Accreditation reports reveal unsafe care in aged care
Wound and skin care is the most frequently found safety risk to residents of aged care in accreditation reports
Wound and skin care is the most frequently recorded safety risk to residents of aged care, followed by resident behaviour and infection control, according to new research from the Australian Institute of Health Innovation (AIHI), Macquarie University, examining accreditation assessment reports.
Lead researcher and patient safety expert, Professor Peter Hibbert, examined accreditation assessments conducted by the Aged Care Quality and Safety Commission (ACQSC) to identify priority areas for improving the safety of aged care residents. The research is published in the International Journal for Quality in Healthcare.
Accreditation assessment reports are not primarily used to identify safety risks, however this research shows the benefit of examining their narrative descriptions in future quality improvement initiatives, Prof Hibbert said.
More than one third (37%) of organisations that had an accreditation assessment between September 2020 and March 2021, did not meet at least one requirement of the compulsory standard for personal and clinical care (known as Standard 3).
The most frequent clinical issues, which comprised more than 10% of safety issues, were wound or skin management, infection control, and restraint management. Not adequately recognising pain, was also a relatively frequent issue - this is important as it can significantly impact a resident’s quality of life and it is not well reported in incident reporting data.
The analysis investigated reports for 65 organisations that were identified by ACQSC accreditation assessments as failing to meet Standard 3. Private, community based, and charitable aged care providers were included in the study. Most were from metropolitan areas. 2267 safety incidents were identified within these reports, mainly from within care documents including care plans, and assessments.
Prof Hibbert said that one report included the description “Multiple photos of the wounds recorded in the resident’s charts were of poor quality and do not show the full representation of how the wound has deteriorated” providing a valuable insight into unsafe practices that might not otherwise be identified.
Another report included a description of poor infection control: “…. resident rooms, bathrooms and furnishings were observed by the assessment team to be covered in dirt and grime and mould in some showers.”
This is the first study of its kind to use accreditation assessments to identify and evaluate safety risks in aged care.
This research provides new evidence to policy makers and aged care providers that safety risks identified in accreditation assessments can be used to prioritise improvements within residential aged care facilities.
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