Masked up to control infection

When it comes to infection control, OCAV’s Director of Nursing and Quality Control Manager Shaaron Robilliard is under no illusion: it is her number one priority because it keeps residents and staff well.

“This year has been a terrible year for infectious disease – flu and gastroenteritis – have hit the public hard, and residential aged care is never immune,” Ms Robilliard said.

While OCAV’s aged care facility – Liscombe House – was given the tick of approval by the Australian Aged Care Quality Agency recently, she continually reviews policy and procedures to make sure that OCAV is ahead of current practice.

OCAV has long had a policy that staff at Liscombe House wear surgical masks with P2 respirators when there is an influenza outbreak.

“We made the decision because all evidence that we had seen and our nursing experience suggested that P2 respirators do a better job of protecting against droplet respiratory infection,” Ms Robilliard said.

The OCAV approach differs from Australian aged care guidelines introduced in July this year which recommended that residential aged care staff providing direct care to a resident with influenza, wear a single-use surgical mask.

This advice was provided through a practical guide developed by the Working Group on Influenza Outbreaks in Residential Care Facilities on behalf of the Communicable Diseases Network of Australia (CDNA) and endorsed by CDNA at the beginning of March.

Ms Robilliard said that while the Australian guidelines suggested there was a lack of evidence to support the use of respirators, the authors of a new study confirm that P2 respirators should be used to ensure health workers are protected at the frontline.

Researchers from the University of New South Wales compared the effectiveness of surgical masks with respirators. They drew from the data of two randomised controlled trials involving 3,591 Chinese participants to test the efficacy of hospital infection control guidelines that recommend surgical masks for infections spread by droplets.

According to the findings, the evidence was overwhelming that P2 respirators do a better job of protecting against respiratory infection that are presumed to be spread by the droplet mode than surgical masks and added the evidence that supports surgical masks is very weak.

“Long-held beliefs on infection control have now been turned upside down, and it appears our cautionary approach based on our nursing knowledge has won out,” Ms Robilliard said.

The Minister for Aged Care Ken Wyatt has ordered an “urgent review” into the infectious disease management practices of all aged care facilities following an increase in flu-related deaths in residential aged care this winter.