Identifying gaps in infection prevention and control practice in Australian residential aged care using scenarios.

Abstract

Background: Older people living in residential aged care are vulnerable to infections. High quality infection prevention and control (IPC) practice is therefore vital in this setting. It is important to assess current IPC practice to identify areas where best practice is lacking, and where improvement efforts could most effectively be targeted. The aim of this study was to identify evidence-practice gaps in IPC practice in residential aged care.

Methods: This study used two scenarios to assess use of a range of standard and transmission-based precautions in residential aged care. Systematic methods were used to design the scenarios. Twenty-seven staff from four residential aged care facilities participated in semi-structured interviews. Participants were presented with the scenarios and asked what IPC actions they would take in everyday practice. Individual and team-based practice was explored. Participants reported practices were then compared to evidence-based practice.

Results: Results from both scenarios were combined and a total of 11 evidence-practice gaps identified. These included gaps in performing hand hygiene before touching a resident (for example, when helping a resident transfer) and not donning protective eyewear or face shield before taking a nasal/throat swab on the resident with suspected respiratory viral infection.

Conclusion: The use of scenarios provided a practical and acceptable method to rapidly assess a range of IPC practices among a diverse group of participants. The IPC evidence-practice gaps identified will be used in the next phase of work where barriers to uptake of the identified IPC evidence-practice gaps will be explored.