IMpleMenting Effective infection prevention and control in ReSidential aged carE (IMMERSE)

Summary Summary Older people living in aged care homes are susceptible to infections such as influenza. Our aim is to protect their health by promoting a strong focus on infection prevention and control (IPC). We will investigate gaps in IPC procedures such as how staff training is provided, how residents participate in IPC, and gaps in staff IPC practice, and identify solutions to address gaps. We will upskill IPC leads to drive change and co-design a community of practice that enables IPC leads to share knowledge, experiences, and resources. PhD Scholarship Opportunity: The PhD candidate will work with the project team to investigate the features of community of practice among nurse IPC leads that improve infection control practices in residential aged care facilities.

Project Details

Older people living in residential aged care facilities (RACFs) are at high risk of acquiring infections, and effective evidence-based infection prevention and control (IPC) is key to providing safe and high-quality care to this vulnerable group. The disproportionate number of COVID-19 outbreaks in RACFs and resultant deaths of residents highlighted major weaknesses in IPC practice in this sector. Initial reports from these outbreaks found there were inadequacies in staff IPC knowledge, skills, awareness in-the-moment and behaviours, as major barriers to effective IPC. Further investigation of issues in IPC practice in RACFs are required.

This project will comprehensively investigate barriers to practice change using the Theoretical Domains Framework of behaviour change (TDF). The TDF provides a theoretical basis and method for assessing implementation problems and staff behaviours to inform development of interventions. As well as knowledge and skills, it includes domains such as environmental context, beliefs about consequences, and professional role. We will assess organisational readiness and use scenario-based assessments involving outbreaks of infections such as influenza to identify barriers experienced by RACF staff in translating evidence-based recommendations into practice - investigate the “know-do” gap. We will then determine feasible and locally relevant actions to address these barriers.

This project complements the requirement that RACFs appoint an on-site lead for IPC (IPC lead). We will upskill IPC leads to facilitate changes to staff behaviour. Local customisation is key for IPC practice improvement, and it is expected that a ‘one size fits all’ approach is unlikely to be successful. Rather IPC leads are likely to benefit from support to tailor activities and foster innovation to meet local needs. To further enhance IPC leads skill development, we will co-design a community of practice that enables sharing of knowledge, experiences, and resources.