Infection rates in residential aged care facilities, Grampians region, Victoria, Australia

Mary Smith (A D) , Ann L. Bull (B) , Michael Richards(B ) , Pauline Woodburn (C) and Noleen J. Bennett (B)

(A) Department of Health, Grampians Region, 21 McLachlan Street, Horsham, Victoria, 3400 Vic., Australia.
(B) Victorian Healthcare Associated Infection Surveillance System (VICNISS) Co-ordinating Centre, 10 Wreckyn St, North Melbourne, 3051, Vic., Australia.
(C) Bendigo Health, 62 Lucan St, Bendigo, 3550 Vic., Australia.
(D) Corresponding author. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Healthcare Infection 16(3) 116-120
Submitted: 14 June 2011  Accepted: 12 August 2011   Published: 26 September 2011

Abstract

In 2010, 30 eligible residential aged care facilities (RACFs) in the Grampians region, Victoria, participated in a 6-month pilot healthcare-associated infection (HAI) surveillance program. The aims of the pilot program were to establish if there was a need for a program, and if yes, to determine if the program, as currently structured, was plausible. Data was continuously collected for five surveillance modules – ‘bronchitis and tracheo-bronchitis’, ‘cellulitis’, ‘conjunctivitis’, ‘gastroenteritis’ and ‘symptomatic urinary tract infections’. The overall confirmed and total (confirmed and excluded) infection rates were 2.2 and 3.6 infections per 1000 resident days, respectively.

Infections reported by clinical staff employed at the RACFs had to be either confirmed or excluded by an infection control consultant. The main reason infections could not be confirmed was because supporting documentation was incomplete.

Although the infection rates were lower or equivalent to those reported elsewhere, it was recommended that the implementation of an HAI surveillance program in the Grampians RACFs be considered. Some program elements, such as the supporting documentation and infection definitions, would need to be reviewed.

• [1]  Australian Government. Residential aged care in Australia 2007–08. Canberra, Australian Government. 2009.
• [2]  Garibaldi RA. Residential care and the elderly: the burden of infection. J Hosp Infect 1999; 43: S9–18.
  | CrossRef |
• [3]  Nicolle LE. Preventing infections in non-hospital settings: long-term care. Emerg Infect Dis 2001; 7: 205–7.
  | CrossRef | CAS |
• [4]  Strausbaugh LJ, Joseph CL. The burden of infection in long-term care. Infect Control Hosp Epidemiol 2000; 21: 674–9.
  | CrossRef | CAS |
• [5]  Finn JC, Flicker L, Mackenzie E, Jacobs IG, Fatovich DM, Drummond S, et al Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia. Med J Aust 2006; 184: 432–5.
• [6]  Finucane PM, Wundke R, Whitehead C, Williamson L, Baggoley CJ. Profile of people referred to an emergency department from residential care. Aust N Z J Med 1999; 29: 494–9.
  | CrossRef | CAS |
• [7]  Hillen JC, Reed RL, Woodman RJ, Law D, Hakendorf PH, Fleming BJ. Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999). Australas J Ageing 2010; : .
  | CrossRef |
• [8]  Reilly M. Infection surveillance in residential aged high care facilities in Western Australia. Griffith University, Brisbane, 2001.
• [9]  Forrest J. Bean Counting the Bugs: Evaluation of 5 years of infection surveillance data in 6 residential aged care facilities. Australian Infection Control Association, Sydney 2006.
• [10]  Calver J, Horner B, Boldy D, Bulsara M. The burden of infectious diseases in Western Australian residential aged care facilities: a population-based record linkage study. Australian Infection Control 2006; 11: 79–89.
• [11]  Karmel R, Gibson D, Lloyd J, Anderson P. Transitions from hospital to residential aged care in Australia. Australas J Ageing 2009; 28: 198–205.
  | CrossRef |
• [12]  Australian Government Department of Health and Aging . http://www.agedcareaustralia.gov.au/internet/agedcare/publishing.nsf/Content/Glossary+Index+H
  [13]  Australian Commission on Safety and Quality in Healthcare. Report on National Clostridium difficile Infection Workshop, 2010, Commonwealth of Australia, Canberra.
• [14]  McGeer A, Campbell B, Emori TG, Hierholzer WJ, Jackson MM, Nicolle LE, et al Definitions of infection for surveillance in long-term care facilities. Am J Infect Control 1991; 19: 1–7.
  | CrossRef | CAS |
• [15]  Nicolle LE, Strausbaugh LJ, Garibaldi RA. Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev 1996; 9: 1–17.
  | CAS |
• [16]  Australian Government Department of Health and Aging. Infection Control Guidelines for the prevention of transmission of infectious diseases in the healthcare setting. Canberra, Australian Government Publishing Service 2004.
• [17]  Simor AE. The role of the laboratory in infection prevention and control programs in long-term-care facilities for the elderly. Infect Control Hosp Epidemiol 2001; 22: 459–63.
  | CrossRef | CAS |
• [18]  Brusaferro S, Regattin L, Silvestro A, Vidotto L. Incidence of hospital-acquired infections in Italian long-term-care facilities: a prospective six-month surveillance. J Hosp Infect 2006; 63: 211–5.
  | CrossRef | CAS |
• [19]  Engelhart ST, Hanses-Derendorf L, Exner M, Kramer MH. Prospective surveillance for healthcare-associated infections in German nursing home residents. J Hosp Infect 2005; 60: 46–50.
  | CrossRef | CAS |
• [20]  Eriksen HM, Koch AM, Elstrom P, Nilsen RM, Harthug S, Aavitsland P. Healthcare-associated infection among residents of long-term care facilities: a cohort and nested case-control study. J Hosp Infect 2007; 65: 334–40.
  | CrossRef | CAS |
• [21]  Collignon P, Dreimanis D, Feguson J, van Gessel H, Taylor P, Wilkinson I. et al. Bloodstream infection. In Cruickshank M, Ferguson J, eds. Reducing Harm to Patients from Health Care Associated Infections: The Role of Surveillance. Canberra, Commonwealth of Australia 2008.
• [22]  Woodburn P. Residential Aged Care Facility Point Prevalence Surveillance of Infection and Device use. 2010. Rural Infection Control Practice Group, Melbourne.
• [23]  Nicolle LE. The chronic indwelling catheter and urinary infection in long-term-care facility residents. Infect Control Hosp Epidemiol 2001; 22: 316–21.
  | CrossRef | CAS |
• [24]  Kirk MD, Hall GV, Veitch MG, Becker N. Assessing the incidence of gastroenteritis among elderly people living in long term care facilities. J Hosp Infect 2010; 76: 12–7.
  | CrossRef | CAS |
• [25]  Berman P, Hogan DB, Fox RA. The atypical presentation of infection in old age. Age Ageing 1987; 16: 201–7.
  | CrossRef | CAS |
• [26]  High KP, Bradley SF, Gravenstein S, Mehr DR, Quagliarello VJ, Richards C, et al Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 48: 149–71.
  | CrossRef |
• [27]  Norman DC. Fever in the elderly. Clin Infect Dis 2000; 31: 148–51.
  | CrossRef | CAS |
• [28]  Brooks S, Warshaw G, Hasse L, Kues JR. The physician decision-making process in transferring nursing home patients to the hospital. Arch Intern Med 1994; 154: 902–8.
  | CrossRef | CAS |
• [29]  Golliot F, Astagneau P, Cassou B, Okra N, Rothan-Tondeur M, Brucker G. Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance. Infect Control Hosp Epidemiol 2001; 22: 746–53. | CrossRef | CAS |