Why COVID-19 training and education is still important in 2023

As Australia experiences its fourth year with COVID-19, aged care remains susceptible to outbreaks, and as a result, the need for ongoing COVID-19 prevention and management has never been greater.

Externally, public perceptions have shifted following the removal of widespread restrictions, while the lack of direction on vaccinations means there is no real sense of urgency ahead of potential winter outbreaks due to the latest XBB.1.5 ‘Kraken’ subvariant.

However, summer was not necessarily forgiving for aged care residents. The total number of deaths has now passed 5,000, while the surge workforce continues to be utilised across 30+ different homes.

As a result, aged care providers have continued to step up and engage staff in additional training to maintain preparedness. The threat of an outbreak spreading quickly is one that has spurred a renewed interest in reinforcing infection prevention and control measures.

Michael Page is the Clinical Facilitator at Uniting Communities, and although he has only been in the role since late 2022, he has worked in aged care and healthcare settings throughout the duration of the pandemic.

Being adaptable

Mr Page said those early experiences, like many, have shaped the knowledge used today to combat outbreaks.

“We learnt a lot from real-life experience and we learnt as we went along with the outbreaks from the change from Delta to Omicron. You had to be adaptable,” said Mr Page.

“South Australia was lucky to a large degree because the borders stayed shut for so long and we really missed the Delta variant that hit Victoria and New South Wales in that first year.

“Because of those restrictions we had some time to prepare, but I think everyone who’s gone through a COVID outbreak would say the same; it doesn’t matter how much preparation you have, it’s still going to be an overwhelming experience as you get your head around it and start to manage it.”

Over time, regular challenges have included the loss of experienced staff due to outbreaks, workforce shortages and a general lack of guidance regarding COVID-19 management from the Government.

Ongoing training

But as leaders and staff have adapted and learned, there has been more time to focus on the implementation of successful outbreak prevention and management plans. Mr Page said much of the success has come from clear communication.

“Every home is different, even within organisations, and COVID-19 reacts and responds in a different way to different environments. Aged care homes aren’t hospitals, they’re not clinical facilities, and it’s very difficult to control the spread of something like COVID-19,” said Mr Page.

“When the COVID-19 outbreak happens, especially if you have a relatively small workforce, then if the senior managers are furloughed with COVID-19 what happens then?”

“So we have to be ready, we have to have the outbreak plan ready. It has to be communicated well across the organisation in the corporate sectors but also to new starters and agencies.

“They have to know what to do in the first 30 minutes of an outbreak so they feel safe and confident to come to work as well.”

Faced with the risk that experienced staff could be unavailable due to outbreaks, interest in the training and education of as many staff as possible increased. 

This interest has continued through to 2023 due to the uncertainty of potential outbreaks and a desire to upskill as many staff as possible.

Being vigilant

Mr Page said one of the most effective ways to keep staff informed and engaged with infection control and prevention is by providing real-life training examples on a regular basis.

“Regularly and sporadically go and check how it’s actually being done on the floor and in reality,” said Mr Page.

“Question and ask people to paraphrase back or to demonstrate their understanding, not just in teaching sessions in the classroom, but in the flow of work and in the reality of what they do every day.

“It’s about continual training, spaced and repetitious learning, going back and checking that people are still doing what they’re doing and just involving them and appealing to their motivations.”

Simple personal protective equipment (PPE) checks and online training are not enough to reinforce and remind staff of correct processes, particularly when some may no longer be as concerned about the threat of COVID-19.

“Aged care is a busy environment and people may become slightly complacent about what may be happening. We may seemingly be COVID-19 free but we don’t know that for sure,” said Mr Page.

“Initially, it was very scary and most staff were concerned, asking questions like ‘will I die’, ‘could I infect my family at home’, but for some people, that’s worn off.

“That’s why we have to be even more vigilant now, we have to keep doing the drills, the on-floor questioning of staff, asking them to paraphrase if this situation or scenario occurred what would you do.”

Mr Page said there is always a focus on ensuring that a number of different staff can implement an outbreak management plan in case a worst-case scenario occurs.

A fresh approach

The evolution of COVID-19 protection has been an interesting one as restrictions have eased. Initially, the focus was on isolating infected persons entirely, while now the public is essentially self-monitoring.

Aged care has always been different as it has not always been possible or safe to move residents. 

Ultimately the best answer is one that works and continues to work best for your home. You need to continually identify the most effective and safest practices that suit the current stage of the COVID-19 pandemic.

“There are lots of complications if you have one or two cases in one area of the home as you have to determine whether you move the residents, cohabitate them with other residents with COVID-19 or do you leave them where they are,” said Mr Page.

“It’s difficult to have a black-and-white answer because everything will be different in each scenario.”

As a fresh set of eyes for Uniting Communities, Mr Page brought in a birds-eye view of their operations to assess the efficiency of their existing COVID-19 management plans. 

He said the most recent Christmas period brought opportunities for analysis and feedback to influence protocols moving forward.

“I went into the COVID-positive zones to see what was going on, just to observe how people were taking out waste, how they were dealing with laundry, and to give some suggestions,” said Mr Page.

“There was nothing that was done incorrectly, but there were better ways to problem-solve it.

“For example, having staff enter through one area and go out through another would limit traffic, but it would also allow us to set up donning stations in one place and doffing stations in another.

“I could also look at the layout on the map of the home to see if there is an easier way that we can move people through the home while trying to keep things as normal as possible when there was an outbreak.”

And much like the hands-on approach to training staff, a hands-on approach for management has continued to provide learning opportunities and growth at all levels.

Where some organisations may have previously opted to remove experienced staff to prevent the loss of valuable experience during an isolation period, Mr Page reinforced the need to keep leaders on the ground as a way to support best practices.

“If staff see you alongside them, supporting them, guiding them, ensuring they’re doing everything correctly and safely, continuing to have meaningful engagement with residents, that can have really positive outcomes both for resident care and limiting the length of that outbreak,” said Mr Page.

“You can support staff, work alongside them and show solidarity. Don’t ask them to do anything that you won’t visibly demonstrate yourself.”