Feb

23

2022

Managing COVID outbreaks in North Coast RACFs

Residential Aged Care Facility (RACF) outbreak numbers across the region have reduced by 50% in the last few weeks providing a small period of recuperation for all.

Over 85% of RACFs have had an outbreak or exposure, and as we move into outbreaks being part of business, as usual, the learnings from the last month assist to function in the new normal.

Supporting this approach, the Commonwealth Govt. has updated the National Guidelines for Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities.

The most significant changes are summarised below.

The definitions of an outbreak or exposure are now:

  • A RACF COVID-19 exposure is defined as:
    • any case of COVID-19 in staff, residents or a visitor at the facility during their infectious period that does not meet the definition of an outbreak.
  • A RACF COVID-19 outbreak is defined as either:
    • two or more residents of a residential care facility who have been diagnosed with COVID-19 via RAT or PCR test within 5 days and has been onsite at the residential care facility at any time during their infectious period; or
    • five or more staff, visitors and/or residents of the residential care facility diagnosed with COVID-19 through RAT or PCR test within past 7 days who worked/visited during their infectious period.

Declaring an outbreak over:

  • The source of infection and transmission is understood within the facility, and there is no further risk of transmission.
  • No further resident cases identified within past 7 days from when the last case was effectively isolated.
  • Where residents identified as a case or close contact are able to effectively isolate, and there is no ongoing risk, the RACF can consider a staged return to business as usual.

This week, NSW Health will update the local jurisdiction advice to guide practice in relation to the above. Until then, the RACFs are working to the current definitions.

Antiviral medications have been delivered to all RACFs; because of the short time period to commence the treatment, we encourage GPs to work with the RNs and coordinate anticipatory orders for residents that meet the criteria.

The CEC Medication Safety Updates provides:

  • information on both treatments; Molnupiravir and Nirmatrelvir/Ritonavir
  • consent forms for residents
  • declaration form to be completed.

Until the antivirals are on the PBS the RACF will restock supplies used in an outbreak through the Commonwealth Case Managers.

Australian Defence Force

The Australian Defence Force (ADF) is currently in our region supporting one of the outbreaks, and feedback has been extremely positive.

NSW has 10 ADF teams providing support to RACFs, particularly in rural and remote areas. The teams predominantly provide general support with administration, screening, companionship, cleaning, etc.

There are two teams with clinical personnel available. The focus is not only during an outbreak but on fatigue management after an outbreak to assist with recovery.

Healthy North Coast acknowledges the hard work of all the RACFs, Public Health Unit and Local Health Districts involved in the outbreak management across the region.

Visit the Mid & North NSW HealthPathways website for related information:

COVID-19 Assessment and Management in Residential Aged Care

Username: manchealth
Password: conn3ct3d

Submit A Story

We acknowledge the Traditional Custodians of the lands across our region, and pay our respect to Elders past, present and on their journey. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to the land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander Peoples as the Land’s first peoples and honour the rich diversity of the oldest living cultures.

Healthy North Coast is an independent, not-for-profit organisation proudly delivering the PHN program in North Coast NSW. We are committed to improving the health of our communities through quality primary health care.
The PHN program is an Australian Government Initiative.
Facebook Linkedin

Aged Care Disaster Management Planning

Strategic Priority Area: One team

North Coast is identified as the region most likely to be impacted by climate change in Australia and also forecasted greatest growth in those 65+.

Healthy North Coast takes a lead role in ensuring the older population and the sector that supports them are prepared for, can respond to and recover from disasters and other emergencies.

We have led eight regional disaster management capacity building workshops, bringing together SES, community organisations and the aged care sector.

We have also developed disaster preparedness tip sheets for both residential and community aged care providers.

Read the media release: Aged Care Homes Prepare for Disasters

Voluntary Assisted Dying

Strategic Priority Area: One team

In May 2022, the NSW Parliament passed the Voluntary Assisted Dying Act 2022. Effective from Tuesday, 28 November 2023, eligible people have the choice to access voluntary assisted dying. 

Healthy North Coast has developed a webpage for both health professionals and consumers, with links to available information and resources.

Visit the Voluntary Assisted Dying webpage

Living with Dementia resources

Strategic Priority Area: No one is left behind

Healthy North Coast has worked with people living with dementia, their families and local service providers to develop an information booklet that will help them connect with local and national supports along their journey.

The booklet includes commonly asked questions for people to ask their GP and/or specialist.

The resource is available in digital and printed copies, with more than 5,000 distributed across the region. An e-version is available to clinicians via the Dementia and Cognitive Impairment HealthPathway.

View the Living with Dementia booklet (PDF)

Deteriorating Resident Triage Tool Pilot

Strategic Priority Area: One team

The Deteriorating Resident Response Tool (DRRT) has been developed to guide RN’s in Residential Aged Care homes (RACHs) to better understand, anticipate and make clinical decisions responding to the deteriorating health of residents.

The objective of the DRRT is to give RACH staff clear information to triage and provide appropriate care for a range of residents’ health conditions, and, in turn, prevent unnecessary presentations to ED.

The tool has been designed together with a specialist geriatrician, consulting with stakeholders such as Residential Aged Care Managers, NSW Ambulance, GPs, and experts from Mid and North Coast LHDs.

The pilot commences in March with four participating RACHs. Evaluation measures will include effectiveness in building RN confidence and reported reduction in unnecessary hospitalisations. Findings will inform a future planned, region-wide implementation.

View the deteriorating resident response tool

North Coast Care Finders Program

Strategic Priority Area: No one is left behind

The Care Finders program is a free region-wide service to support vulnerable older people who have no-one else to help them, to learn about, apply for and set up support services.

Care finders can help people understand what aged care services are available, set up an assessment, and find and choose services. They also help people with access to other supports in the community, both accessing services for the first time and changing or finding new services and supports.

On the North Coast, Healthy North Coast has commissioned four organisations to provide this important service: EACH, Carexcell, Lifetime Connect and Footprints.

Visit the commissioned services listings to find out more, including service contact information.
icon with person and hands

Psychological services in residential aged care homes

Strategic Priority Area: Improving Lives Now

Healthy North Coast commissions two service providers to deliver psychological therapies and supports for older people with, or at risk of developing, a mental illness and who are living in residential aged care homes (RACHs).

The aim of the program is to both provide direct support to residents and their families and carers, as well as upskill the RACH workforce to respond to the needs of residents presenting with mental health concerns.

Visit the commissioned services listings to find out more, including service contact information.​

Social prescribing (Healthy Me Healthy Community)

Strategic Priority Area: Securing a Healthier Future

Delivered by Feros Care, the Healthy Me, Healthy Community program aims to build individual and community connections to reduce loneliness and improve wellbeing in Port Macquarie.

The program helps people to connect with community, activities, supports and services that address their broader social determinants of health, as an alternative or supplement to a clinical approach.

Visit the Healthy Me Healthy Community service page
Read the consumer story: Jim’s confidence boost brings a new lease on life
icon with person and hands

Digital Health in Residential Aged Care

Strategic Priority Area: Improving Lives Now

Timely access to primary health care professionals, whether through face-to-face consultation or telehealth, is recognised as an issue for many Residential Aged Care Homes (RACHs), that in some cases can lead to potentially preventable hospitalisations. RACHs require adequate telehealth facilities to support access to virtual consultations for their residents.

Project goals

  • Assist participating RACHs to have appropriate telehealth facilities and equipment to enable their residents to virtually consult when needed with their primary health care professionals, specialists and other clinicians. 
  • Provide training to participating RACH staff to support them to have the capabilities to assist their residents in accessing virtual consultation services.
  • Encourage increased use of My Health Record by RACHs, to improve the availability and secure transfer of resident’s health care information between RACHs, primary care and acute care settings.
For more information, visit the Residential Aged Care Virtual Care Project webpage
icon with person and hands

Greater Choice at Home Palliative Care Program

Strategic Priority Area: Improving Lives Now

Aims to provide people who have life limiting conditions the opportunity to exercise choice and receive high quality care at home, harnessing improved and better coordinated supports and services that meet their individual needs.

Program objectives:

  • Improve access to palliative care at home and support end-of-life care systems and services (in primary health care and community care)
  • To enable the right care at the right time and in the right place (to reduce unnecessary hospitalisation)
  • Generate and use data to support continuous improvement of services across sectors
  • Use available technologies to support flexible and responsive palliative care at home, including in the after-hours.

These objectives will contribute to achieving the following intended overarching outcomes of:

  • Improved capacity and responsiveness of services to meet local needs and priorities
  • Improved patient access to quality palliative care services in the home
  • Improved coordination of care for patients across health care providers and integration of palliative care services in their region.
Download the 2023 Palliative and End-of-life Care Needs Assessment (PDF)

Education & training funding elibility

Funding is open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.

References

  1. Healthy North Coast Health Needs Assessment, 2022-2025
  2. Northern Rivers Vital Signs, 2023
  3. Northern Rivers Community Foundation Flood Impact Report, May 2023
  4. Centre for Evidence and Innovation, Participatory Grantmaking: Building the Evidence, May 2023
  5. Lee, G., Vine, K., Atkinson, A-R., Tong, M., Longman, J., Barratt, A., Bailie, R., Vardoulakis, S., Matthews, V., & Mizanur Rahman, K. (2023). Impacts of Climate Change on Health and Health Services in Northern New South Wales, Australia: A Rapid Review. International Journal of Environmental Research and Public Health, 20, 6285. 
  6. Sewell, T., Stephens, R., Dominey-Howes, D., Bruce, E., & Perkins-Kirkpatrick, S. (2016), Disaster declarations associated with bushfires, floods and storms in New South Wales, Australia between 2004 and 2014. Scientific Reports (6). 
  7. Dominey-Howes, D., Bruce, E., Stephens, R., Perkins-Kirkpatrick, S., & Sewell, T. (2016). Natural disasters are affecting some of Australia’s most disadvantaged communities. The Conversation. Natural disasters are affecting some of Australia’s most disadvantaged communities (theconversation.com).

Workforce Locum support and R&R funding criteria

  • Available to primary care services in disaster impacted communities within the Healthy North Coast footprint.
  • Available to support short-term workforce coverage, allowing clinicians to rest and recover.
  • Workforce-support funding in total is capped for each site, over a 12-month period:
    • $10k for GPs and/or
    • $5K for nursing and/or
    • $5k administration support and/or
    • $5K allied/pharmacy and other.
  • Funding is not to be used to fill gaps in staffing that have not been able to recruit to and not to replace existing staff.
  • Healthy North Coast will assess requirements and approve available funding directly with the service requesting support.
  • Priority will be given to sites that have immediate, short-term workforce support needs.
  • Requests will be reviewed and supported on a case-by-case basis.
  • Program funding administered via RCTI Agreement (Recipient Created Tax Invoice) to be paid monthly, or on completion of the placement (whichever comes first).
  • Practices will be required to complete a request for payment form monthly, or on completion of the placement (whichever occurs first).

Wellbeing Flexible Funding Criteria & Eligibility

  • Open to all primary care providers within disaster affected communities across the Healthy North Coast footprint.
  • Activity must be purposeful, with the aim of increasing the wellbeing of your team.
  • Requests will be assessed on a case-by-case basis, with funding allocated based on team size.*
  • Following approval by Healthy North Coast, funding will be administered via RCTI Agreement (Recipient Created Tax Invoice) upon providing proof of expenses.
  • Funding cannot be used for the purchase of alcohol, or any other goods or services where the vendor cannot quote their Australian Business Number.
  • Planned activities must occur prior to 30th June 2024.
  • Funding will not be available for retrospective activities.
*Team Size
(Total staff and contractors)		Funding Available
Small (1-5)$500-$1500
Medium (6-20)$1500-$4000
Large (>20)$4000-$5000