Employing additional Registered Nurses in aged care, and training and accrediting all unregulated health care workers (also known as personal care workers) has been demonstrated to provide better quality care for older Australians and could have potentially reduced the spread of COVID-19 in residential aged care facilities.
"The Australian College of Nursing extends its condolences to every Australian who has lost a loved one due to the COVID-19 outbreak and hopes all those currently fighting this disease make a full recovery," Australian College of Nursing (ACN) President, Professor Christine Duffield FACN said.
"Particularly concerning is the number of aged care residents who have contracted COVID-19 in recent weeks. The shortcomings of our current residential aged care system were exposed long before the pandemic, as evidenced by the establishment in 2018 of the Royal Commission into Aged Care Quality and Safety."
Since 2016, ACN has consistently called on Governments to tie regulation of aged care facilities to having Registered Nurses on-site and leading delivery of care.[1]
"Nurses raise the standard of care, they have a direct impact on health outcomes", Professor Duffield explained." In light of the current challenges presented by COVID-19, we need more nurses present in nursing homes to ensure proper infection control measures are in place."
"There is evidence demonstrating the positive impact Registered Nurses can have on patient and resident health outcomes and this has been reinforced by research coming out of the United States during COVID-19. A study from the University of Rochester found nursing homes with more Registered Nurses on duty during the pandemic, had 22 per cent less confirmed coronavirus cases." [2] [3]
ACN welcomes the measures being taken to ensure aged care facilities in Victoria are adequately staffed, including the mobilisation of Australian Defence Force personnel and redeployment of hospital staff.
"Long-term, it is not simply as easy as saying we need a certain number of Registered Nurses, we need to get the skill-mix right and ensure all staff providing care have appropriate training," Professor Duffield said.
"Caring for older Australians is becoming very complex as they increasingly now have chronic conditions, co-morbidities and complicated medication regimes. In addition, ageing in place means many will not want to be transferred out of their residential aged care facility as their health deteriorates. End-of-life care requires sophisticated nursing skills." Professor Duffield said.
Between 2003 and 2015, the number of residential aged care places increased by 30 per cent and dependency levels of residents rose from 64.4 per cent assessed as high care to 89 per cent.[4] As at 2016, unregulated health care workers made up 70 per cent of the aged care workforce, while the number of registered nurses fell from 21 per cent in 2003 to less than 15 per cent.[5]
In 2019, ACN released its Regulation of the Unregulated Health Care Workforce across the Health Care System White Paper calling for unregulated health care workers to obtain a minimum qualification before working within primary, acute or residential aged care, and for regulation of this workforce.
"Older Australians deserve the best possible care and this requires more Registered Nurses in our residential aged care facilities, and accredited training and registration for all unregulated health care workers," Professor Duffield said.
The Australian College of Nursing looks forward to continuing to work with the Commonwealth Chief Nursing and Midwifery Officer, Alison McMillan MACN to address the issues raised in aged care.
[1] ACN Position Statement: The role of Registered Nurses in residential aged care facilities. July 2016
[2] Li, Y., Temkin‐Greener, H., Shan, G. and Cai, X. 2020. COVID ‐19 Infections and Deaths among Connecticut Nursing Home Residents: Facility Correlates. J Am Geriatr Soc. doi:10.1111/jgs.16689
[3] The Weekly Source 2020. US study links lack of RNs to number of COVID-19 cases - recommends regulator target homes with lower infection control. Published 23 June 2020. Viewed at: https://www.theweeklysource.com.au/us-study-links-lack-of-rns-to-number-of-covid-19-cases-recommends-regulator-target-homes-with-lower-infection-control/
[4] Royal Commission into Aged Care Quality and Safety 2019. Royal Commission into Aged Care Interim Report. Viewed at: https://agedcare.royalcommission.gov.au/publications/interim-report
[5] HelloCare 2019. Unregulated staff make up 70% of aged care workforce. Published March 2019. Viewed at: https://hellocaremail.com.au/unregulated-staff-make-70-aged-care-workforce/
