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Poor flu vaccination practices in aged care facilities

A new study, Examining the use of antiviral prophylaxis for influenza outbreaks in residential aged care facilities in NSW, Australia, has had a timely release, with South Australia (SA) Health reporting there has been 70 flu outbreaks in residential care facilities around the State, including aged care homes.

The study found many aged care facilities were not able to accurately recognise when a flu outbreak had begun in a nursing home. [Source: Shutterstock].
The study found many aged care facilities were not able to accurately recognise when a flu outbreak had begun in a nursing home. [Source: Shutterstock].

The study into flu vaccination and outbreaks in aged care facilities found most homes aren’t administering antiviral drugs effectively, in some cases taking 8.5 days to give antiviral after the onset date of the first influenza case.

Research showed a residential aged care facility would administer medication as soon as it arrived at the facility, which was one day after when an antiviral drug should be administered.

Under Australian guidelines, antiviral drugs should be administered within 24 hours of the onset date of influenza in a resident.

The study found early outbreak recognition was key to controlling the spread of influenza and resulted in a shorter outbreak duration.

A delay in recognising an influenza outbreak contributed greatly to the timing of initiating antiviral medication to residents, according to the study.

It speculated that the identification of influenza in the elderly was challenging due to existing traits exhibited by people in aged care.

The study group included 86 aged care facilities in New South Wales (NSW) that had influenza outbreaks, affecting around 9,067 residents in 2015. Data shows that 69 percent affected by influenza were female, and the average age for sufferers was 85 years olds.

Just over 50 percent of residents in any participating nursing homes received a vaccination or preventative to help before flu season.

Most public health units were only contacted by an aged care facility six days after the first case of influenza was found in the facility that had taken preventative measures.

For a nursing home with no prevention put in place, on average they only contacted a public health units seven days after the first case of influenza.

Ten of the aged care facilities involved only contacted the PHU after the onset date of the last influenza case.

Residential homes that have influenza prevention in place had high vaccination rates for residents, 80.6 percent, while aged care facilities with no influenza prevention in place had a slightly lower vaccination rate, 74.7 percent.

This statistic is similar to aged care staff vaccination, with nursing homes with preventative measures in place having around 70 percent vaccination rates for their unvaccinated staff, compared to nursing homes with no prevention in place having 44 per cent of their staff vaccinated.

The study suggests the administering of antiviral drugs needs to be improved at a large number of aged care facilities since so many only administered antiviral drugs to fewer than 50 percent of residents.

Newly appointed Chief Clinical Advisor for the Australian Aged Care Quality and Safety Commission, Dr Melanie Wroth, recently released an alert in regards to influenza and its prevention in aged care facilities.

With the recent projected estimation of 4,000 people dying this year from flu, Dr Wroth has advised aged care providers to make sure they have appropriate measures, preventions and controls in place to stop the spread of influenza.

These recommendations include:

  • Annual vaccination for people over the age of 65 as well as aged care staff

  • Washing hands often and encouraging visitors at nursing homes to do the same

  • Being alert to influenza symptoms

  • Establishing an action plan to manage influenza activity, for example, quarantine arrangements, medical referral or reporting suspected influenza outbreaks

  • Encouraging staff and visitors to not visit aged care facilities if unwell or have recently visited somewhere with influenza.

Dr Wroth says, “Influenza, also known as the flu, is a highly contagious disease that can cause severe illness for older Australians with serious complications including death.

“The start to this influenza season has seen a high level of influenza activity with recent statistics showing that already at least 54 Australians have died from influenza, of which 42 have been aged 65 and over.

“Individuals who have contact with older people outside of an aged care service should also be aware of the above measures, particularly the importance of vaccination for themselves and others.”

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