Department of Aged Care, Royal Melbourne Hospital, Level 8 CRM, 300 Grattan Street, Parkville, VIC, 3050, Australia.
Department of Medicine - Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3010, Australia.
BMC Geriatr. 2023 Feb 23;23(1):109. doi: 10.1186/s12877-023-03766-9.
Older people living in residential aged care facilities are at high risk of acquiring infections such as influenza, gastroenteritis, and more recently COVID-19. These infections are a major cause of morbidity and mortality among this cohort. Quality infection prevention and control practice in residential aged care is therefore imperative. Although appointment of a dedicated infection prevention and control (IPC) lead in every Australian residential aged care facility is now mandated, all people working in this setting have a role to play in IPC. The COVID-19 pandemic revealed inadequacies in IPC in this sector and highlighted the need for interventions to improve implementation of best practice.
Using mixed methods, this four-phase implementation study will use theory-informed approaches to: (1) assess residential aged care facilities' readiness for IPC practice change, (2) explore current practice using scenario-based assessments, (3) investigate barriers to best practice IPC, and (4) determine and evaluate feasible and locally tailored solutions to overcome the identified barriers. IPC leads will be upskilled and supported to operationalise the selected solutions. Staff working in residential aged care facilities, residents and their families will be recruited for participation in surveys and semi-structured interviews. Data will be analysed and triangulated at each phase, with findings informing the subsequent phases. Stakeholder groups at each facility and the IMMERSE project's Reference Group will contribute to the interpretation of findings at each phase of the project.
This multi-site study will comprehensively explore infection prevention and control practices in residential aged care. It will inform and support locally appropriate evidence-based strategies for enhancing infection prevention and control practice.
居住在养老院的老年人感染流感、肠胃炎等疾病的风险很高，最近还感染了 COVID-19。这些感染是该人群发病率和死亡率的主要原因。因此，在养老院进行高质量的感染预防和控制实践是至关重要的。虽然现在要求每个澳大利亚养老院都指定一名专门的感染预防和控制（IPC）负责人，但所有在该环境中工作的人都在 IPC 中发挥作用。COVID-19 大流行揭示了该行业 IPC 的不足，并强调需要采取干预措施来改善最佳实践的实施。
本四项实施研究将采用混合方法，利用理论指导的方法：（1）评估养老院进行 IPC 实践变革的准备情况，（2）使用基于情景的评估来探索当前的实践，（3）调查最佳实践 IPC 的障碍，（4）确定和评估可行且适合当地的解决方案，以克服确定的障碍。IPC 负责人将接受培训并得到支持，以实施选定的解决方案。将招募居住在养老院的工作人员、居民及其家属参与调查和半结构化访谈。将在每个阶段进行数据分析和三角测量，研究结果将为后续阶段提供信息。每个设施的利益相关者团体和 IMMERSE 项目的参考小组将有助于解释项目各个阶段的研究结果。
本多地点研究将全面探讨养老院的感染预防和控制实践。它将为加强感染预防和控制实践提供信息和支持，并提供基于证据的本地适用策略。
