Analysis of infection prevention and control documentation in residential aged care based on a behaviour specification framework.

Background: Clear specification of desired behaviour within evidence-based guidelines and policies might make them more actionable, i.e. increase the likelihood that those behaviours will take place in practice. It was our expectation that the level of specificity in such documents would be higher, i.e. more detailed, at the organisational level compared with the national level, given that local documents are developed for a specific setting and workforce. This study aimed to compare infection prevention and control (IPC) behaviours and their specificity in a national guideline with local residential aged care policies and procedures.

Methods: The document analysis was informed by the Action, Actor, Context, Target and Time (AACTT) framework. The Australian Guidelines for the Prevention and Control of Infection in Healthcare and the local policies and procedures of eight residential aged care providers were investigated.

Results: There was some overlap between behaviours in the national guideline and local policies and procedures. However, of the 63 behavioural statements in the guideline relating to hand hygiene and appropriate use of gloves and masks, only eight statements were mentioned by all residential aged care providers. Twelve statements were mentioned in the local policies and procedures but not mentioned in the guideline and two statements mentioned locally seemed to conflict with the guideline. IPC statements were generally not well specified in either the national guideline or local documents.

Conclusion: Local policies and procedures should be more aligned with national guidelines to reflect the evidence base. Once this alignment is in place, attention should be given to increasing the specificity and actionability of these documents.