Poor staffing increases aged care hospitalisations

Inadequate staffing and skill levels have been identified as major contributing factors in avoidable hospital visits by many aged care residents in New South Wales, coupled with lengthy delays in being discharged after a hospital stay.

A new report compiled by 11 members of the NSW Aged Care Roundtable (representing medical, clinical, nursing and consumer groups) outlines systemic issues linked to the quality of personal and clinical care in residential aged care facilities. Each group undertook surveys of their own members to inform the report.

Falls, palliative care, behaviour management in dementia sufferers, catheterisation and pain management were common reasons aged care residents had been transferred to hospital.

Deficiencies in simple wound care, medication errors or basic pain relief were also highlighted among avoidable hospitalisations.

Each of the groups indicated improved access to general practitioners in aged care was essential, meanwhile adequate registered nurse staffing and skill levels were also universally identified.

A lack of general practitioner availability and limited registered nurses on site at residential aged care facilities were among key concerns raised by members of the NSW Nurses and Midwives’ Association (NSWNMA).

NSWNMA General Secretary, Brett Holmes, said urgent change was required to enhance the safety and quality of care provided within residential aged care facilities.

“A survey of our aged care members found 95% had transferred a resident to hospital in the past year for anything from a urinary tract infection, dehydration or poor nutrition, to pain relief,” said Mr Holmes.

“Alarmingly, 78% of those same aged care members believed those hospital transfers were avoidable.

“Improved staffing in residential aged care is paramount, with 74% of our members stating hospital transfers could have been prevented if more nursing staff were rostered on, while 49% said a lack of GP availability was a contributing factor.

“It’s clear that poor staffing in residential aged care facilities are placing a significant burden on nearby public hospitals.

“The situation not only leaves aged care residents vulnerable to injury, it’s also shifts the cost of their care onto an already stretched public hospital system.

“Enhancing shift-by-shift nursing staff and skills mix inside residential aged care facilities, as well as GP availability, would help towards alleviating these issues.”

The report also recommends national clinical care benchmarking for residential aged care to reduced avoidable hospital presentations, and better integration with primary care services.

The report has been submitted to the Royal Commission into Aged Care Quality and Safety ahead of its planned hearings into the aged care workforce next month.

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