Jul 29
Infection Prevention for Wound Care and Invasive Devices in Aged Care
Preventing Infections Before They Start
A Practical Guide for Nurses, IPC Leads, and Care Workers in Australia and New Zealand
Wounds, including pressure injuries, and invasive devices such as indwelling urinary
catheters (IDCs), percutaneous endoscopic gastrostomy (PEG) tubes, subcutaneous
infusion devices, and peripheral intravenous catheters (PIVCs) are among the most
common entry points for infection in residential aged care.
This practical guide is designed for care workers, nurses, and IPC Leads who manage wound care and invasive devices every day. It explains the most common wound and device-related infections, typical treatment approaches, and the evidence based practices that help prevent infection and protect residents from avoidable harm. The content is informed by the Australian Commission on Safety and Quality in Health Care's Aged Care Infection Prevention and Control Guide and New Zealand's NZS 8134:2021 Ngā Paerewa Health and Disability Services Standard.
This practical guide is designed for care workers, nurses, and IPC Leads who manage wound care and invasive devices every day. It explains the most common wound and device-related infections, typical treatment approaches, and the evidence based practices that help prevent infection and protect residents from avoidable harm. The content is informed by the Australian Commission on Safety and Quality in Health Care's Aged Care Infection Prevention and Control Guide and New Zealand's NZS 8134:2021 Ngā Paerewa Health and Disability Services Standard.
Why Do Wounds and Invasive Devices Increase Infection Risk in Aged Care?
Any break in the skin, or any device that enters the body, provides microorganisms
with a direct route of entry. Older residents are more vulnerable because ageing skin
is thinner and heals more slowly, and many residents live with reduced mobility,
incontinence, malnutrition, or chronic conditions such as diabetes.
Invasive devices carry their own risks. Indwelling urinary catheters (IDCs), PEG tubes, and subcutaneous devices such as syringe-driver cannulae all bypass the body's natural defences. Although intravenous (IV) devices may occasionally be encountered, they are less common in residential aged care than subcutaneous access devices. The longer a device remains in place, the higher the risk of complications and infection, which is why "the shortest time necessary" remains the golden rule for every device in your facility.
Invasive devices carry their own risks. Indwelling urinary catheters (IDCs), PEG tubes, and subcutaneous devices such as syringe-driver cannulae all bypass the body's natural defences. Although intravenous (IV) devices may occasionally be encountered, they are less common in residential aged care than subcutaneous access devices. The longer a device remains in place, the higher the risk of complications and infection, which is why "the shortest time necessary" remains the golden rule for every device in your facility.
What Are the Most Common Infections Linked to Wounds and Devices?
Catheter-Associated Urinary Tract Infections (CAUTIs)
Indwelling catheters are responsible for most healthcare-associated UTIs. Bacteria
usually enter through a break in aseptic technique during insertion or care, or by
migrating backwards from a contaminated drainage bag. Watch for urinary
symptoms, fever, new confusion, or pain, but be cautious; research shows UTIs are
frequently over-diagnosed in aged care, and treating asymptomatic bacteriuria
(bacteria present without symptoms) contributes to unnecessary antibiotic use.
Wound and Pressure Injury Infections
Pressure injuries and skin tears are common among older residents, particularly
those with limited mobility. An infected wound usually shows:
- Spreading redness or heat around the wound
- Purulent (pus-like) discharge
- Increased pain or swelling
- Fever, a faster heart rate, or new confusion in more advanced cases
Left untreated, a local wound infection can progress to a spreading infection and,
eventually, sepsis; so early recognition matters.
Infections Associated with Subcutaneous Devices, PEG Tubes and Intravenous
Access Devices
Subcutaneous Device Infections
Subcutaneous infusion devices are frequently used in aged care, particularly during palliative and end-of-life care. Although the risk of serious infection is lower than with intravenous devices, insertion sites should still be checked every shift for redness, swelling, pain, leakage, bleeding, or discharge. Sites should be changed according to local policy or sooner if complications occur.
Subcutaneous infusion devices are frequently used in aged care, particularly during palliative and end-of-life care. Although the risk of serious infection is lower than with intravenous devices, insertion sites should still be checked every shift for redness, swelling, pain, leakage, bleeding, or discharge. Sites should be changed according to local policy or sooner if complications occur.
PEG Tube Infections
PEG tube infections most commonly involve the stoma site itself, the skin around the
tube entry point. Signs include redness, swelling, discharge, pain, odour, or skin
breakdown. Daily inspection and good stoma care help prevent complications.
Intravenous Device Infections
Intravenous devices such as PIVCs and peripherally inserted central catheter
(PICC) lines are encountered less frequently in residential aged care but may be
present for residents receiving specialist treatment. These devices require regular
assessment, aseptic management, and prompt removal when no longer clinically
required.
How Should Wound and Device Infections Be Treated?
Treatment depends on severity and always rests with the resident's GP or nurse
practitioner:
- Mild or localised wound infection: topical antimicrobial dressings may be trialled, with review if there is no improvement within 14 days.
- Advancing infection, cellulitis, or systemic symptoms: systemic antibiotics and urgent medical review if sepsis is suspected.
- Non-viable tissue: debridement by a qualified clinician supports healing and reduces the risk of infection.
- Suspected device infection: notify the GP promptly so the device can be
reviewed and removed if it is safe to do so.
Antimicrobial stewardship matters here too. Overprescribing, particularly for
suspected UTIs that prove to be asymptomatic bacteriuria, drives antibiotic
resistance without benefiting the resident. If in doubt, escalate for a clinical
assessment rather than assuming antibiotics are the answer.
How Can Your Facility Prevent These Infections Every Day?
Prevention comes down to consistent daily practice. Build these habits into every
shift:
- Question the need: Every invasive device should be in place only if it is genuinely necessary and removed the moment it isn't.
- Practise aseptic technique: Apply the 5 Moments for Hand Hygiene around every wound, dressing, or device interaction: perform hand hygiene before touching the resident, before the procedure, immediately after the procedure or any bodily fluid exposure, after touching the resident, and after touching their surroundings.
- Use the right equipment: Single-use sterile items, appropriate skin antiseptics, and correct dressing selection all reduce risk.
- Check the site daily: Look for redness, swelling, leakage, bleeding, discharge, or pain at each wound and device site, and document what you observe.
- Keep skin healthy: Good nutrition, hydration, regular repositioning, and moisturising all support skin integrity and reduce the risk of pressure injuries.
- Educate residents and families: A resident who understands why a catheter or dressing is in place is more likely to help you keep it clean and to report problems early.
- Escalate early: Report any change, such as new redness, odour, fever, or
confusion, to the nurse in charge without delay.
What Does Good Device Management Look Like on the Floor?
A well-run facility makes device safety visible and routine:
- Document why the device was inserted and the plan for its removal from day one.
- Review the ongoing need for each device at each shift handover.
- Record insertion site checks in the resident's notes every time.
- Flag any signs of infection to a nurse immediately, rather than waiting for the next scheduled review.
- Keep training current; competency in insertion, maintenance, and removal
should never be assumed.
Frequently Asked Questions
How long can an indwelling catheter safely stay in place?
There is no fixed number; the aim is always the shortest time necessary. Facilities
should have local policies on maximum dwell times, and the ongoing need should
be reviewed daily.
Does cloudy urine always mean a UTI?
No. Cloudy or smelly urine alone does not confirm infection in a catheterised
resident. Clinical symptoms; fever, new pain, or confusion; matter more than urine
appearance alone, and a GP should assess before antibiotics are started.
What is the biggest risk factor for wound infection in aged care?
Reduced mobility, combined with fragile, ageing skin, is the biggest driver, which is
why repositioning, nutrition, and early recognition are such effective preventive
measures.
Take-Home Message
The safest device is the one that is no longer needed.
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Lyndon Forrest
Managing Director | CEO
Lyndon is the Managing Director of Infection Prevention Services (IPS), bringing over 30 years' experience supporting aged care providers across Australia and New Zealand.
With a background spanning outbreak response, compliance, and infection risk management — alongside hands-on experience leading teams, managing multi-site operations, and navigating business turnaround — he understands both the clinical and organisational pressures aged care providers face. Lyndon holds a Master of Commerce (Industrial Relations), and applies that foundation to the people, process, and growth challenges that come with running a complex healthcare services business.
He is passionate about building the systems and capability that make infection prevention sustainable — not just compliant — and about helping organisations grow their confidence alongside their practice.
Lyndon's focus is straightforward: strengthen operations, develop the right people, and drive proactive infection prevention strategies that protect residents, staff, and communities for the long term.
Lyndon is the Managing Director of Infection Prevention Services (IPS), bringing over 30 years' experience supporting aged care providers across Australia and New Zealand.
With a background spanning outbreak response, compliance, and infection risk management — alongside hands-on experience leading teams, managing multi-site operations, and navigating business turnaround — he understands both the clinical and organisational pressures aged care providers face. Lyndon holds a Master of Commerce (Industrial Relations), and applies that foundation to the people, process, and growth challenges that come with running a complex healthcare services business.
He is passionate about building the systems and capability that make infection prevention sustainable — not just compliant — and about helping organisations grow their confidence alongside their practice.
Lyndon's focus is straightforward: strengthen operations, develop the right people, and drive proactive infection prevention strategies that protect residents, staff, and communities for the long term.
Erica Callaghan
Marketing Manager
Erica Callaghan is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Erica Callaghan is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Toni Sherriff
Clinical Nurse Specialist
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Julie Hadfield
Accounts & Payroll
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Andrea Murray
Content Editor
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
Personally, I lived in the UK for 10 years. My two children were born in Scotland, and now both are living in Europe, one in Amsterdam, Netherlands, and the other in Edinburgh, Scotland. I live close to Fairlie on the South Island of NZ, a beautiful part of the country, and I love being out of the city.
Princess
Customer Support
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Dianne Newey
Senior Infection Prevention and Control Consultant
Dianne is a Senior Clinical Consultant at Infection Prevention Services (IPS), bringing over 35 years of nursing experience and a depth of clinical knowledge that most people would need two careers to accumulate.
Having served as Clinical Director at Royal Ryde Rehabilitation Hospital alongside a career spanning the full breadth of clinical practice, Dianne has seen it all — and more importantly, knows exactly what to do about it. She is the person in the room that everyone quietly hopes will speak first.
For more than seven years she has been a cornerstone of the IPS team, providing clinical advice, developing and reviewing policies and procedures, delivering monthly IPC webinars to IP Leads, and conducting environmental audits in aged care facilities across Australia and New Zealand. If infection prevention has a question, Dianne almost certainly has the answer — and she'll deliver it with a laugh that you'll hear from the other end of the corridor.
A true fountain of knowledge, wrapped in the kind of warmth and humour that only three decades of nursing can produce. Customers don't just trust Dianne — they look forward to hearing from her.
Dianne is a Senior Clinical Consultant at Infection Prevention Services (IPS), bringing over 35 years of nursing experience and a depth of clinical knowledge that most people would need two careers to accumulate.
Having served as Clinical Director at Royal Ryde Rehabilitation Hospital alongside a career spanning the full breadth of clinical practice, Dianne has seen it all — and more importantly, knows exactly what to do about it. She is the person in the room that everyone quietly hopes will speak first.
For more than seven years she has been a cornerstone of the IPS team, providing clinical advice, developing and reviewing policies and procedures, delivering monthly IPC webinars to IP Leads, and conducting environmental audits in aged care facilities across Australia and New Zealand. If infection prevention has a question, Dianne almost certainly has the answer — and she'll deliver it with a laugh that you'll hear from the other end of the corridor.
A true fountain of knowledge, wrapped in the kind of warmth and humour that only three decades of nursing can produce. Customers don't just trust Dianne — they look forward to hearing from her.
Caoimhe (Keva) Stewart
Clinical & Business Operations Manager
Caoimhe is the Clinical & Business Operations Manager at Infection Prevention Services (IPS), bringing a clinical background as a Registered Nurse across the UK and Australia — and an almost unsettling ability to make technology do exactly what she wants.
With experience in Occupational Health, Palliative Care, and Community Nursing, she understands the real challenges faced by healthcare teams. What she may lack in stature she more than makes up for in impact — Caoimhe is the kind of person who walks into a problem, sizes it up, and has three solutions before anyone else has finished reading the brief.
Customers love her. Not just because she delivers — though she always does — but because she genuinely cares about the outcome on the other side. She is passionate about creating seamless learning experiences and empowering organisations with the tools, knowledge, and support needed to strengthen infection prevention practices and improve care outcomes.
Small in size. Mighty in results. Completely irreplaceable.
Caoimhe is the Clinical & Business Operations Manager at Infection Prevention Services (IPS), bringing a clinical background as a Registered Nurse across the UK and Australia — and an almost unsettling ability to make technology do exactly what she wants.
With experience in Occupational Health, Palliative Care, and Community Nursing, she understands the real challenges faced by healthcare teams. What she may lack in stature she more than makes up for in impact — Caoimhe is the kind of person who walks into a problem, sizes it up, and has three solutions before anyone else has finished reading the brief.
Customers love her. Not just because she delivers — though she always does — but because she genuinely cares about the outcome on the other side. She is passionate about creating seamless learning experiences and empowering organisations with the tools, knowledge, and support needed to strengthen infection prevention practices and improve care outcomes.
Small in size. Mighty in results. Completely irreplaceable.
Bridgette Mackie
Clinical Nurse Educator
Bridgette is an experienced New Zealand Registered Nurse, qualified Healthcare Auditor, and Healthcare Educator with a strong background in clinical quality, competency assessment, and infection prevention. She has led large-scale OSCE and CAP training programmes for internationally qualified nurses, developed sector-specific educational resources, and coordinated HealthCERT audit preparation in the surgical sector.
Known for her engaging teaching style and genuine passion for supporting learners, Bridgette excels at making complex topics accessible and relevant. She blends operational leadership with a deep commitment to professional development and safe, effective practice.
Bridgette is an experienced New Zealand Registered Nurse, qualified Healthcare Auditor, and Healthcare Educator with a strong background in clinical quality, competency assessment, and infection prevention. She has led large-scale OSCE and CAP training programmes for internationally qualified nurses, developed sector-specific educational resources, and coordinated HealthCERT audit preparation in the surgical sector.
Known for her engaging teaching style and genuine passion for supporting learners, Bridgette excels at making complex topics accessible and relevant. She blends operational leadership with a deep commitment to professional development and safe, effective practice.
