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National guidelines for nursing homes.

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Minister for Ageing


15 July 2008

National guidelines for nursing homes

In response to recent gastroenteritis outbreaks in nursing homes, the Minister for Ageing, Mrs Justine Elliot, today announced a response plan.

It involves: • A review of the accreditation standards on infection control; • Development of a gastroenteritis awareness and prevention education kit; and • Development of new national guidelines specifically on norovirus - a common

and highly infectious cause of gastroenteritis in nursing homes.

This new plan will build on the new Food Safety Standard which was gazetted in October 2006 by the previous Government and will come into effect on 5 October 2008.

This new standard mandates a requirement for organisations, including nursing homes to deliver food services to vulnerable populations to implement a food safety plan.

In Australia, there are currently 2,839 nursing homes receiving Australian Government subsidies to provide care to more than 170,000 people in aged care.

In 2007, there were 1,825 gastroenteritis outbreaks reported in Australia. Of those, 989 (54 per cent) were in nursing homes.

Since 1 January 2008, there have been 671 gastro reported outbreaks nationally, with 383 (57 per cent) reported in nursing homes.

State and territory governments have legislation in place regarding infectious disease and are responsible for investigating them. Nursing homes must meet the state and territory requirements.

Currently, the Department of Health and Ageing is working with the states and territories to develop a national communication strategy for a more rapid information flow about outbreaks of infectious diseases between nursing homes, public health authorities and the Aged Care Complaints Investigation Scheme.

“My primary concern is the welfare and care of residents,” Mrs Elliot said.

“States and territories are responsible for investigating and controlling outbreaks of gastroenteritis and other infectious illnesses, and the Australian Government works in partnership with them and nursing home providers.

“Australian nursing homes and staff provide world-class care, but there is always room for improvement.

“Infection control in nursing homes is a big task when one considers that residents are often frail, aged and vulnerable to infection.

“We can never wipe out infectious diseases but we must always look at ways to minimise risk.”

A review of the accreditation standards • The current standard on infection control is very broad. • The review of the standards will also make sure that staff training in infection control is thoroughly checked by the independent watchdog, the Aged Care Standards and

Accreditation Agency. • The department will begin discussions with key stakeholders about these changes and other aspects of reviewing the Standards at the Ageing Consultative Committee in August 2008. • New standards will cover in more detail on how homes can reduce the likelihood of

an outbreak; stop the spread of an outbreak through good hand washing practices; and safe disposal of bodily waste and proper use and provision of gowns, gloves and masks. • New standards will ensure proper hydration of residents who are unwell and minimising contact with sick residents reduce person-to-person spread.

Gastroenteritis Awareness and Prevention Education Kit • This kit will be developed by the Department of Health and Ageing in consultation with key stakeholders and sent to all nursing homes by October 2008. • It will provide practical, brief information sheets and materials on how to recognise

an outbreak; how to minimise cross infection; and guidance for ongoing avoidance of further outbreaks. • An important part of the kit will be information for residents and their families about gastroenteritis, how infection may be avoided and how to minimise spread such as

hand washing. • It will also include state and territory contact information as these are the authorities responsible for managing outbreaks of infectious disease.

New national guidelines specifically on norovirus • The Department of Health and Ageing is working with the states and territories on new national and consistent guidelines specifically on prevention and management of norovirus, a common and highly infectious cause of gastroenteritis in nursing

homes. • The draft guidelines are expected to be completed by the end of this year and stakeholders will be consulted. • The Australian Commission for Safety and Quality in Health Care has

commissioned the National Health and Medical Research Council to revise the national infection control guidelines. The revised guidelines will aim to provide sector-specific guidance on infection control best practice, including nursing homes.

Gastroenteritis background Gastroenteritis outbreaks are most common between late winter through to early summer, but occur throughout the year.

Nearly all the gastroenteritis outbreaks in nursing homes are person-to-person transmission with a viral origin. Outbreaks of viral gastroenteritis are extremely difficult to control, due to the highly infectious nature of the viruses.

The best means of preventing viral gastroenteritis is to ensure that people maintain good hygienic practices and reduce the number of visitors to the home during an outbreak.

For more information, contact Mrs Elliot's office on (02) 6277 7280