Glossary

Definitions of key terms relevant to the NISPAC project.

Aged Care Act 1997 – The Act is the legislative basis for the Australian system of aged care. Commonwealth-subsidised aged care is provided under the Act as either residential, home care, or flexible care. The Act also enables the Minister to make Principles required or permitted under the Act, or necessary or convenient to carry out or give effect to Parts or sections of the Act (see section 96-1 of the Act).

Aged care service – A service that provides care for older persons through residential, home or flexible care.

Antimicrobial Resistance – A microorganism that causes an infection that has developed resistance to the medication used to treat it.

Antimicrobial Stewardship (AMS) – The responsible management and use of antimicrobials. Facilities may have AMS programs which involve a range of activities to ensure the appropriate use of antimicrobials.

Antimicrobial Use Surveillance – An important element of AMS programs is to monitor the volume and types of antimicrobials being administered at a facility.

Benchmark – A validated measure that may be used for comparison provided data are collected in the same way as that of the benchmark data. Benchmarks are used to compare HAI rates to data that use the same definitions for infection and are appropriately adjusted for patient risk factors so that meaningful comparisons can be made. Comparing HAI rates to a validated benchmark will indicate whether the rates are below or above the recognized average.

Bronchial Breathing – Higher pitched breathing noise

Cellulitis – Infection of the connective tissue

Colonisation – A germ or pathogen is present on a persons body, but not causing infection. The person may be at a higher risk of being infected due to the presence of the organism.

Consumer – A consumer is someone who will use a service or program. In the case of NISPAC, consumers are largely aged care workers and management as they will be directly using the program, it also includes residents and carers. Each of these consumers will have a different experience with NISPAC because they are engaged with it in different capacities.

Flexible care – Flexible aged care places are provided through a number of different programs which provide an alternative to more traditional community and residential care. These include Multipurpose Services, the Transition Care Program and the Aged Care Innovative Pool.

Gastrointestinal Infection – Infection of the stomach and/or intestines

Government-subsidised aged care facility – A term previously used to describe an Australian Government-subsidised residential aged care facility. These facilities receive funding from the Australian Government and are bound by the requirements of the Aged Care Act 1997.

Health Care-associated Infection (HAI) – A term relating to an infection that is acquired during the delivery of health care that was not present or incubating at the time of admission.

Herpes Simplex – Disease caused by a virus leading to a rash (often around the lips and nose) with groups of bladders containing fluid which soon dry out.

Herpes Zoster – Disease caused by a virus; mostly painful bladder-shaped rash in areas where many sensory nerves are present (e.g. face, chest, shoulders and hip).

Infection Prevention and Control (IPC) – Processes used to reduce the risk of infection transmission within facilities.

Infection Prevention and Control Lead – An IPC Lead is a nurse responsible for IPC activities at a residential aged care facility (RACF). They are required to undertake an IPC course and are responsible for observing, reporting and assessing IPC activities at a facility and help to develop IPC procedures. RACFs in Australia are now required to have an IPC Lead.

Infection Risk – The probability that a patient/resident will acquire an infection based on the characteristics of the individual, the inherent risks associated with a procedure, or other factors that might put the individual at risk for a health care-associated infection.

Infection Surveillance – An important element of IPC. Infection surveillance is the monitoring of certain types of infections. This can assist in identifying outbreaks of infection.

Infiltrate – Deposition of fluid (e.g. blood, pus…) in tissues and cells

Maculopapular Rash – Rash characterised by spots and bumps

MRSA – Methicillin Resistant Staphylococcus aureas. A type of antimicrobial resistant bacteria that can cause infections which are hard to treat.

Multi-Resistant Organisms (MROs) – Organisms that have become resistant to multiple medications that are usually used to treat them.

Numerator – Each event/infection that occurs during the surveillance period.

Nursing home – The previous name for residential aged care facilities.

Outbreak – An increase in the number of a certain infection above what is considered normal for that setting over a set period of time.

Outcome surveillance – Surveillance used to measure client/patient/resident outcomes (changes in the resident’s health status that can be attributed to preceding care and service). An example of outcome surveillance related to infection prevention and control is surveillance of HAI rates.

Point Prevalence Study – A data collection methodology commonly used to measure the prevalence of infections and antimicrobial use at a point in time. They aid in estimating disease burden and risk factors.

Primary bloodstream infection – Infection originated directly into the bloodstream; secondary bloodstream infections are those originating outside the vascular system (e.g. urinary or respiratory infection) later involving the bloodstream

Process Surveillance – Surveillance used to assess or measure resident processes (things done to or for a resident during their encounter with the health care system). An example of process surveillance related to infection prevention and control is planned audits to verify that procedures and/or standards of practice are being followed.

Proportion – A ratio in which the numerator must be included in the denominator. Often expressed as a percentage. the numerator represents a part of the whole (the denominator).

Rales – Crackles or a series of discontinued short sounds heard on auscultation (listening with a stethoscope) due to air movements

Rate – A ratio with a particular relationship between the numerator and the denominator, where the denominator includes time measurement. Term often loosely applied generically to all numerical measurements.

Ratio – A general term, obtained by dividing one number by another. The numerator and denominator do not have to be related.

Resident – A person who permanently or temporarily resides in a residential aged care facility.

Residential Aged Care Facility – A facility that provides personal and/or nursing care including accommodation, meals, cleaning services, furniture and equipment. The residential aged care facility must meet certain building standards and appropriate staffing in provision of care and accommodation.

Respiratory Tract Infection – Can be an infection of the higher or lower respiratory tract
Higher respiratory tract infection – Infection of the (naso)pharynx ((naso)pharyngitis), paranasal sinus (sinusitis) or tonsils (tonsillitis).
Lower respiratory tract infection – Infection of the trachea and bronchus (bronchitis), bronchiole (bronchiolitis) or lung and alveoli (pneumonia)

Rhonchi – Continued noises in the lower respiratory tract due to vibrations.

Scabies – Contagious and heavy itching disease of the skin caused by a mite

Sentinel Event – A colonization/infection in which the occurrence of perhaps even a single case may signal the need to re-examine preventive practices

Skin and Soft Tissue Infection – Infections of the skin and underlying soft tissues.

Soft tissues – Tissues that connect support or surround other structures or organs 20
(muscles, tendons, ligaments, nerves, blood vessels, fat, fibrous tissues, fascia and membranes).

Sputum – Secretion expectorated from the lower respiratory tract (not to be confused with saliva)

Surveillance – The ongoing systematic collection, analysis, and interpretation of data, closely integrated with the timely dissemination of these data to those responsible for preventing and controlling disease and injury.(Thacker and Berkelman, 1988)

Systemic Infection – Infection caused by a micro-organism and disseminated to several organs in the different systems of the body.

Urinary Tract Infection – Infections of any part of the urinary system, including kidneys, ureter, urethra, bladder or vagina.