Nurses are lifesavers for the elderly
Having an RN on duty would cut infection rates and deaths in facilities hit by COVID-19.
The chance of a nursing home resident contracting COVID-19 decreases substantially for every registered nurse employed, recent international studies show.
Even an additional 20 minutes of nursing a day per resident was found to cut pandemic deaths and cases by more than 20 per cent.
A report published by the Journal of the American Medical Association, which reviewed 4255 nursing homes across eight US states, found nursing homes with more nurses had fewer cases of COVID-19.
Another study in the US state of Connecticut found that every 20-minute (per resident day) increase in RN staffing was associated with 22 per cent fewer confirmed cases and 26 per cent fewer deaths, the Sydney Morning Herald reported.
In Canada, where more than 80 per cent of COVID cases were in aged care facilities, a study looking at the impact of private ownership of aged care homes said policy should be directed at funding, mandating and enforcing sufficient staffing levels.
The Canadian report cited a Californian study that found facilities with fewer nurses than the recommended minimum standard (45 minutes per resident day) were twice as likely to have residents with coronavirus infection than adequately staffed facilities.
Assistant General Secretary Judith Kiejda said the US and Canadian findings vindicated our ongoing national campaign for ratios in aged care.
In submissions to the Royal Commission the ANMF has advocated for minimum mandated staffing with a skill mix of RNs, ENs and Assistants in Nursing.
Previously, the NSWNMA had run a state-based campaign to ensure RNs were employed in nursing homes around the clock after federal legislation removed the distinction between high and low care in 2014.
This led the NSW government to decide that no aged care operator would be required to employ an RN or appoint a DoN.
Decisions regarding staffing would be left for operators to make, and the aged care regulator to monitor.
“The government’s move ignored the fact that increasing numbers of high-care residents were being admitted to residential facilities,” Judith said.
“Also, a growing number of high-care residents were being cared for in former low-care ‘hostels’ where RNs were not legislated.”
The campaign gathered over 25,000 community signatures.
National Campaign for minimum staffing continues
The state government implemented a transitional regulation that ‘grandfathered’ the requirement for an RN to be on duty at all times, and a DoN in facilities that were classified as nursing homes prior to 1 July 2014.
However, its continuation relies upon annual lobbying from the NSWNMA and community groups.
“This provides only a tenuous safeguard for high-care residents and RNs employed in former nursing homes,” Judith said.
“Governments need to recognise aged care as an integral part of health care, and staff with trained nurses accordingly.
“Our national campaign will continue for minimum staffing ratios of RNs, ENs and AiNs/care workers, including a clinical director or director of nursing who is an RN.
“COVID-19 has also highlighted the need for facilities to appoint a clinician responsible for infection prevention and control, who could also be the DoN or an RN with additional qualifications.”
Public homes safer in pandemic
Non-government nursing homes in Victoria, which have no legislated staff ratios, have experienced 40 times more cases than public homes that have mandated ratios for nurses.
In August, Victorian Premier, Daniel Andrews, said government-run nursing homes, which have about 5400 beds, had six cases of COVID-19, a rate of about 0.1 per cent.
In contrast, there had been 1923 cases in non-government homes with 44,600 beds, a rate of 4 per cent.
Regulators failed to plan for COVID-19
During hearings at the aged care royal commission in August, counsel assisting the commission, Peter Rozen QC, criticised the Aged Care Quality and Safety Commission (ACQSC) for failing to plan for COVID-19.
“The evidence will reveal that neither the commonwealth department of health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector,” Mr Rozen said.
“Given that it was widely understood that recipients of aged care services were a high-risk group, this seems surprising.”
He also said it was surprising the ACQSC had not investigated the circumstances of the Dorothy Henderson Lodge and Newmarch House outbreaks in Sydney, despite incident investigations being “normally one of the key tasks of any regulator”.
Monash University professor Joseph Ibrahim, a leading authority on aged care, told the royal commission: “The system is broken. And what we’ve seen with COVID is that the system is broken at a high level because it’s not the aged care workers that have failed us in this.
“It is our people who are in governance roles – and I’m not going to call them leaders because they’re not leading – the people in governance positions who are accountable for what happens is where we have failed.
“They have not recognised the magnitude of the problem staring them in the face.”