August 12, 2020

Caring for the most vulnerable – Residential In-Reach

Our Residential In-Reach program provides specialist medical and nursing support to nursing homes seven days a week. With COVID-19, due to multiple outbreaks in our catchment, the team have substantially increased both medical and nursing staffing to meet the demand. With the recent outbreaks in St Basil’s and Heritage Epping Gardens, Dr Sandra Brown and her team were the first to arrive.

Dr Brown, Residential In-Reach Program Lead, explained the team now have three doctors and three nurses available to go out into nursing homes seven days a week.

“In these facilities, our team is usually the first on the ground, when we are notified of an outbreak. We go in and advise on processes on how to reduce the risk of infection. While the staff in nursing homes have plans for these situations, they might lack practical experience in managing a pandemic outbreak. That is when our team gives practical advice on stopping the spread and necessary immediate measures,” she explained.

The response team, usually a doctor and a nurse, will provide basic infection control advice and check on COVID-19 positive residents to determine if they are stable enough to stay in the facility. The team also provides information to families, notifies them of the resident’s condition and tries to understand what their wishes are.

Dr Brown explains that, from her experience, COVID-19 patients are often stable in the first week, and then they can rapidly get very sick.

“We monitor them over that week period to ensure they remain stable. Most of our work is checking that everyone is stable. We offer residents oxygen and fluids in the facility if they do not wish for hospital care. If someone is dying, we ensure they are comfortable and have the right medication for end of life symptoms,” she explained.

While providing care to the stable patients, the team also monitors the patients that have deteriorated and arranges transfer to hospital if required.

Although COVID-19 is currently the main focus for the team, they still provide care to residents who might have other health issues, like falls and low blood sugar levels.

“The families are grateful to hear on how their relative is going, and the aged care staff in those facilities really appreciate that we are there, as it does show them help is available,” she said.

Program team members are very committed, and a number of senior medical staff have volunteered to do extra shifts. That has enabled the program to now have senior geriatricians available on the weekends too, which previously wasn’t the case. A number of senior nurses with aged care experience have agreed to be redeployed to the team, and the Hospital in the Home team have also been supporting.

“I am really proud how doctors and nurses across Northern Health have supported this service and enabled us to do our job of providing care in nursing homes, whilst avoiding people coming to hospital who aren’t going to benefit from hospital care,” Dr Brown said.

Dr Paul Viray is one of the team members – he is a registrar and geriatric medicine advanced trainee.

“It’s been hectic in the last couple of weeks. The team has been working extended hours to help improve the quality of life for the nursing home residents. It has been an absolute honour to work with the whole team. We will keep going – this is what we do and we’ll do whatever it takes to keep residents well and protect their quality of life,” he said.