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Infection control should be a concern for aged care executives, not just clinicians: experts

Facility design and materials play a part in controlling the spread of infection in aged care, and with the rise of multi-resistant organisms, experts say aged care executives need to be involved.

Issues such as cleanliness, odour control and the potential spread of infectious organisms are all ongoing areas of concern within the aged care sector, according to Greg Whiteley, managing director of Whiteley Corporation, a provider of aged care infection control solutions.

Greg Whiteley

Greg Whiteley

As aesthetics and a desire for a homelike environment drive processes more in aged care than they do in healthcare, the design of facilities and diversity of materials used to minimise and control infection are different, he said.

“In aged care you have a much higher frequency of incontinence, which is a substantial issue. Straightaway that leads to a range of odour control issues,” Mr Whiteley told Australian Ageing Agenda.

For example, things that affect aesthetics and sound, such as floor and wall coverings and furnishings, also have the ability to absorb odours, said Mr Whiteley. Air changes, air flow through a facility and the location of particular client groups also had a substantial impact, he said.

“The mixture of materials and smells gives you very different outcomes. In a well-run aged care facility you won’t have any odours because they will be well-designed and well-managed,” he said.

Home versus hospital

While an aged care facility was a resident’s home, for the sake of infection control there still needed to be a health-focused approach, said Margaret Jennings, a microbiologist, infection control educator and consultant.

“There is a failure by staff in aged care right from management down to recognise that it’s not a resort or a hotel,” Ms Jennings told AAA.

She argued the most appropriate approach to follow for infection control in aged care was the healthcare standard because aged care residents were the most vulnerable in the community, staff conduct high levels of clinical care and there was a lot of contact with bodily fluids.

Top-down policy

Margaret Jennings

Margaret Jennings

As infection control was more than a clinical practice issue, Ms Jennings said senior management needed to take a greater interest in the area, understand the issues and ensure facility procedures were adequate.

According to aged care’s quality standards, providers must have an effective infection control program, however, Ms Jennings said many of the organisational policies, procedures and practices she saw were outdated.

Among key areas she looked for were whether alcohol was touted as gold standard for clinical care and that there was an expectation that all staff would have their influenza shot annually.

Staff education is the other area where policies and procedures were falling short because staff were often not sufficiently educated on infection control, she said.

“One of the most common things I have to repeat is that during a gastro outbreak you do not use alcohol for hand hygiene, you go back to hand washing for everything because the norovirus, which is the most common cause of gastro outbreaks, is not as affected by the alcohol.”

Ms Jennings said the latest hot topic particularly relevant to management was the rise of multi-resistant organisms (MROs), such as MRSA, which she said all facilities had and that it was directly related to the use of antibiotics. She recommended facilities took on anti-microbial stewardship to refine when to use antibiotics.

An extended version of this report appears in the current issue of AAA magazine (July-August) 

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