Where do you start when it comes to identifying infection hazards in aged care?
Let’s start by outlining why it is so important to identify and manage infection hazards in aged care. The Victorian DHHS states that “Older adults with multiple comorbidities and high care needs living in residential aged care facilities are at risk of acquiring infections because of close living proximity and frequent contact between residents and staff”. To help keep them safe, people living and working in this shared space need to take precautions to minimise the risk of infection transmission.
So, we know why it is important to identify and manage infection hazards in aged care, but what are the most common hazards?
Non-compliance with standard precautions
One of the biggest general infection hazards/risks is non-compliance with standard precautions. As you know, to achieve a basic level of infection prevention and control, standard precautions are to be used at all times, for all residents, in all situations.
Let’s break down the work practices of standard precautions to identify what the infection hazards are when standard precautions are not appropriately undertaken.
Hand hygiene is the most effective means of preventing the transmission of infection. The World Health Organization (WHO) notes that hand hygiene should be performed by staff in all healthcare settings at particular moments, that is, the 5 Moments of Hand Hygiene. However, it is not only when you wash your hands but also how you wash your hands that is important.
‘Poor hand hygiene compliance among healthcare workers is strongly associated with healthcare associated infection (HAI) transmission and is a major factor in the spread of antibiotic-resistant organisms within hospitals. Improving hand hygiene among healthcare workers will help the spread of antibiotic–resistant organisms within healthcare settings.’
We have identified that poor hand hygiene is a major infection hazard, so onto another infection hazard in aged care, another standard precaution work practice, that if not performed correctly is an infection hazard.
The use of sharp devices exposes healthcare workers to the risk of injury and potential exposure to bloodborne infectious agents, including hepatitis B virus, hepatitis C virus and HIV.
Safe work practices should be in place when handling needles and other sharp objects. This includes:
- not re-capping used needles
- immediately disposing of sharps in an appropriate sharps’ container at the point of use
- transporting the sharps container on a trolley rather than carrying it
- storing sharps containers in a secure area and 1.3–1.5 metres from the floor
- not overfilling sharps bins.
If these safe work practices are not adhered to, staff are at risk of injury and potentially serious infections.
Infectious agents can be widely found in healthcare settings and there is a body of clinical evidence, derived from case reports and outbreak investigations, suggesting an association between poor environmental hygiene and the transmission of infectious agents in healthcare settings. A risk of transmission of infectious agents from the environment to residents may occur through direct contact with contaminated equipment, furniture and other items, or indirectly via hands that are in contact with contaminated equipment or the environment that then touch the resident.
Each facility will have a routine environmental cleaning schedule and a cleaning method statement, based on assessment of the risk of transmission of infection within a particular healthcare facility. The risk of transmission of particular infections should be assessed and the cleaning schedule should be adjusted if a known infectious agent is present (e.g. an outbreak of norovirus).
When routine environmental cleaning is not carried out thoroughly, using the correct method, correct product and correct frequency, there is an increased risk of transmission of infection. MRSA can survive on some surfaces, like towels, razors, furniture and athletic equipment, for hours, days, or even weeks. VRE can survive in the environment for several days to weeks.
The above survival times for MRSA and VRE are surely the reason why undetailed, careless cleaning is such an enormous infection risk.
Infection control requires not only constant diligence, but also correct procedure each and every time in order to prevent the transmission of infection. While there are many areas where infection control can fall down, the main infection hazards for aged care are those ones that we complete many times during the course of a shift.
You don’t know what you don’t know. If you want to improve infection control in your facility but don’t know where to start, book an audit with Bug Control now.