Course Access
- This topic has 1 reply, 1 voice, and was last updated 2 weeks, 2 days ago by
.
-
Posts
-
Hi everyone,
We are facing challenges in the community with clients who have infections such as MRSA and shingles. Unfortunately, we are struggling to secure care workers willing to provide services for these clients due to perceived risks of contamination. Some care workers have expressed concerns around low confidence, low immunity, or having vulnerable family members, while others have hesitance due to cultural sensitivities. Additionally, almost all of our staff also support other vulnerable clients, which further impacts their willingness.
We have provided education to care workers on MRSA, including risks and required precautions such as PPE usage, and shared resources from reputable health sites. However, instead of building confidence, this information has unintentionally increased fear around assisting these clients. We have also reached out to brokerage services such as Mable and HireUp, as well as external cleaning providers, but have received very limited responses due to the client’s condition.
I wanted to seek your advice on two points:
How are other aged care providers (HCP/CHSP) in the community managing similar situations?
What additional strategies could we consider to help normalise and better manage these scenarios within community care?
Thank you all in advance.Hi Kavita,
Thank you, a very tricky situation.
Hoping to start up some considerations and discussion.
Consider: Could PPE represent risk and induce staff concerns? Note: PPE is at the bottom of the hierarchy of controls – putting in other measures first may reduce the risk and minimise the use of PPE – hence reducing staff concerns and heightening willingness to work.
See: https://www.safetyandquality.gov.au/sites/default/files/2022-05/using_the_hierarchy_of_controls_in_conjunction_with_infection_prevention_and_-_fact_sheet.pdf
Also: Risk assessing in home care: https://www.agedcarequality.gov.au/sites/default/files/media/quality-and-safety-in-home-services-5-key-areas_0.pdfMRSA:
Consider where the MRSA is located and how the transmission risk may be contained. i.e. is it in a wound that can be covered – removing transmission risk for staff. Where a wound is covered transmission PPE is not required (only standard precautions), potentially reducing the concerns and fear of staff from transmission. RN/Wound Specialist attending to wound management wear contact precaution (gloves/gown) to attend dressing only.
If the transmission risk cannot be contained i.e. multiple breaks in the skin (with MRSA present) caused by skin condition/scratching, then the cause of the skin condition would need to be treated in the first instance as contact precaution PPE would be required here due to indirect and direct contact transmission. Once the skin condition is healed, the risk is removed and the need for transmission PPE – again as a domino effect, remove the need for transmission PPE and reduce staff concerns/fear.Shingles:
Pregnant women can not care for a person with Shingles. Only staff that have had the chicken pox vaccine or who have had chicken pox (acquired immunity) should be caring for a person with shingles. 1st lines of defence.Again, consider looking at when PPE needs to be worn against the risk of transmission. The risks come from the ooze from the pustule sites – potentially contact and airborne transmission; if the pustules have not burst or have scabbed/healed there is no risk. Hence transmission PPE is not required, only standard precautions. (If a person is diagnosed early and on an antiviral for the virus, they are more likely to heal faster.)
If a person has localised shingles on the torso the area can usually be covered with a dry, waterproof dressing and clothes to protect the area – transmission PPE is not required, only standard precautions. Contact precaution PPE (gloves/gown) is only required when the area is exposed – i.e. showering.
Where transmission PPE is not required, it may reduce the concerns and fear of staff and increase willingness to work.
Note: Disseminated shingles = on multiple sites on the body, including the face, is not easy to cover and transmission risk is higher. Here staff should wear contact and airborne (respiratory) precautions with a PFR and eye protection, until all blisters have crusted/healed over.
See the Aged Care Guide pg 80 + pg 82:
https://www.safetyandquality.gov.au/sites/default/files/2024-08/The-Aged-Care-Infection-Prevention-and-Control-Guide.pdfRegards Carrie
