1
|
Bolsewicz KT, White J, Murray P, Vidler M, Durrheim DN. "COVID-19 - A Perfect Storm": A Qualitative Exploration of Residential Care Facility Managers Perspectives on the Psychosocial Impacts of COVID-19. J Appl Gerontol 2024:7334648241238920. [PMID: 38587987 DOI: 10.1177/07334648241238920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Growing evidence highlights the negative impact of managing the COVID-19 pandemic on the wellbeing of the healthcare workforce, including in the aged care sector. We undertook a qualitative study during the pandemic's third year to explore the psychosocial impacts on nine managers of residential care facilities (RCFs) across metropolitan and rural New South Wales, the largest state in Australia. Four themes were identified: (1) Increased pressure on maintaining aged care services, (2) Increased responsibility on RCF managers, (3) Psychosocial impacts due to accumulating pressures, and (4) Experience of beneficial supports. COVID-19 compounded pre-pandemic sector challenges and added new stressors. While resilient and resourceful, RCF managers experienced workplace stress and burnout, which may affect quality of resident care and impact on staff retention. There is a need for more investment to effectively support staff, and research to identify optimal psychosocial and management supports.
Collapse
Affiliation(s)
- Katarzyna T Bolsewicz
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer White
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Peter Murray
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Megan Vidler
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - David N Durrheim
- Health Protection, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
2
|
Gilbert AS, Garratt SM, Brijnath B, Ostaszkiewicz J, Batchelor F, Dang C, Dow B, Goh AMY. "Keeping our distance": Older adults' experiences during year one of the COVID-19 pandemic and lockdown in Australia. J Aging Stud 2023; 67:101170. [PMID: 38012941 DOI: 10.1016/j.jaging.2023.101170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 11/29/2023]
Abstract
The first year of the COVID-19 pandemic had a profound impact on everyday life in Australia despite relatively low infection rates. Lockdown restrictions were among the harshest in the world, while older adults were portrayed as especially vulnerable by politicians and the media. This study examines the perceptions and experiences of the pandemic and lockdowns among 31 older Australians. We investigated how participants perceived their own vulnerability, their attitudes towards lockdowns and protective behaviors, and how the pandemic affected everyday life. We found that participants were cautious about COVID-19 and vigilant observers of physical distancing. Despite approving of public health guidelines and lockdowns, participants raised concerns about weakening social ties and prolonged social isolation. Those living alone or lacking strong family ties were most likely to report increased loneliness. Most participants nonetheless regarded themselves as "fortunate": they perceived older age as affording them financial, emotional, and relational stability, which insulated them from the worst impacts of the coronavirus pandemic. In their views, financial independence and post-retirement lifestyles helped them adapt to isolation and the disruption of lockdowns.
Collapse
Affiliation(s)
- Andrew S Gilbert
- National Ageing Research Institute, Parkville, VIC, Australia; La Trobe University, Melbourne, VIC, Australia.
| | - Stephanie M Garratt
- National Ageing Research Institute, Parkville, VIC, Australia; Monash University, Melbourne, Australia
| | - Bianca Brijnath
- National Ageing Research Institute, Parkville, VIC, Australia; Curtin University, Perth, WA, Australia; University of Western Australia, WA, Australia
| | - Joan Ostaszkiewicz
- National Ageing Research Institute, Parkville, VIC, Australia; Deakin University, Melbourne, VIC, Australia
| | - Frances Batchelor
- National Ageing Research Institute, Parkville, VIC, Australia; Deakin University, Melbourne, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia
| | - Christa Dang
- National Ageing Research Institute, Parkville, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, VIC, Australia; Deakin University, Melbourne, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia
| | - Anita M Y Goh
- National Ageing Research Institute, Parkville, VIC, Australia; The University of Melbourne, Parkville, VIC, Australia; Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia.
| |
Collapse
|
3
|
Watson E, Dowson L, Dunt D, Thursky K, Worth LJ, Sluggett JK, Appathurai A, Bennett N. Identifying barriers and enablers to participation in infection surveillance in Australian residential aged care facilities. BMC Public Health 2023; 23:2160. [PMID: 37924023 PMCID: PMC10625226 DOI: 10.1186/s12889-023-16891-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Infection surveillance is a vital part of infection prevention and control activities for the aged care sector. In Australia there are two currently available infection and antimicrobial use surveillance programs for residential aged care facilities. These programs are not mandated nor available to all facilities. Development of a new surveillance program will provide standardised surveillance for all facilities in Australia. METHODS This study aimed to assess barriers and enablers to participation in the two existing infection and antimicrobial use surveillance programs, to improve development and implementation of a new program. A mixed-methods study was performed. Aged Care staff involved in infection surveillance were invited to participate in focus groups and complete an online survey comprising 17 items. Interviews were transcribed and analysed using the COM-B framework. RESULTS Twenty-nine staff took part in the focus groups and two hundred took part in the survey. Barriers to participating in aged care infection surveillance programs were the time needed to collect and enter data, competing priority tasks, limited understanding of surveillance from some staff, difficulty engaging clinicians, and staff fatigue after the COVID-19 pandemic. Factors that enabled participation were previous experience with surveillance, and sharing responsibilities, educational materials and using data for benchmarking and to improve practice. CONCLUSION Streamlined and simple data entry methods will reduce the burden of surveillance on staff. Education materials will be vital for the implementation of a new surveillance program. These materials must be tailored to different aged care workers, specific to the aged care context and provide guidance on how to use surveillance results to improve practice.
Collapse
Affiliation(s)
- Eliza Watson
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia
| | - Leslie Dowson
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - David Dunt
- Professor Emeritus, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Karin Thursky
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 , Australia
- The Royal Melbourne Hospital Guidance Group, Melbourne, VIC, 3000, Australia
| | - Leon J Worth
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010 , Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Janet K Sluggett
- University of South Australia, UniSA Allied Health and Human Performance, Adelaide, SA, 5001, Australia
- Registry of Senior Australians (ROSA), Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA, 5001, Australia
| | - Amanda Appathurai
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Noleen Bennett
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, VIC, 3000, Australia.
- National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Parkville, VIC, 3010, Australia.
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
| |
Collapse
|
4
|
Dadich A, Kearns R, Harris-Roxas B, Ni Chroinin D, Boydell K, Ní Shé É, Lim D, Gonski P, Kohler F. What constitutes brilliant aged care? A qualitative study of practices that exceed expectation. J Clin Nurs 2023; 32:7425-7441. [PMID: 37314051 DOI: 10.1111/jocn.16789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
AIM This study aimed to explore what constitutes brilliant aged care. BACKGROUND Although many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care-practices that exceeded expectation. DESIGN The methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning. METHODS This study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency. RESULTS According to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise. CONCLUSIONS This study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation. RELEVANCE TO CLINICAL PRACTICE For those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms. PATIENT OR PUBLIC CONTRIBUTION The nominees, who included carers, were invited to participate in workshops with other carers and older people to co-design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data.
Collapse
Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, Parramatta, New South Wales, Australia
| | - Rachael Kearns
- Institute for Culture and Society, Western Sydney University, Penrith, New South Wales, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Danielle Ni Chroinin
- South Western Sydney Local Health District, University of New South Wales, Liverpool, New South Wales, Australia
| | | | - Éidín Ní Shé
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Lim
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Peter Gonski
- South Eastern Sydney Local Health District & University of New South Wales, Sydney, New South Wales, Australia
| | - Friedbert Kohler
- HammondCare Health, South Western Sydney Local Health District & University of New South Wales, Prairiewood, New South Wales, Australia
| |
Collapse
|
5
|
Dix S, Rawson H, Russo P, Team V, Griffiths D, Morphet J. Practical infection control training for Victoria's aged care workforce at the time of COVID-19 pandemic: a community case study. Front Public Health 2023; 11:1155980. [PMID: 37304118 PMCID: PMC10248151 DOI: 10.3389/fpubh.2023.1155980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
The need to improve career development and training for residential aged care workers in Australia to achieve required essential competencies, including infection prevention and control competencies, has been repeatedly highlighted. In Australia long-term care settings for older adults are known as residential aged care facilities (RACFs). The COVID-19 pandemic has brought to light the lack of preparedness of the aged care sector to respond to emergencies, and the urgent need to improve the infection prevention and control training in residential aged care facilities. The government in the Australian State of Victoria allocated funds to support older Australians in RACFs, including funds toward infection prevention and control training of RACF staff. The School of Nursing and Midwifery at Monash University addressed some of these challenges in delivering an education program on effective infection prevention and control practices to the RACF workforce in Victoria, Australia. This was the largest state-funded program delivered to RACF workers to date in the State of Victoria. The aim of this paper is to provide a community case study, where we share our experience of program planning and implementation during early stages of the COVID-19 pandemic and lessons learned.
Collapse
|
6
|
Kelly RM, Xing Y, Baker S, Waycott J. Video Calls as a Replacement for Family Visits During Lockdowns in Aged Care: Interview Study with Family Members. JMIR Aging 2023. [PMID: 37191951 DOI: 10.2196/40953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Lockdowns have been employed to prevent the spread of transmissible illnesses such as influenza, norovirus, and COVID-19 in care homes. However, lockdowns deny care home residents supplemental care and socioemotional enrichment that comes from seeing family members. Video calling has the potential to enable ongoing contact between residents and family members during lockdowns. Yet video calls can be considered by some as being a poor substitute for in-person visits. It is important to understand family members' experiences with video calling during lockdowns to ensure effective use of this technology in the future. OBJECTIVE This study aimed to understand how family members used video calls to communicate with relatives living in aged care during lockdowns. We focused on experiences during the COVID-19 pandemic, which involved extensive lockdowns in aged care homes. METHODS We conducted semi-structured interviews with 18 adults who had been using video calls with relatives living in aged care during pandemic lockdowns. The interviews focused on how participants had been using video calls, what benefits they gained from video-based interactions, and what challenges they encountered when using the technology. We analysed the data using Braun & Clarke's 6-phase reflexive approach to thematic analysis. RESULTS We developed 4 themes through our analysis. Theme 1 interprets video calling as a medium for continuation of care during lockdowns. Using video calls, family members were able to provide social enrichment for residents and engaged in health monitoring to uphold residents' welfare. Theme 2 highlights how video calling extended care by supporting frequent contact, by transmitting non-verbal cues that were essential for communication, and by negating the need for face masks. Theme 3 interprets organizational issues such as lack of technology and staff time as impediments to continuation of familial care through video. Finally, theme 4 highlights the need for two-way communication, interpreting residents' unfamiliarity with video calling and their health conditions as further barriers to continuation of care. CONCLUSIONS This study suggests that, during restrictions arising from the COVID-19 pandemic, video calls became a medium for enabling family members to continue participating in the care of their relatives. The use of video calls to continue care illustrates their value for families during times of mandatory lockdown, and supports the use of video to complement face-to-face visits at other times. However, better support is needed for video calling in aged care homes. This study also reveals a need for video calling systems that are designed for the aged care context. CLINICALTRIAL
Collapse
Affiliation(s)
- Ryan M Kelly
- School of Computing and Information Systems, University of Melbourne, Parkville, Melbourne, AU
| | - Yushan Xing
- School of Computing and Information Systems, University of Melbourne, Parkville, Melbourne, AU
| | - Steven Baker
- School of Human Services and Social Work, Griffith University, Brisbane, AU
| | - Jenny Waycott
- School of Computing and Information Systems, University of Melbourne, Parkville, Melbourne, AU
| |
Collapse
|
7
|
COVID-19 pandemic in long-term care: An international perspective for policy considerations. Int J Nurs Sci 2023; 10:158-166. [PMID: 37095850 PMCID: PMC10063321 DOI: 10.1016/j.ijnss.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
This paper identifies key factors rooted in the systemic failings of the long-term care sector amongst four high income countries during the COVID-19 pandemic. The goal is to offer practice and policy solutions to prevent future tragedies. Based on data from Australia, Canada, Spain and the United States, the findings support evidence-based recommendations at macro, meso and micro levels of practice and policy intervention. Key macro recommendations include improving funding, transparency, accountability and health system integration; and promoting not-for-profit and government-run long-term care facilities. The meso recommendation involves moving from warehouses to “green houses.” The micro recommendations emphasize mandating recommended staffing levels and skill mix; providing infection prevention and control training; establishing well-being and mental health supports for residents and staff; building evidence-based practice cultures; ensuring ongoing education for staff and nursing students; and fully integrating care partners, such as families or friends, into the healthcare team. Enacting these recommendations will improve residents' safety and quality of life; families’ peace of mind; and staff retention and work satisfaction.
Collapse
|
8
|
Hodge E, Oversby S, Chor J. Why are some outbreaks worse than others? COVID-19 outbreak management strategies from a PHU perspective. BMC Public Health 2023; 23:597. [PMID: 36997870 PMCID: PMC10060923 DOI: 10.1186/s12889-023-15498-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND From a Public Health Unit (PHU) perspective, this review aimed to examine factors associated with adverse outbreak outcomes, to identify evidence based focal strategies of managing COVID-19 outbreaks in aged care settings. METHODS A retrospective review of PHU documentation examined all 55 COVID-19 outbreaks in Wide Bay RACFs across the first 3 COVID-19 waves in Queensland, through thematic and statistical analysis. . RESULTS Thematic analysis using the framework approach identified 5 themes associated with outcomes of COVID-19 outbreaks in RACFs. These were analysed for statistical significance against outbreak outcomes including duration, attack rate and case fatality rate. There was a significant relationship between memory support unit (MSU) involvement and adverse outbreak outcomes. Attack rate was significantly associated with communication frequency, symptom monitoring and case detection approach, staff shortages and cohorting. Staff shortages were also significantly associated with a prolonged outbreak duration. There was no statistically significant relationship between outbreak outcomes and resource availability or infection control strategy. . CONCLUSIONS This emphasises the importance of frequent communication between PHUs and RACFs during active outbreaks, as well as the need for regular symptom monitoring and prompt case detection, to minimise viral transmission. Staff shortages and cohorting are also crucial factors to be addressed during outbreak management. IMPLICATIONS FOR PUBLIC HEALTH This review adds to the evidence basis of COVID-19 outbreak management strategies to improve PHU advice to RACFs, to mitigate viral transmission and ultimately reduce the burden of disease associated with COVID-19 and other communicable diseases.
Collapse
Affiliation(s)
- Emma Hodge
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia.
| | - Shannen Oversby
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia
| | - Josette Chor
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia
| |
Collapse
|
9
|
Jadhav S, Imran A, Haque M. Application of six sigma and the system thinking approach in COVID-19 operation management: a case study of the victorian aged care response centre (VACRC) in Australia. OPERATIONS MANAGEMENT RESEARCH 2022. [PMCID: PMC9546421 DOI: 10.1007/s12063-022-00323-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
COVID-19 has posed many unique and critical challenges in various contexts and circumstances. This often led the stakeholders and decision-makers to depart from traditional thinking and the business-as-usual processes and to come up with innovative approaches to tackle various mission-critical situations within a short time frame. In this paper, a real-life case study of COVID-19 operation management following a multi-disciplinary, multi-stakeholder novel integrated approach in aged care facilities in Victoria, Australia, is presented which yielded significant and positive outcomes. The purpose of the intervention was to develop an integrated system performance approach through the application of various quality management tools and techniques to achieve organizational excellence at the aged care centers. The case involved the use of mathematical models along with statistical tools and techniques to address the specific problem scenario. A system-wide management plan was proposed, involving various agencies across several residential aged care facilities during the pandemic. A three-step methodological framework was developed, where Six Sigma, a system thinking approach, and a holistic metric were proposed to manage the value chain of the pandemic management system. The experimental result analyses showed significant improvement in the management process, suggesting the validity and potential of this holistic approach to stabilize the situation and subsequently set the conditions for operations excellence within the sectors. The model offers new insight into the existing body of knowledge and offers an efficient approach to achieving operational excellence in any organization or business regardless of its type, shape and complexity, which can help practitioners in managing complex, mission-critical situations like a pandemic.
Collapse
|
10
|
Duckett S. Public Health Management of the COVID-19 Pandemic in Australia: The Role of the Morrison Government. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10400. [PMID: 36012035 PMCID: PMC9407931 DOI: 10.3390/ijerph191610400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 05/24/2023]
Abstract
The Australian Commonwealth government has four health-related responsibilities during the SARS-CoV-2 pandemic: to provide national leadership; to manage external borders; to protect residents of residential aged care facilities; and to approve, procure and roll-out tests and vaccines. State governments are responsible for determining what public health measures are appropriate and implementing them-including managing the border quarantine arrangements and the testing, tracing, and isolation regime-and managing the hospital response. This paper analyses the national government's response to the pandemic and discusses why it has attracted a thesaurus of negative adjectives.
Collapse
Affiliation(s)
- Stephen Duckett
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
| |
Collapse
|
11
|
Kunasekaran MP, Mongha A, Chughtai AA, Poulos CJ, Heslop DJ, MacIntyre RC. Policy Analysis for Prevention and Control of Influenza in Aged Care. J Am Med Dir Assoc 2022; 23:1741.e1-1741.e18. [PMID: 35809635 DOI: 10.1016/j.jamda.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to analyze national influenza infection control policy documents within aged care settings by identifying the consistencies, inconsistencies, and gaps with the current evidence and by evaluating methodological quality. Aged care providers can use these findings to identify their policy documents' strengths and weaknesses. DESIGN A quality and content analysis of national level policy documents. SETTING AND PARTICIPANTS Aged care settings rely on national agencies' policy recommendations to control and prevent outbreaks. There is limited research on the effectiveness of control measures to prevent and treat influenza within aged care settings. Because of the complexities around aged care governance, the primary responsibility in developing a comprehensive facility-level, infection-prevention policy, falls to the providers. METHODS The analysis was conducted using the (1) International Appraisal of Guidelines, Research and Evaluation assessment tool, containing 23 items across 6 domains; and the (2) Influenza Related Control Measures in Aged Care settings checklist, developed by the authors, with 82 recommendations covering: medical interventions, nonmedical interventions, and physical layout. RESULTS There were 19 documents from 9 different high-income countries, with a moderately high methodological quality in general. The quality assessment's average score was 40.2% (95% CI 31.9%-44.7%). "Stakeholder involvement" ranked third, and "Editorial independence" and "Rigor of development" had the lowest average scores across all domains. The content analysis' average score was 37.2% (95% CI 10.5%-21.5%). The highest scoring document (59.1%) included term definitions, cited evidence for recommendations, and clear measurable instructions. "Physical Layout" had the least coverage and averaged 21.9% (95% CI 4.2%-37.5%), which shows a substantial gap in built environment recommendations. CONCLUSIONS AND IMPLICATIONS Existing policy documents vary in their comprehensiveness. The higher scoring documents provide an ideal model for providers. The checklist tools can be used to assess and enhance documents. Further research on document end-user evaluation would be useful, as there is room for improvement in methodological quality and coverage of recommendation coverage, especially related to physical layout.
Collapse
Affiliation(s)
- Mohana P Kunasekaran
- The University of New South Wales, Kirby Institute, Biosecurity Program, Sydney, New South Wales, Australia.
| | - Aditi Mongha
- The University of New South Wales, Kirby Institute, Biosecurity Program, Sydney, New South Wales, Australia
| | - Abrar A Chughtai
- The University of New South Wales, School of Population Health, Sydney, New South Wales, Australia
| | - Christopher J Poulos
- The University of New South Wales, School of Population Health, Sydney, New South Wales, Australia; Hammond Care, Sydney, New South Wales, Australia
| | - David J Heslop
- The University of New South Wales, School of Population Health, Sydney, New South Wales, Australia
| | - Raina C MacIntyre
- The University of New South Wales, Kirby Institute, Biosecurity Program, Sydney, New South Wales, Australia
| |
Collapse
|
12
|
Hashan MR, Chapman G, Walker J, Jayne Davidson S, Auriac J, Smoll N, Kirk M, Akbar D, Booy R, Khandaker G. Protocol on establishing a prospective enhanced surveillance of vaccine preventable diseases in residential aged care facilities in Central Queensland, Australia: an observational study. BMJ Open 2022; 12:e060407. [PMID: 36691252 PMCID: PMC9171214 DOI: 10.1136/bmjopen-2021-060407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/29/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Infectious diseases are a major cause of mortality and morbidity among the highly vulnerable occupants of residential aged care facilities (RACFs). The burden of vaccine preventable diseases (VPDs) among RACFs residents is mostly unknown and there is a lack of quality data from population-based prospective VPD surveillance in RACFs. The increasing burden of emerging and existing VPDs (eg, COVID-19, influenza, pneumococcal, pertussis and varicella-zoster) necessitates the establishment of an active enhanced surveillance system to provide real-time evidence to devise strategies to reduce the burden of VPDs in RACFs. METHOD AND ANALYSIS This study proposes a prospective active enhanced surveillance that will be implemented in RACFs across the Central Queensland (CQ) region. The study aims to measure the burden, identify aetiologies, risk factors, predictors of severe outcomes (eg, hospitalisations, mortality) and impact of the existing National Immunization Program (NIP) funded vaccines in preventing VPDs in this vulnerable population. CQ Public Health Unit (CQPHU) will implement the active surveillance by collecting demographic, clinical, pathological, diagnostic, therapeutic and clinical outcome data from the RACFs based on predefined selection criteria and case report forms as per routine public health practices. Descriptive statistics, univariate and multivariate regression analysis will be conducted to identify the predictors of morbidity and clinical outcomes following infection. ETHICS AND DISSEMINATION The study has been approved by the CQHHS Human Research Ethics Committee (HREC) (reference number HREC/2021/QCQ/74305). This study involves data that is routinely collected as part of the surveillance of notifiable conditions under the Public Health Act 2005. The CQHHS HREC approved a request to waive consent requirements of study participants as researchers will be provided non-identifiable data. The findings from the study will be actively disseminated through publication in peer-reviewed journals, conference presentations, social and print media, federal, state, and local authorities to reflect on the results that may facilitate revision of policy and highlight the stakeholders, funding bodies both locally and internationally.
Collapse
Affiliation(s)
- Mohammad Rashidul Hashan
- School of Business and Law, Central Queensland University, Rockhampton North, Queensland, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Gwenda Chapman
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Jacina Walker
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Sonya Jayne Davidson
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Jill Auriac
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Nicolas Smoll
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Michael Kirk
- Rockhampton Business Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
| | - Delwar Akbar
- School of Business and Law, Central Queensland University, Rockhampton North, Queensland, Australia
| | - Robert Booy
- National Centre for Immunisation Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Gulam Khandaker
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
- Research Division, Central Queensland University, Rockhampton North, Queensland, Australia
| |
Collapse
|
13
|
Graso M. The new normal: Covid-19 risk perceptions and support for continuing restrictions past vaccinations. PLoS One 2022; 17:e0266602. [PMID: 35395026 PMCID: PMC8993013 DOI: 10.1371/journal.pone.0266602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 03/23/2022] [Indexed: 01/30/2023] Open
Abstract
I test the possibility that over-estimating negative consequences of COVID-19 (e.g., hospitalizations, deaths, and threats to children) will be associated with stronger support the 'new normal' (i.e., continuation of restrictions for an undefined period starting with wide-spread access to vaccines and completed vaccinations of vulnerable people). The new normal was assessed by endorsing practices such as vaccine passports, travel restrictions, mandatory masking, continuing contact tracing, and pursuing elimination. Results are based on five samples (N = 1,233 from April 2021 and N = 264 from January 2022) and suggest that people over-estimate COVID-19 risks to children and healthy people, as evidenced by median estimates that 5% of all global deaths were children, 29% were generally healthy people under 65, and that a healthy person under the age of 65 has 5% chance of dying from COVID-19. Over-estimates observed in this study align with those based on representative samples, and they were consistently related to stronger support for the new normal. This relationship emerged when participants estimated risks with percentages (core indicators) and indicated the extent to which risk-based statements are true/supported with evidence or false/unsupported (alternative indicators). People were notably more likely to support continuing restrictions if they believed that COVID-19 risk and risk mitigation tactics are true, even when they are not (e.g., children need to be prioritized for boosters). These relationships persisted when considering competing explanations (political ideology, statistics literacy, belief in conspiracy theories). I trace these effects to well-meaning efforts to prevent under-estimation. Public policy and people's perceptions of risks are intertwined, where even inaccurate judgments may influence decisions. Failure to combat all misinformation with equal rigor may jeopardize the restoration of the social and economic life essential for building adaptive post-pandemic societies.
Collapse
Affiliation(s)
- Maja Graso
- Department of Management, University of Otago, Dunedin, New Zealand
| |
Collapse
|
14
|
A critique of the marketisation of long-term residential and nursing home care. THE LANCET. HEALTHY LONGEVITY 2022; 3:e298-e306. [PMID: 36098302 DOI: 10.1016/s2666-7568(22)00040-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/24/2022] Open
Abstract
Long-term care systems across countries within the Organisation for Economic Co-operation and Development have undergone a progressive marketisation and financialisation in recent decades, characterised by the embedding of neoliberal market values such as competition, consumer choice, and the profit motive. In this Personal View, we argue that these make poor guiding principles for the care sector, identifying the dysfunctional dynamics that arise as a result, and reflecting on the clinical implications of each, with a focus on facility-based care. We outline why providers can scarcely respond to competitive forces without compromising care quality. We explain why the promotion of consumer choice cannot effectively motivate improvements to quality of care. And we explore how privatisation opens the door to predatory financial practices. We conclude by considering how far proposals for reform can take us, ultimately arguing for a rejection of neoliberal market ideology, and calling for sector-wide discussions about what principles would be more fitting for a caring economy.
Collapse
|
15
|
Brydon A, Bhar S, Doyle C, Batchelor F, Lovelock H, Almond H, Mitchell L, Nedeljkovic M, Savvas S, Wuthrich V. National Survey on the Impact of COVID-19 on the Mental Health of Australian Residential Aged Care Residents and Staff. Clin Gerontol 2022; 45:58-70. [PMID: 34634217 DOI: 10.1080/07317115.2021.1985671] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES This study is the first to obtain data on the prevalence of, contributors to, and supports required for, pandemic-related distress within the residential aged care sector in Australia. A nested mixed-methods approach was used to examine aged care leaders' opinions about the impact of COVID-19 on the mental health of aged care residents and staff. METHODS A total of 288 senior staff of Australian residential aged care facilities (care managers, clinical care coordinators, and lifestyle team leaders; mean age = 52.7 years, SD = 10.3) completed an online survey between 10th September and 31st October 2020. RESULTS On average, nearly half of their residents experienced loneliness (41%) and a third experienced anxiety in response to COVID-19 (33%). The most frequently noted contributors to poor mental health among residents were restrictions to recreational outings and watching news coverage relating to COVID-19. Participants emphasized the need for increased access to counseling services and improved mental health training amongst staff. Residential care staff were similarly impacted by the pandemic. More than a third of staff were reported as anxious (36%) and 20% depressed, in response to COVID-19. Staff were worried about introducing COVID-19 into their facility and were impacted by news coverage of COVID-19. Staff would feel supported by financial assistance and by increased staff-resident ratios. CONCLUSIONS Senior staff perceive that the mental health of Australian aged care residents and staff was negatively impacted by the COVID-19 pandemic. The most noted contributors were identified, as was the mental health support for aged care communities. CLINICAL IMPLICATIONS This study provides government and policymakers with clear intervention targets for supporting the sector. Clinicians can support residential aged care communities by providing on-site or telehealth counseling, and upskill and train residential aged care staff on how to respond to the emotional needs of residents in response to COVID-19.
Collapse
Affiliation(s)
- Aida Brydon
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Colleen Doyle
- National Ageing Research Institute, Melbourne, Australia
| | | | | | - Helen Almond
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Leander Mitchell
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Maja Nedeljkovic
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Steven Savvas
- National Ageing Research Institute, Melbourne, Australia
| | - Viviana Wuthrich
- Department of Psychology, Macquarie University, Sydney, Australia
| |
Collapse
|
16
|
Ischia L, Naganathan V, Waite LM, Le Couteur DG, Thillainadesan J. COVID-19 and geriatric medicine in Australia and New Zealand. Australas J Ageing 2021; 41:301-308. [PMID: 34904362 DOI: 10.1111/ajag.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/12/2021] [Accepted: 10/28/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To investigate geriatricians' views about issues facing geriatric medicine, and the preparedness of the health-care system during the COVID-19 pandemic. METHODS An online survey of heads of geriatric medicine departments in hospitals in Australia and New Zealand undertaken in May 2020. RESULTS The majority of hospitals had admitted one or more patients with suspected COVID-19. Most geriatricians believed their hospital was 'adequately' or 'well prepared' for the pandemic. Inpatient capacity increased to manage acute, post-acute and rehabilitative care of older patients with COVID-19. Non-inpatient services for older people were reduced and telehealth-instituted widely. Increases in work hours, on-call and staffing levels were reported. Geriatricians voiced major concerns about the preparedness of residential aged care facilities to manage the pandemic. CONCLUSIONS The COVID-19 pandemic impacted on geriatricians and the provision of geriatric medicine services. Many issues that subsequently affected older people were predicted in advance.
Collapse
Affiliation(s)
- Liesl Ischia
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
| | - Louise M Waite
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia.,ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Janani Thillainadesan
- Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.,Centre for Education and Research on Ageing, Ageing and Alzheimers Institute, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Concord, Sydney, New South Wales, Australia
| |
Collapse
|
17
|
Lindley RA, Steele EJ. Analysis of SARS-CoV-2 haplotypes and genomic sequences during 2020 in Victoria, Australia, in the context of putative deficits in innate immune deaminase anti-viral responses. Scand J Immunol 2021; 94:e13100. [PMID: 34940992 PMCID: PMC8646704 DOI: 10.1111/sji.13100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 02/05/2023]
Abstract
The SARS-CoV-2 epidemic infections in Australia during 2020 were small in number in epidemiological terms and are well described. The SARS-CoV-2 genomic sequence data of many infected patients have been largely curated in a number of publicly available databases, including the corresponding epidemiological data made available by the Victorian Department of Health and Human Services. We have critically analysed the available SARS-CoV-2 haplotypes and genomic sequences in the context of putative deficits in innate immune APOBEC and ADAR deaminase anti-viral responses. It is now known that immune impaired elderly co-morbid patients display clear deficits in interferon type 1 (α/β) and III (λ) stimulated innate immune gene cascades, of which APOBEC and ADAR induced expression are part. These deficiencies may help explain some of the clear genetic patterns in SARS-CoV-2 genomes isolated in Victoria, Australia, during the 2nd Wave (June-September, 2020). We tested the hypothesis that predicted lowered innate immune APOBEC and ADAR anti-viral deaminase responses in a significant proportion of elderly patients would be consistent with/reflected in a low level of observed mutagenesis in many isolated SARS-CoV-2 genomes. Our findings are consistent with this expectation. The analysis also supports the conclusions of the Victorian government's Department of Health that essentially one variant or haplotype infected Victorian aged care facilities where the great majority (79%) of all 820 SARS-CoV-2 associated deaths occurred. The implications of our data analysis for other localized epidemics and efficient coronavirus vaccine design and delivery are discussed.
Collapse
Affiliation(s)
- Robyn A. Lindley
- GMDxgen Pty LtdMelbourneVictoriaAustralia
- Department of Clinical Pathology, The Victorian Comprehensive Cancer Centre, Faculty of MedicineDentistry & Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
- Melville Analytics Pty LtdMelbourneVictoriaAustralia
| | - Edward J. Steele
- Melville Analytics Pty LtdMelbourneVictoriaAustralia
- CYO'Connor ERADE Village Foundation24 Genomics RisePiara WatersAustralia
| |
Collapse
|
18
|
Trauer JM, Lydeamore MJ, Dalton GW, Pilcher D, Meehan MT, McBryde ES, Cheng AC, Sutton B, Ragonnet R. Understanding how Victoria, Australia gained control of its second COVID-19 wave. Nat Commun 2021; 12:6266. [PMID: 34725323 PMCID: PMC8560916 DOI: 10.1038/s41467-021-26558-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
During 2020, Victoria was the Australian state hardest hit by COVID-19, but was successful in controlling its second wave through aggressive policy interventions. We calibrated a detailed compartmental model of Victoria's second wave to multiple geographically-structured epidemic time-series indicators. We achieved a good fit overall and for individual health services through a combination of time-varying processes, including case detection, population mobility, school closures, physical distancing and face covering usage. Estimates of the risk of death in those aged ≥75 and of hospitalisation were higher than international estimates, reflecting concentration of cases in high-risk settings. We estimated significant effects for each of the calibrated time-varying processes, with estimates for the individual-level effect of physical distancing of 37.4% (95%CrI 7.2-56.4%) and of face coverings of 45.9% (95%CrI 32.9-55.6%). That the multi-faceted interventions led to the dramatic reversal in the epidemic trajectory is supported by our results, with face coverings likely particularly important.
Collapse
Affiliation(s)
- James M Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Michael J Lydeamore
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Victorian Department of Health, Government of Victoria, Melbourne, VIC, Australia
| | - Gregory W Dalton
- Victorian Department of Health, Government of Victoria, Melbourne, VIC, Australia
| | - David Pilcher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael T Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Allen C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Victorian Department of Health, Government of Victoria, Melbourne, VIC, Australia
| | - Brett Sutton
- Victorian Department of Health, Government of Victoria, Melbourne, VIC, Australia
| | - Romain Ragonnet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
19
|
Pienaar K, Flore J, Power J, Murphy D. Making publics in a pandemic: Posthuman relationalities, 'viral' intimacies and COVID-19. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:244-259. [PMID: 34338143 DOI: 10.1080/14461242.2021.1961600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has placed sexual relationships into sharp focus as strict containment measures, including physical distancing and 'stay at home' restrictions, were initiated to control the spread of the virus. Governments in some jurisdictions prevented contact between non-cohabiting sexual partners (except for couples in pre-existing relationships), while community organisations recommended people avoid casual sexual encounters. This article analyses Australian media articles, commentary and public health messages published during March to October 2020 to explore the normative assumptions underpinning these measures. Applying posthumanist perspectives and Warner's (2002) conceptualisation of 'publics', we consider how COVID-19 public health advice enacts the (human) subject of public health as monogamous, coupled, and living with their partner or nuclear family. Those in non-normative relationships and households are not only excluded from this narrow enactment of the 'ideal' public health subject, but are rendered potentially risky disease vectors by virtue of their alternative kinship arrangements. We explore the implications of these findings for the more-than-human relationalities that shape health inequalities and processes of marginalisation during public health crises, and we offer suggestions for public health measures that address the needs of diverse 'publics'.
Collapse
Affiliation(s)
- Kiran Pienaar
- School of Humanities and Social Sciences, Deakin University, Melbourne, Australia
- School of Social Sciences, Monash University, Melbourne, Australia
| | - Jacinthe Flore
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia
| | - Jennifer Power
- Australian Research Centre for Sex, Health and Society (ARCSHS), La Trobe University, Melbourne, Australia
| | - Dean Murphy
- Kirby Institute, University of New South Wales, Sydney, Australia
| |
Collapse
|
20
|
St Clair B, Jorgensen M, Georgiou A. Incidence of adverse incidents in residential aged care. AUST HEALTH REV 2021; 46:405-413. [PMID: 34662271 DOI: 10.1071/ah21090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/11/2021] [Indexed: 11/23/2022]
Abstract
ObjectiveAdverse incident research within residential aged care facilities (RACFs) is increasing and there is growing awareness of safety and quality issues. However, large-scale evidence identifying specific areas of need and at-risk residents is lacking. This study used routinely collected incident management system data to quantify the types and rates of adverse incidents experienced by residents of RACFs.MethodsA concurrent mixed-methods design was used to examine 3 years of incident management report data from 72 RACFs in New South Wales and the Australian Capital Territory. Qualitative thematic analysis of free-text incident descriptions was undertaken to group adverse incidents into categories. The rates and types of adverse incidents based on these categories were calculated and then compared using incidence rate ratios (IRRs).ResultsDeidentified records of 11 987 permanent residents (aged ≥65 years; mean (±s.d.) age 84 ± 8 years) from the facilities were included. Of the 60 268 adverse incidents, falls were the most common event (36%), followed by behaviour-related events (33%), other impacts and injuries (22%) and medication errors (9%). The number of adverse incidents per resident ranged from 0 (42%) to 171, with a median of 2. Women (IRR 0.804; P < 0.001) and residents with low care needs (IRR 0.652; P < 0.001) were significantly less likely to adverse incidents compared with men and residents with high care needs respectively.ConclusionThis study demonstrates that data already collected within electronic management systems can provide crucial baseline information about the risk levels that adverse incidents pose to older Australians living in RACFs.What is known about the topic?To date, research into aged care adverse incidents has typically focused on single incident types in small studies involving mitigation strategies. Little has been published quantifying the multiple adverse incidents experienced by residents of aged care facilities or reporting organisation-wide rates of adverse incidents.What does this paper add?This paper adds to the growing breadth of Australian aged care research by providing baseline information on the rates and types of adverse incidents in RACFs across a large and representative provider.What are the implications for practitioners?This research demonstrates that the wealth of data captured by aged care facilities' incident management information systems can be used to provide insight into areas of commonly occurring adverse incidents. Better use of this information could greatly enhance strategic planning of quality improvement activities and the care provided to residents.
Collapse
Affiliation(s)
- Bella St Clair
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia
| | - Mikaela Jorgensen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia
| |
Collapse
|
21
|
Benvenuti E, Rivasi G, Bulgaresi M, Barucci R, Lorini C, Balzi D, Faraone A, Fortini G, Vaccaro G, Del Lungo I, Gangemi S, Giardini S, Piga C, Barghini E, Boni S, Bulli G, Carrai P, Crociani A, Lo Forte A, Martella L, Pupo S, Marozzi I, Bandini G, Buscemi P, Cosma C, Stacchini L, Baggiani L, Ungar A, Mossello E, Bonaccorsi G, Landini G. Caring for nursing home residents with COVID-19: a "hospital-at-nursing home" intermediate care intervention. Aging Clin Exp Res 2021; 33:2917-2924. [PMID: 34417733 PMCID: PMC8378521 DOI: 10.1007/s40520-021-01959-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/09/2021] [Indexed: 01/30/2023]
Abstract
Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality. Aims To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering “hospital-at-nursing home” care to NH residents with COVID-19 in Florence, Italy. Methods The GIROT activity was set-up during the first wave of the pandemic (W1, March–April 2020) and became a structured healthcare model during the second (W2, October 2020–January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported hospitalization and infection lethality rates recorded in SARS-CoV-2-positive NH residents during W1 and W2. Results The GIROT activity involved 21 NHs (1159 residents) and 43 NHs (2448 residents) during W1 and W2, respectively. The percentage of infected residents was higher in W2 than in W1 (64.5% vs. 38.8%), while both hospitalization and lethality rates significantly decreased in W2 compared to W1 (10.1% vs 58.2% and 23.4% vs 31.1%, respectively). Discussion Potentiating on-site care in the NHs paralleled a decrease of hospital admissions with no increase of lethality. Conclusions An innovative “hospital-at-nursing home” patient-centred care model based on comprehensive geriatric assessment may provide a valuable contribution in fighting COVID-19 in NH residents. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01959-z.
Collapse
Affiliation(s)
- Enrico Benvenuti
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Giulia Rivasi
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy.
| | - Matteo Bulgaresi
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Riccardo Barucci
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy
| | - Daniela Balzi
- Epidemiology Unit, Local Health Unit "Toscana Centro", Florence, Italy
| | - Antonio Faraone
- Department of Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Giacomo Fortini
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Gabriele Vaccaro
- Department of Health Science, University of Florence, Florence, Italy
| | - Ilaria Del Lungo
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Salvatore Gangemi
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Sante Giardini
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Cecilia Piga
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Eleonora Barghini
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Serena Boni
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Giulia Bulli
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Paolo Carrai
- Department of Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Andrea Crociani
- Department of Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Aldo Lo Forte
- Department of Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Letizia Martella
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Simone Pupo
- Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| | - Irene Marozzi
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | - Giulia Bandini
- Division of Internal Medicine, Careggi Hospital, Florence, Italy
| | - Primo Buscemi
- Department of Health Science, University of Florence, Florence, Italy
| | - Claudia Cosma
- Department of Health Science, University of Florence, Florence, Italy
| | - Lorenzo Stacchini
- Department of Health Science, University of Florence, Florence, Italy
| | | | - Andrea Ungar
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | - Enrico Mossello
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50139, Florence, Italy
| | | | - Giancarlo Landini
- Department of Internal Medicine, Santa Maria Nuova Hospital, Local Health Unit "Toscana Centro", Florence, Italy
| |
Collapse
|
22
|
Abu EK, Oloruntoba R, Osuagwu UL, Bhattarai D, Miner CA, Goson PC, Langsi R, Nwaeze O, Chikasirimobi TG, Ovenseri-Ogbomo GO, Ekpenyong BN, Charwe DD, Mashige KP, Ishaya T, Agho KE. Risk perception of COVID-19 among sub-Sahara Africans: a web-based comparative survey of local and diaspora residents. BMC Public Health 2021; 21:1562. [PMID: 34404377 PMCID: PMC8370831 DOI: 10.1186/s12889-021-11600-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/24/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Perceived risk towards the coronavirus pandemic is key to improved compliance with public health measures to reduce the infection rates. This study investigated how Sub-Saharan Africans (SSA) living in their respective countries and those in the diaspora perceive their risk of getting infected by the COVID-19 virus as well as the associated factors. METHODS A web-based cross-sectional survey on 1969 participants aged 18 years and above (55.1% male) was conducted between April 27th and May 17th 2020, corresponding to the mandatory lockdown in most SSA countries. The dependent variable was the perception of risk for contracting COVID-19 scores. Independent variables included demographic characteristics, and COVID-19 related knowledge and attitude scores. Univariate and multiple linear regression analyses identified the factors associated with risk perception towards COVID-19. RESULTS Among the respondents, majority were living in SSA (n = 1855, 92.8%) and 143 (7.2%) in the diaspora. There was no significant difference in the mean risk perception scores between the two groups (p = 0.117), however, those aged 18-28 years had lower risk perception scores (p = 0.003) than the older respondents, while those who were employed (p = 0.040) and had higher levels of education (p < 0.001) had significantly higher risk perception scores than other respondents. After adjusting for covariates, multivariable analyses revealed that SSA residents aged 39-48 years (adjusted coefficient, β = 0.06, 95% CI [0.01, 1.19]) and health care sector workers (β = 0.61, 95% CI [0.09, 1.14]) reported a higher perceived risk of COVID-19. Knowledge and attitude scores increased as perceived risk for COVID-19 increased for both SSAs in Africa (β = 1.19, 95% CI [1.05, 1.34] for knowledge; β = 0.63, 95% CI [0.58, 0.69] for attitude) and in Diaspora (β = 1.97, 95% CI [1.16, 2.41] for knowledge; β = 0.30, 95% CI [0.02, 0.58] for attitude). CONCLUSIONS There is a need to promote preventive measures focusing on increasing people's knowledge about COVID-19 and encouraging positive attitudes towards the mitigation measures such as vaccines and education. Such interventions should target the younger population, less educated and non-healthcare workers.
Collapse
Affiliation(s)
- Emmanuel Kwasi Abu
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, 00233 Cape Coast, Ghana
| | - Richard Oloruntoba
- School of Management and Marketing, Faculty of Business and Law, Curtin University, Bentley, WA 6151 Australia
| | - Uchechukwu Levi Osuagwu
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560 Australia
- Discipline of Optometry, School of Health Sciences, African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629 South Africa
| | - Dipesh Bhattarai
- Faculty of Health, School of Medicine, Deakin University, Geelong, Victoria Australia
| | - Chundung Asabe Miner
- Department of Community Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
| | | | - Raymond Langsi
- Health Division, University of Bamenda Bambili, Bamenda, Cameroon
| | - Obinna Nwaeze
- County Durham and Darlington National Health Service (NHS) Foundation, Darlington, DL3 0PD UK
| | - Timothy G. Chikasirimobi
- Department of Optometry and Vision Sciences, School of Public Health, Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, Kakamega, 50100 Kenya
| | - Godwin O. Ovenseri-Ogbomo
- Discipline of Optometry, School of Health Sciences, African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629 South Africa
- Department of Optometry, Center for Health Sciences, University of Highlands and Islands, Old Perth Road, IV2 3JH Scotland
- Department of Optometry, Faculty of Life Sciences, University of Benin, Benin City, Nigeria
| | - Bernadine N. Ekpenyong
- Discipline of Optometry, School of Health Sciences, African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629 South Africa
- Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Calabar, Cross River State Nigeria
| | | | - Khathutshelo Percy Mashige
- Discipline of Optometry, School of Health Sciences, African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629 South Africa
| | - Tanko Ishaya
- Department of Computer Science, University of Jos, Jos, Nigeria
| | - Kingsley Emwinyore Agho
- Discipline of Optometry, School of Health Sciences, African Vision Research Institute (AVRI), University of KwaZulu-Natal, Westville Campus, Durban, 3629 South Africa
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560 Australia
| |
Collapse
|
23
|
Lau JS, Buntine P, Price M, Darzins P, Newnham E, Connell A, Chean R, Edwards G, Guy S. SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia. Infect Dis Health 2021; 26:208-213. [PMID: 33903074 PMCID: PMC8043617 DOI: 10.1016/j.idh.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Healthcare workers (HCW) are exposed to an increased risk of COVID-19 through direct contact with patients and patient environments. We calculated the; seroprevalence of SARS-CoV-2 in HCW at Eastern Health, a tertiary healthcare network in Victoria, and assessed associations with demographics, work location and role. METHODS A cross-sectional cohort study of HCW at Eastern Health was conducted. Serum was analysed for the presence of antibodies to SARS-CoV-2, and all participants completed; an online survey collecting information on demographics, place of work, role, and exposures; to COVID-19. Seroprevalence was calculated as the proportion participants with SARS-CoV-2; antibodies out of all tested individuals. RESULTS The crude seroprevalence of SARS-CoV-2 antibodies in this study was 2.17% (16/736). Thirteen of the 16 (81.2%) positive cases had previously been diagnosed with COVID-19 by PCR: the seroprevalence in the group not previously diagnosed with COVID by PCR was 0.42% (3/720). Having direct contact with COVID-19 patients did not increase the likelihood of having positive serology. A prior history of symptoms consistent with COVID-19 was associated with a higher likelihood of having positive serology (OR 17.2, p = 0.006, 95%CI: 2.25-131.55). CONCLUSION Our calculated seroprevalence of 2.17% is higher than estimated in the general Australian population, but lower than that reported in HCW internationally. The; majority of those with positive serology in our study had previously been diagnosed with COVID-19 by PCR based testing. Seropositivity was not associated with interaction with COVID-19 positive patients, highlighting effective infection prevention and control practices within the workplace.
Collapse
Affiliation(s)
- Jillian Sy Lau
- Department of Infectious Diseases, Eastern Health, Box Hill, 3128, Australia.
| | - Paul Buntine
- Department of Emergency Medicine, Eastern Health, Box Hill, 3128, Australia; Eastern Health Clinical School, Monash University, Clayton, 3800, Australia
| | - Melanie Price
- Department of Emergency Medicine, Eastern Health, Box Hill, 3128, Australia
| | - Peteris Darzins
- Eastern Health Clinical School, Monash University, Clayton, 3800, Australia
| | - Evan Newnham
- Eastern Health Clinical School, Monash University, Clayton, 3800, Australia
| | - Ailie Connell
- Eastern Health Pathology, Eastern Health, Box Hill, 3128, Australia
| | - Roy Chean
- Eastern Health Pathology, Eastern Health, Box Hill, 3128, Australia
| | - Glenn Edwards
- Eastern Health Pathology, Eastern Health, Box Hill, 3128, Australia
| | - Stephen Guy
- Department of Infectious Diseases, Eastern Health, Box Hill, 3128, Australia; Eastern Health Clinical School, Monash University, Clayton, 3800, Australia
| |
Collapse
|
24
|
Ibrahim JE, Li Y, Brown C, McKee G, Eren H, Pham T. Risk Stratification of Nursing Homes to Plan COVID-19 Responses: A Case Study of Victoria, Australia. Disaster Med Public Health Prep 2021; 16:1-8. [PMID: 34140061 PMCID: PMC8376849 DOI: 10.1017/dmp.2021.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/25/2021] [Accepted: 06/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Emergency management responses to coronavirus disease 2019 (COVID-19) in nursing homes lacked preparation and nuance; moving forward, responses must recognize nursing homes are not generic organizations or services, and individually appreciate each's unique nature, strengths, and limitations. The objective of this study was to describe an approach to stratifying nursing homes according to risk for COVID-19 outbreak. METHODS Population-based cross-sectional study of all accredited nursing homes in Victoria (n = 766), accommodating 48,824 permanent residents. We examined each home's facility structure, governance history, socio-economic status, proximity to high-risk industry, and proximity and size of local acute public hospital, stratified by location, size, and organizational structure. RESULTS Privately owned nursing homes tend to be larger and metropolitan-based, and publicly owned homes regionally based and smaller in size. The details reveal additional nuance, eg, privately owned metropolitan-based medium- to large-sized facilities tended to have more regulatory noncompliance, no board of governance, and fewer Chief Executive Officers with clinical background. In contrast, the smaller, publicly owned, remote facilities perform better on those same metrics. CONCLUSIONS Nursing homes should not be regarded as generic entities, and there is significant underlying heterogeneity. Stratification of nursing homes according to risk level is a viable approach to informing more nuanced policy direction and resource allocation for emergency management responses.
Collapse
Affiliation(s)
- Joseph E. Ibrahim
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Yingtong Li
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Charlotte Brown
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Grace McKee
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Hagar Eren
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Tony Pham
- Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| |
Collapse
|
25
|
Usher K, Durkin J, Gyamfi N, Warsini S, Jackson D. Preparedness for viral respiratory infection pandemic in residential aged care facilities: A review of the literature to inform post-COVID-19 response. J Clin Nurs 2021:10.1111/jocn.15863. [PMID: 34021650 PMCID: PMC8242770 DOI: 10.1111/jocn.15863] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 05/04/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To examine what was known about disaster preparedness in residential care and to consider this in the light of the current COVID-19 pandemic. BACKGROUND Care homes provide long-term care to vulnerable, frail older people, as well as to young people with profound disabilities. The COVID-19 pandemic has shown that the residential care sector has been seriously affected in many parts of the world and has exposed major flaws and vulnerabilities in infection control and other processes that have resulted in considerable loss of life of residents of these facilities. DESIGN Discursive paper informed by a systematic literature. Review was carried out in line with PRISMA reporting guidelines. The review protocol was registered with PROSPERO on 2020 [CRD42020211847]. RESULTS The review identified six papers meeting inclusion criteria across care residential facilities in different countries. Several prevention and mitigation strategies were identified to manage and reduce the spread and severity of viral respiratory infection pandemics. These strategies include isolation, restriction of movement, personal protective and hygienic measures, health education and information sharing, monitoring and coordination, and screening and treatment. Preparedness strategies identified were contingency planning such as reporting/communication, leadership, human resource, insurance, occupational health and resource availability. The prevention/mitigation and preparedness strategies helped to achieve decline in disease severity, reduced prevalence, reduced spread of the disease, improved readiness criteria, resource usefulness and increased intervention acceptability. This paper presents a conceptual framework exploring the interconnectedness of preparedness and prevention/ mitigation strategies and associated outcomes. We discuss areas of concern in the context of workforce employment patterns in the sector. Concerns related to the unintended consequences of strategies placed on aged care facilities, which may worsen mental health outcomes for residents, are discussed. CONCLUSIONS Persons in residential care settings are at greater risk of infection during a pandemic, and therefore, strict measures to protect their safety are warranted. However, they are also a group who already experience social isolation and so any measures involving restrictions to visiting and social interaction, particularly over the longer term, must be accompanied by strategies to mitigate potential loneliness and mental health sequelae arising from long-term pandemic restrictions. RELEVANCE TO CLINICAL PRACTICE Though there was evidence of activity in preparedness for disasters within the residential care sector, various contextual factors affecting the sector were clearly not adequately considered or addressed in pre-pandemic disaster planning, particularly in the areas of staff movements between care homes and the length of time that social isolation and restriction measures would need to be in place. Future pandemic planning should consider the nature of the workforce model in the care home sector, and factor in strategies to better support the mobile and highly casualised workforce.
Collapse
Affiliation(s)
- Kim Usher
- School of HealthUniversity of New EnglandArmidaleNSWAustralia
| | - Joanne Durkin
- School of HealthUniversity of New EnglandArmidaleNSWAustralia
| | - Naomi Gyamfi
- School of HealthUniversity of New EnglandArmidaleNSWAustralia
| | | | - Debra Jackson
- Susan Wakil School of NursingUniversity of SydneySydneyNSWAustralia
| |
Collapse
|
26
|
Ioannidis JPA, Axfors C, Contopoulos-Ioannidis DG. Second versus first wave of COVID-19 deaths: Shifts in age distribution and in nursing home fatalities. ENVIRONMENTAL RESEARCH 2021; 195:110856. [PMID: 33581086 PMCID: PMC7875012 DOI: 10.1016/j.envres.2021.110856] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To examine whether the age distribution of COVID-19 deaths and the share of deaths in nursing homes changed in the second versus the first pandemic wave. ELIGIBLE DATA We considered all countries that had at least 4000 COVID-19 deaths occurring as of January 14, 2021, at least 200 COVID-19 deaths occurring in each of the two epidemic wave periods; and which had sufficiently detailed information available on the age distribution of these deaths. We also considered countries with data available on COVID-19 deaths of nursing home residents for the two waves. MAIN OUTCOME MEASURES Change in the second wave versus the first wave in the proportion of COVID-19 deaths occurring in people <50 years ("young deaths") among all COVID-19 deaths and among COVID-19 deaths in people <70 years old; and change in the proportion of COVID-19 deaths in nursing home residents among all COVID-19 deaths. RESULTS Data on age distribution were available for 14 eligible countries. Individuals <50 years old had small absolute difference in their share of the total COVID-19 deaths in the two waves across 13 high-income countries (absolute differences 0.0-0.4%). Their proportion was higher in Ukraine, but it decreased markedly in the second wave. The proportion of young deaths was lower in the second versus the first wave (summary prevalence ratio 0.81, 95% CI 0.71-0.92) with large between-country heterogeneity. The proportion of young deaths among deaths <70 years did not differ significantly across the two waves (summary prevalence ratio 0.96, 95% CI 0.86-1.06). Eligible data on nursing home COVID-19 deaths were available for 11 countries. The share of COVID-19 deaths that were accounted by nursing home residents decreased in the second wave significantly and substantially in 8 countries (prevalence ratio estimates: 0.36 to 0.78), remained the same in Denmark and Norway and markedly increased in Australia. CONCLUSIONS In the examined countries, age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave, but the contribution of COVID-19 deaths in nursing home residents to total fatalities has decreased in most countries in the second wave.
Collapse
Affiliation(s)
- John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, and Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA, USA.
| | - Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA, USA; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | |
Collapse
|
27
|
Loh E, Matthews NR, Mackinnon S. Ten minutes with Professor Erwin Loh, Chief Medical Officer and Group General Manager of Clinical Governance, St Vincent’s Health Australia, Melbourne, Australia. BMJ LEADER 2021. [DOI: 10.1136/leader-2021-000456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
28
|
Reid A, Ronda‐Perez E, Schenker MB. Migrant workers, essential work, and COVID-19. Am J Ind Med 2021; 64:73-77. [PMID: 33355943 DOI: 10.1002/ajim.23209] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/04/2020] [Accepted: 12/06/2020] [Indexed: 01/27/2023]
Abstract
Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.
Collapse
Affiliation(s)
- Alison Reid
- School of Public Health, Faculty of Health Sciences Curtin University Bentley Western Australia Australia
| | - Elena Ronda‐Perez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science University of Alicante Alicante Spain
| | - Marc B. Schenker
- Department of Public Health Sciences University of California Davis California USA
| |
Collapse
|