Press Releases

Government will help elderly homes enhance competency in infection control

The Government would adopt measures to help residential care homes for the elderly (RCHEs) to enhance their competency in infection control, with a view to ensuring that they are more able to work in partnership with departments concerned in preventing the spread of infectious diseases in their premises, a spokesman for the Health, Welfare and Food Bureau (HWFB) said today (October 19).

 

The spokesman said: "The findings in the reports submitted by the Social Welfare Department (SWD) and the Department of Health (DH) on the norovirus outbreak in the Shui Oi Convalescent Home have pointed to the fact that despite the continuing and concerted efforts of relevant Government departments, the awareness of and skills in infection control in individual RCHEs may still fall short of our expectation, in particular during crisis."

 

        The norovirus outbreak in Shui Oi in early September had affected 14 of the 31 residents and four staff members. On September 8, the Secretary for Health, Welfare and Food asked SWD and DH to submit detailed reports on the incident.

 

        The HWFB had studied the report findings. It concluded that:

 

*The improper handling of the vomitus and insufficient disinfection of the vomited areas by the staff of Shui Oi were the principal causes of the norovirus outbreak.

 

*The closure of the toilet facilities, which severely tested the crisis management capability of Shui Oi, was the contributing factor. The lack of alertness and inadequate knowledge on infection control of Shui Oi, and its failure to report promptly the closure of the toilet facilities to SWD had exacerbated the problems by preventing timely intervention by SWD and DH.

 

*As the licensing authority, SWD could have monitored the developments of the events more aggressively in consultation with DH when the closure of the toilet facilities had first come to its notice.

 

*The relocation exercise was conducted smoothly in full consultation with the elderly residents and their families.

 

       Enhancing the awareness and capabilities of RCHEs on infection control has always been one of the top priorities of the HWFB, SWD, DH and the Hospital Authority in protecting the elders in RCHEs,�� the spokesman said.

 

        HWFB had reviewed the existing infection control measures for RCHEs, the existing infectious disease notification mechanism for RCHEs, and the actions which SWD could take against RCHEs for non-compliance with licensing requirements and standards on infection control.

 

        The bureau noted that the existing measures were generally effective in helping and monitoring RCHEs in infection control. However, it was possible to make further improvements.

 

        For individual RCHEs found not meeting our standards regarding infection control and crisis management through regular monitoring, SWD would conduct joint visits with DH to identify follow-up actions required, including training for RCHE staff on infection control. SWD will make available customised training on management for RCHEs in collaboration with training institutes and concerned parties.

 

        SWD would step up training on infection control and crisis management for its staff in the licensing office of RCHEs. SWD would also work with DH to facilitate closer collaboration between the two departments to tackle sanitation and infection control problems in RCHEs.

 

        SWD would tighten the requirement for timely reporting of the outbreak of infectious diseases by imposing sanctions for non-compliance with the Code of Practice for Residential Homes (Elderly Persons).  SWD is now reviewing the Code in consultation with parties concerned.

 

        The HWFB would monitor the implementation of these measures and coordinate the efforts of various departments.

 

        As part of the contingency measures, SWD had ordered the temporary suspension of the operation of Shui Oi in the premises and directed it to take rectification measures, including the installation of in-house toilet facilities and kitchen.

 

        Shui Oi had completed the rectification measures to the satisfaction of SWD and DH on October 15. Also, its staff received training on infection control provided by DH on  September 25, 2004, and the Home��s management staff have been enrolled in management training course. Having ensured that Shui Oi has met the licensing requirements, the Director of Social Welfare (DSW) gave approval for Shui Oi to resume operation on  October 18.  SWD would continue to closely monitor the operation of Shui Oi in consultation with DH where necessary.

 

        Taking into account the personal preference of individual Shui Oi residents, SWD would arrange those who had requested to continue to stay in Shui Oi to move back, and arrange others to live in other RCHEs at their requests. The majority of the residents who had been temporarily relocated to the Cheung Muk Tau Holiday Centre for the Elders had requested to move back to Shui Oi.

 

        DSW would reduce the number of places it would purchase from the Home under the Enhanced Bought Place Scheme with effect from November 1, 2004, having taken into account the condition of the Home after refurbishment, and the personal preference and well-being of the residents of the Home. The purchase agreement would be reviewed every six months.

 

        Drawing on the lessons from the incident, the Government wishes to appeal to operators and staff of all RCHEs to be extremely vigilant during the coming high-risk season of viral gastroenteritis, especially on handling vomitus and faecal materials.

 

Staff should wear gloves when disposing of vomitus and faeces and wash hands afterwards. They should clean and disinfect contaminated areas and items promptly and thoroughly with household bleach diluted in a ratio of 1 in 49 units of water. They might seek help from SWD and DH as appropriate.

 

        Efforts had been made in the past few years to prevent and control infectious diseases in RCHEs, in particular after the outbreak of the Severe Acute Respiratory Syndrome (SARS).

 

        These included the appointment of Infection Control Officers (ICOs) in RCHEs, the introduction of an enhanced surveillance and notification system for RCHEs to report SARS and infectious diseases, the publication of a guideline on prevention of communicable diseases in RCHEs, and the provision of one-off funding support to RCHEs to enhance their infection control facilities in 2003.

 

        A series of training programmes were developed by DH and provided to ICOs and other staff of RCHEs to enhance their capabilities. Besides, DH had been conducting outreaching visits covering all RCHEs every year since 2003 to identify areas for improvement in infection control in individual homes and provided guidance and training to them.

 

[SWD and DH��s reports are accessible via the homepages of the HWFB (www.hwfb.gov.hk), SWD (www.info.gov.hk/swd/) and DH (www.info.gov.hk/dh/).]

 

Ends/Tuesday, October 19, 2004

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Full report submitted by Social Welfare Department (PDF file)

Full report submitted by the Department of Health (PDF file)