Protecting elderly residents in care facilities against influenza and COVID-19 - the InFLUenza Communication, Advice and REporting (FluCARE) application: Feasibility Study.

Abstract

Early detection and response to influenza and COVID-19 outbreaks in aged care facilities (ACFs) is critical to minimising health impacts. The Sydney Local Health District (SLHD) Public Health Unit (PHU) has developed and implemented a novel web-based application (app) to assist ACFs in outbreak response with integrated functions for online line listings, detection algorithms and automatic notifications to responders. The goal of the InFLUenza outbreak Communication, Advice and Reporting (FluCARE) app is to reduce time delays to notifications, which we hope will reduce the spread, duration and health impacts of an influenza or COVID-19 outbreak, as well as ease workload burdens on ACF staff. The specific aims of the study were: 1.To evaluate the acceptability and user satisfaction in the implementation and use of FluCARE in helping ACFs recognise, notify and manage influenza and COVID-19 outbreaks in their facility; 2. To identify the safety of FluCARE and identify any potential adverse outcomes of using the app; and 3.To identify any perceived barriers or facilitators to the implementation and use of FluCARE from the ACF user perspective. The FluCARE app was piloted from September 2019 to December 2020 in SLHD. Associated implementation included promotion and engagement, user training, and operational policies. Participating ACF staff were invited to complete a post-training survey. Staff were also invited to complete a post pilot evaluation survey which included a user Mobile Application Rating Scale (uMARS) measuring app acceptance, utility, and barriers and facilitators to use. An issues log was also prospectively maintained to assess safety. Survey data were analysed descriptively or via content analysis where appropriate. Thirty-one users from 27 ACFs consented and completed the surveys. FluCARE was rated 3.91/5 overall on the uMARS. The study reported that 25 of the 31 users (80%) would definitely use FluCARE for future outbreaks, and all users agreed that the app was useful for identifying influenza and COVID-19 outbreaks at their facilities. There were no reported critical issues with incorrect or missed outbreak detection. User training, particularly online training modules, and technical support were identified as key facilitators to FluCARE use. FluCARE is an acceptable, useful and safe app to assist ACF staff with early detection and response to influenza and COVID-19 outbreaks. This study supports feasibility for ongoing implementation and efficacy evaluation, followed by scale-up into other health districts in New South Wales (NSW).