Enacting infection prevention and control (IPC) in elderly long-term care facilities (LTCFs): a meta-synthesis of qualitative studies

Conference:

2020 SAPC North

Talk Code:

B1.5

Presenter:

Paul Pascall Jones

Twitter:

@@PaulPascall

Author institutions:

University of Manchester

The problem

Individual, local and national factors make the care home setting susceptible to infectious diseases. The Covid-19 pandemic has highlighted longstanding complexities in preventing and controlling carriage of infection between care home residents and staff. Increased susceptibility to infection of residents makes infection prevention and control a key issue in reducing mortality and complication rates from infectious disease in the older population. To date the experiences of key stakeholders in relation to infection control practices and behaviours in care homes have not been understood in depth.

Approach

A qualitative meta-synthesis using Noblit’s Meta-Ethography methodology was conducted. Multiple databases were searched from inception to June 2020 including CINAHL, Medline, Embase, PsychINFO and ASSIA. Fifteen eligible studies were identified from 28 which reached inclusion criteria from 652 screened abstracts, on the basis of relevance and trustworthiness. We synthesised these findings of these 15 studies into key concepts, assessed where the literature is alike or diverges, and look to move beyond single studies conceptually.

The learning

Findings are emergent but early analysis identified a range of factors influencing infection prevention and control including resident and staff behaviour and knowledge, health system design and culture, and interaction between care home and other healthcare settings. The findings suggest that organisational and systemic change, rather than an individualistic blame culture focused on those who receive inadequate training, will do better to increase infection prevention and control. There is a absence in the literature of residents voices.

Why it matters

The care home is a specific environment separate from hospital and private accommodation. As such it requires evidence-based infection policy derived from trustworthy research specific to it. Our findings point towards organisational changes to prevent and contain infections including Covid-19.

Presenting author: Paul Pascall Jones, Manchester Medical School, University of Manchester, Medical Student (LTHTR Base Hospital), SPCR NIHR Intern 2020

Email: Paul.pascalljones@student.manchester.ac.uk

Twitter handle: @PaulPascall

Primary Investigator: Gavin Daker-White, NIHR Greater Manchester Patient Safety Translational Research Centre (Greater Manchester PSTRC) , The University of Manchester,

Gavin,daker-white@manchester.ac.uk

Co-authors: Maria Panagioti, NIHR Greater Manchester Patient Safety Translational Research Centre (Greater Manchester PSTRC) , The University of Manchester,

Maria.panagioti@manchester.ac.uk

Sally Giles, NIHR Greater Manchester Patient Safety Translational Research Centre (Greater Manchester PSTRC) , The University of Manchester,

Sally.giles@manchester.ac.uk

Thomas Blakeman, NIHR Greater Manchester Patient Safety Translational Research Centre (Greater Manchester PSTRC) , The University of Manchester,

T.m.blakeman@manchester.ac.uk

Victoria Moore

School of Social Sciences, Manchester