Adoption of a Delphi technique to achieve consensus for a national infection surveillance program in Australian residential aged care facilities
Assoc/Prof Noleen Bennett1,2, Ms Eliza Watson 1, Dr Lyn-li Lim1, Dr Janet Sluggett3, Prof Karin Thursky2, Assoc/Prof Leon Worth1 for the NISPAC Advisory Group
1. Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Melbourne VIC 3000
2. National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, The University of Melbourne, Melbourne VIC 3000
3. University of South Australia, UniSA Allied Health and Human Performance, Adelaide, SA 5001
Background
The National Infection Surveillance Program for Aged Care (NISPAC) is seeking to develop, implement and evaluate a standardised program. In order to define the scope of surveillance activity, an appropriate method for stakeholder engagement was required.
Method:
A Delphi technique was employed to gain consensus amongst those with leadership roles in aged care, infection prevention and control and/or antimicrobial stewardship concerning preferred surveillance methods in RACFs. Survey 1 focussed on identifying the importance or appropriateness of including a range of potential program elements for NISPAC. Surveys 2 and 3 repeated this process (same participants), and also sought to rate the feasibility of including these elements. Aggregate agreement levels were classified as consensual (>90%), high (75-89%), moderate (31-74%) or low (<30%).
Results
The table below outlines examples of consensual agreement.
| Element
(no. of options) |
Important to include | Feasible to include |
| Consensual (>90%) agreement level | Agreement levels for consensual options | |
| Infections (15) | Clostridioides difficile, cellulitis, soft tissue
and wound, gastroenteritis, influenza-like illness, norovirus, pneumonia, urinary tract |
1.High: Clostridioides difficile,
gastroenteritis, influenza-like illness, norovirus, urinary tract 2.Moderate: Cellulitis, soft tissue and wound, and pneumonia |
| Organisms (11) | Clostridioides difficile, Escherichia coli,
Influenza, Klebsiella spp., Norovirus, Respiratory syncytial virus, SARS CoV-2 (COVID-19), Staphylococcus aureus |
1.Consensual: Clostridioides difficile,
Escherichia coli, Influenza, Klebsiella spp., Norovirus, SARS CoV-2 (COVID-19), Staphylococcus aureus 2.High: Respiratory syncytial virus |
Conclusion
A Delphi technique was successfully used to achieve expert consensus concerning preferred program elements to be included in NISPAC. Agreement levels for the feasibility of including consensually agreed important program elements were mostly ‘high’ or ‘consensual’.