澳大利亚近期成立了皇家委员会，调查寄宿及老年护理服务质量，凸显了该领域提供护理服务面临的挑战。这项全国性研究确定了澳大利亚RACF中的感染预防与控制（IPC）服务、实践及重点事项。
2018年对158家澳大利亚RACF进行了横断面研究，采用包含42个问题的调查问卷，涵盖与IPC相关的五个关键领域，即治理、教育、实践、监测、能力和资质。
在131名受访者中，大多数（92.4%）报告有书面的IPC计划，22.9%（n = 30）设有专门的感染控制委员会。大多数RACF报告缺乏专业且经验丰富的IPC专业人员（n = 67）。大多数RACF（90.1%，n = 118）报告有指定的负责IPC的员工。在这118名负责IPC的员工中，42.5%拥有IPC相关资质。报告显示，IPC专业人员或外部IPC活动提供者每月平均获得资金支持的工作时长为14小时（95%置信区间9.6 - 18.9小时）。
与医院部门相比，绝大多数RACF在缺乏正式指南的情况下，提供IPC服务，并报告其提供方式符合自身特定情况的需求。优质的无HAI寄宿及老年护理需要正式的结构和组织策略。
