MIPS Research Summary: Preventing infection-related hospitalisation of older adults by identifying root causes

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A new study, performed in collaboration with Resthaven Incorporated and the Centre for Medicine Use and Safety, is providing insight and strategies to prevent infection-related hospitalisations from Australian Residential Aged Care Services (RACS).

Transmission of infection within RACS can be challenging to manage because residents live in close proximity to each other, can have complex health conditions and are often in close contact with health care workers. Developing strategies to prevent and monitor infections in RACFS is important to contain the spread of infection between residents and healthcare workers. Infection control is particularly pertinent when considering the increasing prevalence of antimicrobial resistance.

To ascertain the underlying issues and actions that lead to infection-related hospitalisation, researchers performed root cause analysis of residents in 6 RACS in South Australia.

Researchers reviewed the records from 383 residents and found that 41 residents had infection-related hospitalisation, with a total of 49 hospitalisations. Of these events respiratory infections accounted for 59 per cent followed by 28 per cent for urinary and 10 per cent for skin infections.

Factors identified by researchers as contributing to infection-related hospitalisations included:

  • suboptimal selection of antimicrobial therapy;
  • limited access to medical services (e.g. pathology);
  • vaccination status, and;
  • challenges with communication and coordination of relevant health professionals.

From the root cause analysis, researchers identified a number of strategies that could prevent future infection-related hospitalisations. These strategies included:

  • improving timely access to medical services available to RACS;
  • conducting a medication review;
  • promoting antimicrobial stewardship in RACFs and;
  • identifying infection earlier.

Further to the above strategies, researchers also outlined a model of care involving a multidisciplinary team of healthcare providers (such as geriatricians, nurse practitioners and clinical nurse) that could assist RACS by delivering additional support that is not currently available.

For each of the 49 infection-related hospitalisations, a nurse and a pharmacist conducted an in-depth review of nursing progress notes, medical records, medication charts, hospital summaries, and incident reports using a purpose-built collection tool. A multidisciplinary panel then made recommendations in relation to possible strategies to prevent the hospitalisation.

The recent findings of this study were recently published in the International Journal of Environment Research and Public Health.

Article: Root Cause Analysis to Identify Medication and Non-Medication Strategies to Prevent Infection-Related Hospitalizations from Australian Residential Aged Care Services.

MIPS Authors: Janet Sluggett, Samanta Lalic, Sarah Hosking, Jenni Ilomaki and Simon Bell

Access the article here