If the possibility of failing Standard 3 is keeping you up at night, you’re right to be worried. In March 2020, Pride Living collated and released a report on non-compliant and sanctioned facilities in Australia. This report focused on 1 July 2019 to 30 December 2019, showing the first six months of data collected after the 2019 NHMRC Standards changes.
Note: While the start of this article is a little numbers-heavy, discusses these results in a little more details.
Who is failing Standard 3?
The results are telling. The graph below comes directly from the report and shows that Standard 3 represented over 23% of unmet standards across all non-compliant facilities.
Not only that, but of the top four most commonly unmet requirements, three are from Standard 3:
Graph source: Pride Living, ‘Insight into non-compliance data from Jul-Dec 2019.
- 3(3b) High impact or high prevalence risks managed effectively
- 3(3a) Safe and effective personal and clinical care
- 8(3d) Risk management systems and practices
- 3(3d) Recognition and response to deterioration.
The Pride Living report compared unmet Standards outcomes in facilities that had been sanctioned and those deemed non-compliant:
The above graph shows that 100% of sanctioned facilities failed to meet standard 3, as did 85% of non-compliant facilities.
These findings are echoed in an article from The Conversation, which showed that Standard 3 was the most frequently breached standard since the 2019 changes were brought in
Graph source: Else Kennedy. CC BY-ND.
Clearly facilities are struggling to meet Standard 3. But what does Standard 3 cover, and how serious is failing to meet its requirements?
What does Standard 3 cover?
From the ACQSC:
Consumer outcome 3
(1) I get personal care, clinical care, or both personal care and clinical care, that is safe and right for me.
Organisation statement 3
(2) The organisation delivers safe and effective personal care, clinical care, or both personal care and clinical care, in accordance with the consumer’s needs, goals and preferences to optimise health and well-being
Standard 3 focuses on ensuring safe, effective care for residents. Its seven requirements focus on tailored, best practice care. This is achieved through timely internal communication, changing care as required to suit residents’ changing needs, and the minimisation of infection-related risks.
Standard 3 also links to four other standards, specifically 1, 2, 7 and 8. Failure to meet the requirements of Standard 3 can therefore have a knock-on effect on compliance throughout the facility.
Standard 3 and risk management
Standard 3 can be summarised as covering a range of best practices within an aged care facility. This covers anything, from ensuring residents and their families are kept informed, to making sure high risk activities are performed safely. Risk management isn’t just about preventing needlesticks and cleaning up spills. It also includes making sure that equipment is clean, that standard and transmission-based precautions are being followed, and also that antimicrobial stewardship is being properly administered and documented. It can also show current staffing measures are insufficient, whether as a result of understaffing or undertraining.
The Pride Living study also showed that while larger facilities (over 49 beds) were typically less compliant, there were also non-compliant facilities with fewer than 49 beds. This suggests that failing Standard 3 isn’t just an issue of scale: even small facilities can struggle.
Compliance with Standard 3 not only protects residents and their families, but the facility’s team as well. It can help reduce the risk of outbreaks (including influenza and MROs) and healthcare-associated (nosocomial) infections. Failing Standard 3 can result in sick residents, sick staff and reduced capacity during high-demand situations. Never has this been more relevant than in the time of COVID-19, where asymptomatic spread means that facilities can become infected silently and become quickly overwhelmed.
Passing Standard 3
The easiest way to comply with Standard 3 is to ensure that your day-to-day processes are comprehensive and consistent. Your entire team needs to know what you expect, and how they can perform their duties to the best of their abilities. This involves regular communication with staff, clear reminders on best practice, and regular checks to ensure that they are compliant with Standards. Indeed, the cost of an infection-free facility is eternal vigilance.
If you want more guidance on how to make your facility infection-free, read our blog post ‘Creating an Infection-free Facility in 2020’.