Library: Nursing: Aged care

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Aged Care	362.60994; 362.610094; 362.6, 362.61; 362.196831;615.820846; 617.585; 618.970231; 613.0438; 610.7360994; 610.7361; 651.504261
Alzheimer's disease	362.196831; 362.19683; 362.198310092; 616.831; 616.831042
Arthritis or Osteoarthritis or Rheumatoid arthritis	616.722; 616.7227; 616.72206; 362.1967227
Cancer	616.994; 616.994042; 616.99424; 616.99449; 616.99462; 616.65
Dementia	616.83; 616.8309945; 362.196831; 362.19683; 618.9768983; 610.7365
Depression	616.8527
Multiple sclerosis	616.834; 616.8340019; 616.83406; 362.196834
Osteoporosis	616.716; 616.71605
Palliative Care	616.029; 616.029083; 362.1750994; 362.17508; 610.7361; 610.736; 618.97
Parkinson's disease	616.833; 616.8330092

Selection of books in the Library

Health Care of the Older Adult : An Australian and New Zealand Perspective

Describes the issues and consequences of the increasing ageing population on the Nursing profession in both Australia and New Zealand.

Sexuality and Long-Term Care : understanding and supporting the needs of older adults

What normal sexual expression is in old age and how dementia affects it, ways to protect residents from sexually transmitted disease, and more.

Caring for Older People in Australia: principles for nursing practice

Takes a person-centred, primary healthcare focus to explore the most contemporary issues in aged care, such as: sexuality, culture, nutrition and more.

Long-term caring : residential, home and community aged care

Provides information on all aspects of personal caring to prepare students to work in a range of aged care settings and specialisations;

Care of Older Adults : a strengths-based approach

Presents the topic from a healthy ageing perspective through to chronic illness, frailty and end of life.

Living Dying Caring: life and death in a nursing home

Offers a solid foundation on which nurses can build a positive, affirming experience for dying residents that addresses their physical, spiritual, psychological, and emotional needs.

Selection of eBooks in the Library

Supporting Older People Using Attachment-Informed and Strengths-Based Approaches

How an understanding of attachment theory can empower health and social care staff, and improve the care of older people.

The Aging Brain : Proven Steps to Prevent Dementia and Sharpen Your Mind

Filled with simple, everyday actions we can take to avoid disease, promote vitality, and prevent dementia and late onset Alzheimer's.

Developing a Relational Model of Care for Older People : Creating Environments for Shared Living

Hopes to shatter myths around th nature of aging.

A Pocket Guide to Understanding Alzheimer's Disease and Other Dementias, Second Edition

Written by leading dementia experts, this guide will help you to better understand the conditions, and how they are diagnosed and treated.

Descriptions of the normal aging process, discussions of how health and social factors can impede a persons ability to participate in regular activities.

Shines a light on ageism in our society, through some unforgettable case studies.

Online resources

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Academic Search Premier : EBSCO Content Includes More than 3,200 active full-text journals and magazines More than 2,800 active full-text peer-reviewed journals More than 1,300 active full-text peer-reviewed journals with no embargo More than 2,200 active full-text journals indexed in Web of Science or Scopus Subjects Include: Biology; Chemistry; Engineering; Physics; Psychology; Religion and philosophy; Science and technology Veterinary science; Superb Coverage to Support the Academic Curriculum Academic Search Premier covers the expansive academic disciplines offered in colleges and universities. It provides comprehensive content, including PDF backfiles to 1975 for more than 120 journals and searchable cited references for more than 1,000 titles.
CINAHL Plus with Full Text : EBSCO This comprehensive research database provides full text for nursing and allied health journals indexed in CINAHL Plus. Additional materials include full-text evidence-based care sheets, quick lessons and continuing education modules. Nursing and Allied Health Content from the Most Authoritative Sources CINAHL Plus with Full Text includes publications from the National League for Nursing and the American Nurses Association. Many of the most popular full-text journals are available with no embargo. In addition, this resource offers access to health care books, nursing dissertations, selected conference proceedings, standards of practice, audiovisuals, book chapters and more. CINAHL Plus with Full Text covers a wide range of topics including nursing, biomedicine, health sciences librarianship, alternative/complementary medicine, consumer health and 17 allied health disciplines. A Powerful Research Tool CINAHL Plus with Full Text provides an easy-to-use interface with basic and advanced search features and searchable cited references. CINAHL Subject Headings follow the structure of the Medical Subject Headings (MeSH) used by the National Library of Medicine.
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Health Source: Nursing/Academic Edition : EBSCO Health Source: Nursing/Academic Edition provides researchers, allied health professionals, nurses and medical educators with access to full-text scholarly journals focusing on many medical disciplines. It provides indexing, abstracts and full-text for hundreds of nursing and allied health journals, many of which are peer-reviewed. Content Includes: More than 330 full-text journals; 260 peer-reviewed, full-text journals; Indexing and abstracting from more than 830 journals
Vocational Studies Complete : EBSCO Meeting the Unique Needs of Vocational Programs Vocational Studies Complete contains full-text journals and a selection of full-text books applicable to two-year college programs. Key subjects include biotechnology, computer and data processing, cosmetology, electrical technology, forensics, graphic arts, health information technology, interior design, paralegal studies, robotics and tourism. Subjects Include: Alcohol and drug abuse counselling; Biotechnology; Computer and data processing; Cosmetology; Electrical technology; Fashion design; Forensics; Graphic arts; Health information technology; Interior design; Law enforcement and criminal justice; Travel and tourism; Veterinary assisting Content Includes Nearly 2,200 full-text journals Nearly 360 full-text books
Bed to Wheelchair Transfer : Aged Care (2015) : ClickView online resource This snippet shows one method of transferring a patient from a bed to a wheelchair. In this snippet, an electric sling hoist is used to assist the patient. It is important to be aware of the main risk factors to yourself as carer in this task. Manual handling risks can arise due to the need to reach, the low working height involved and awkward positions that a carer may adopt as they assist the patient.
Bed to Chair Transfer : Aged Care (2015) : ClickView online resource This snippet shows one method of transferring a patient or resident from a bed to a chair. It is relevant for an able-bodied patient with the use of a standing and walking aid. It is important to be aware of the main risk factors to yourself as carer in this task. Manual handling risks can arise due to the awkward positions that a carer may adopt as they assist the patient.
Aged Care: Communicating with Family and Carers (2010) : ClickView online resource Australia is experiencing 'population ageing'. Many older Australians are dependent on the care and support of informal care arrangements provided by the family and formal aged care services delivered in the community or in residential aged care homes. Developing and maintaining respectful interpersonal relationships with the client/resident and family through the use of effective and specialist communication skills can achieve successful outcomes of care that promote quality of life in accordance with legislation, regulatory requirements, professional standards and guidelines. This programme discusses various methods and approaches carers can utilise when communicating, ensuring a successful care arrangement for everyone involved.
Aged Care and Cultural Diversity (2010) : ClickView online resrouce Our cultural backgrounds, experiences and beliefs can influence our day-to-day behaviour without us even realising it. Within aged care, culture has a major impact on how we work and how we communicate with patients and residents. Often a cultural adjustment needs to take place so that an appropriate and culturally sensitive level of care can be delivered to the aged care client. In this programme we investigate what culture is and how we can make our communication relevant in the face of cultural barriers. We also look at different cultural groups and personal cultural history, while also considering individual religious practices and traditions
Aged Care: Communicating with Family and Carers (2010) : ClickView online resource Australia is experiencing 'population ageing'. Many older Australians are dependent on the care and support of informal care arrangements provided by the family and formal aged care services delivered in the community or in residential aged care homes. Developing and maintaining respectful interpersonal relationships with the client/resident and family through the use of effective and specialist communication skills can achieve successful outcomes of care that promote quality of life in accordance with legislation, regulatory requirements, professional standards and guidelines. This programme discusses various methods and approaches carers can utilise when communicating, ensuring a successful care arrangement for everyone involved.
Delirium, Dementia and Depression (2010) : ClickView online resources Delirium and dementia are two of the most common mental disorders elderly people face. Depression is also common in elderly people and often presents with symptoms similar to dementia or delirium. The differentiation between these three conditions can be difficult because many symptoms overlap. As the cause of so much suffering and discomfort, it is important these conditions are effectively addressed by medical staff. This program defines these conditions by detailing symptoms and speaking to medical experts. Potential risk factors, causes of delirium and assessment criteria for all three conditions are outlined along with a brief summary of management strategies.
Nutrition in an Aged Care Environment (2010) : ClickView online resources Developing and maintaining a healthy and well balanced diet is just as important for the elderly as any other age group. For elderly people who can no longer look after themselves, it is of vital importance that adequate meals are provided that will meet the nutritional requirements of this age group. Nutrition sources, portion size and meal frequency are all covered, as well as strategies for getting older people to eat. Aged care workers will find this program invaluable when tending to the nutritional and dietary needs of the elderly.
Palliative Care Nursing : Caring for Yourself (2010) : ClickView online resources Delivering palliative care can be both hugely rewarding and, at times, very stressful. It is likely that all health workers will be involved in caring for a dying person at some time. Nurses need to be able to manage their own stress to deliver a good standard of care to their patients. This program provides an introduction to to palliative care stress management. We define stress, and discuss the differences between personal and work-related stress, and discuss the signs of stress-related burnout. This program will equip viewers with the tools and strategies required to manage stress in palliative care more effectively.
Basic Care Procedures : Showering and Bed-Bathing (2006) : ClickView online resources Maintaining personal hygiene plays an important role in preventing disease, especially infection; as well as contributing to the patient's general well-being, preserving comfort and positive body image. This program demonstrates how to carry out basic care procedures of showering and bed bathing in a professional and caring manner. The general care principles of safety, privacy and comfort are highlighted throughout the program.
How to Stay Fit as You Age Series : 18 video series (2013) : Kanopy online resources As we get older, we discover changes in how our bodies move and behave--changes that contradict how young we feel on the inside. But you can transform your experience of aging into a positive and, above all, healthy one. And it all starts with staying fit. Certified fitness and wellness consultant Dr. Bonura helps you create and practice a balanced, adaptable fitness program. Episode 1 Aging with Optimism—A Holistic Approach Episode 2 Getting and Staying Motivated Episode 3 Self-Care Fundamentals Episode 4 Fitness Fundamentals—Choose Your Activity Episode 5 Fitness beyond the Gym—Active Daily Living Episode 6 It’s Not Just Physical—Mindful Fitness Episode 7 Motivation—Goals and Willpower Episode 8 Friends, Fitness, and Social Support Episode 9 Accepting a New Reality Episode 10 Challenges—Illness and Chronic Pain Episode 11 Small Steps—A Path to Big Benefits Episode 12 Making It Work—The Right Plan for You Episode 13 Relaxation Strategies Episode 14 Foundational Fitness Episode 15 Core Strength and Balance Episode 16 Workplace Fitness Episode 17 Chair Yoga Episode 18 Qigong—Practicing Fluid Movement
Aged Care: Communicating with Family and Carers (2010) : Kanopy online resources Australia is experiencing 'population ageing'. Many older Australians are dependent on the care and support of informal care arrangements provided by the family and formal aged care services delivered in the community or in residential aged care homes. Developing and maintaining respectful interpersonal relationships with the client/resident and family through the use of effective and specialist communication skills can achieve successful outcomes of care that promote quality of life in accordance with legislation, regulatory requirements, professional standards and guidelines. This program discusses various methods and approaches carers can utilise when communicating, ensuring a successful care arrangement for everyone involved. This program has been endorsed by APEC number 120903432 as authorised by Royal College of Nursing, Australia according to approved criteria and has been accredited 1 CNE point.
Preventing Falls in Aged Care (2009) : Kanopy online resources In caring for the elderly - be it in community-based care or within a residential aged care facility - falls prevention is critical. Elderly people are often vulnerable to falls for a variety of reasons - it could be related to infirmness, compromised vision, slippery surfaces, ill-fitting footwear, lack of necessary physical support, being affected by medication, or a number of other factors. Furthermore, the physical injury that can occur with falls is generally exacerbated by age, and recovery times can be much longer compared with those for younger people who experience similar incidents. Knowing how to minimise the risk of falls is essential for any carer or other professional working in aged care. This program has been endorsed by APEC number 120903432 as authorised by Royal College of Nursing, Australia according to approved criteria and has been accredited 1 CNE point.
Understanding the Nature of Conflict: Conflict Management in Health Care (2009) : Kanopy onlin resources Conflict - it occurs in any workplace, and always needs to be carefully managed. In many ways, there is a greater potential for conflict to occur in an aged care environment than in a number of other workplaces. Relationships with residents or clients, their families and carers, other health professionals and managers of aged care services can require delicate balancing. There is generally a range of emotions and issues involved in the care of vulnerable people, and aged care workers often find themselves in positions where they need to think on their feet and deal with conflict effectively. This program serves as an excellent introduction to conflict in an aged care environment. It defines conflict in various forms, and explores conflicting situations specific to the aged care industry. A range of skills needed for conflict resolution are examined, and the program finishes with a look at behaviours that elicit resistance, and those that elicit cooperation. This program is an excellent learning resource for nurses, and students undertaking courses related to working in other roles in the aged care industry. It also serves as an engaging professional development aid for staff of aged care facilities. Chapters: 1. Introduction 2. Defining Conflict 3. Conflicting Situations Specifically in the Aged Care Industry 4. Skills Required For Conflict Resolution 5. Behaviours That Elicit Resistance 6. Behaviours That Elicit Cooperation 7. Conclusion
Aged Care: Effective Wound Management (2007) : Kanopy online resources
Eliminating Bullying and Harassment from the Aged Care Environment (2007) : Kanopy online resources People working in aged care routinely provide love, care and support for the elderly but often they can be less than caring and supportive of each other. This program examines the definitions, types and ramifications of workplace bullying and harassment. The program will also assist employees to identify when they, and others, are being subjected to unfair workplace behaviour and, more importantly, what they can do to stop it and prevent its recurrence, thereby creating a safer, happier and more productive workplace for all.
Manual Handling Minimal Lift - Aged Care Industry (2006) : Kanopy online resources Produced specifically for the aged care industry, this video discusses manual handling safety in relation to a minimal lift policy.

Online EBSCOhost journal articles

Cardona, B. (2018). Measuring outcomes of community aged care programs: challenges, opportunities and the Australian Community Outcomes Measurement ACCOM tool. Health & Quality of Life Outcomes, 16(1), 1-7 pages. Measuring health and wellbeing outcomes of community aged care programs is a complex task given the diverse settings in which care takes place and the intersection of numerous factors affecting an individual's quality of life outcomes. Knowledge of a strong causal relationship between services provided and the final outcome enables confidence in assuming the care provided was largely responsible for the outcome achieved (Courtney et al., Aust J Adv Nurs 26:49-57, 2009). The Department of Health has recently reported on the findings of The National Aged Care Quality Indicator Program - Home Care Pilot (KPMG, National Aged Care Quality Indicator Program - Home Care Pilot, 2017). The Program sought to test various tools to measure quality of life outcomes of their community aged care programs. Some of the key issues raised in the study reiterate the findings from The Australian Community Care Outcome Measurement (ACCOM) pilot study (Cardona et al., Australas J Ageing 36: 69-71, 2017), including the value of the ASCOT SCT4 tool (Adult Social care Outcomes Toolkit, http://www.pssru.ac.uk/ascot/downloads/questionnaires/sct4.pdf ) to measure social care related quality of life (SCRQoL) in community aged care programs in the Australian context, the collection of additional data to map the relationship of various variables such as functional ability, demographic characteristics and quality of life scores and the governance and administration of measurement tools for the purpose of quality reporting and consumer choice.
Fan, L., Lukin, B., Zhao, J., Et al (2018). Cost analysis of improving emergency care for aged care residents under a Hospital in the Nursing Home program in Australia. PLoS ONE, 13(7), 1–17. Background: This study aims to examine the costs associated with a Hospital in the Nursing Home (HiNH) program in Queensland Australia directed at patients from residential aged care facilities (RACFs) with emergency care needs. Methods: A cost analysis was undertaken comparing the costs under the HiNH program and the current practice, in parallel with a pre-post controlled study design. The study was conducted in two Queensland public hospitals: the Royal Brisbane and Women’s Hospital (intervention hospital) and the Logan Hospital (control hospital). Main outcome measures were the associated incremental costs or savings concerning the HiNH program provision and the acute hospital care utilisation over one year after intervention. Results: The initial deterministic analysis calculated the total induced mean costs associated with providing the HiNH program over one year as AU$488,116, and the total induced savings relating to acute hospital care service utilisation of AU$8,659,788. The total net costs to the health service providers were thus calculated at -AU$8,171,671 per annum. Results from the probabilistic sensitivity analysis (based on 10,000 simulations) showed the mean and median annual net costs associated with the HiNH program implementation were -AU$8,444,512 and–AU$8,202,676, and a standard deviation of 2,955,346. There was 95% certainty that the values of net costs would fall within the range from -AU$15,018,055 to -AU$3,358,820. Conclusions: The costs relating to implementing the HiNH program appear to be much less than the savings in terms of associated decreases in acute hospital service utilisation. The HiNH service model is likely to have the cost-saving potential while improving the emergency care provision for RACF residents.
Francis-Coad, J., Etherton-Beer, C., Bulsara, C., Blackburn, N., Chivers, P., & Hill, A. (2018). Evaluating the impact of a falls prevention community of practice in a residential aged care setting: a realist approach. BMC Health Services Research, 181-12 Background: Falls are a major socio-economic problem among residential aged care (RAC) populations resulting in high rates of injury including hip fracture. Guidelines recommend that multifactorial prevention strategies are implemented but these require translation into clinical practice. A community of practice (CoP) was selected as a suitable model to support translation of the best available evidence into practice, as it could bring together like-minded people with falls expertise and local clinical knowledge providing a social learning opportunity in the pursuit of a common goal; falls prevention. The aims of this study were to evaluate the impact of a falls prevention CoP on its membership; actions at facility level; and actions at organisation level in translating falls prevention evidence into practice. Methods: A convergent, parallel mixed methods evaluation design based on a realist approach using surveys, audits, observations and semi-structured interviews. Participants were 20 interdisciplinary staff nominating as CoP members between Nov 2013-Nov 2015 representing 13 facilities (approximately 780 beds) of a RAC organisation. The impact of the CoP was evaluated at three levels to identify how the CoP influenced the observed outcomes in the varying contexts of its membership (level i.), the RAC facility (level ii.) and RAC organisation (level iii.). Results: Staff participating as CoP members gained knowledge and awareness in falls prevention (p
Harris, A., & Sharma, A. (2018). Estimating the future health and aged care expenditure in Australia with changes in morbidity. PLoS ONE, 13(8), 1–10. Aims: We estimate the pure effect of ageing on total health and aged care expenditure in Australia in the next 20 years. Methods: We use a simple demographic projection model for the number of people in older age groups along with a needs based estimate of changes in the public and private cost of care per person in each group adjusted for expected changes in morbidity. Results: A pure ageing model of expenditure growth predicts an increase in health expenditure per elderly person from $7439 in 2015 to $9594 in 2035 and an increase in total expenditure from $166 billion to $320 billion (an average annual growth of 3.33%). If people live longer without additional morbidity, then total health expenditure only grows at an average annual rate of 0.48%. If only some of those additional years are in good health, then the average year on year growth is 1.87%. Conclusion: Ageing will have a direct effect on the growth of health spending but is likely to be dwarfed by other demand and supply factors. A focus on greater efficiency in health production and finance is likely to be more effective in delivering high quality care than trying to restrain the demand for health and aged care among the elderly.
Latta, R., & Massey, P. D. (2018). Outbreak management in residential aged care facilities--prevention and response strategies in regional Australia. Australian Journal Of Advanced Nursing, 35(3), 6-13. Objective To identify the outbreak prevention and response preparedness of residential aged care facilities (RACFs) in the Hunter New England area of New South Wales (NSW). Design A cross-sectional telephone survey. Setting RACFs who provide full time nursing care in regional NSW. Subjects Twenty randomly selected RACFs including nine metropolitan and 11 rural facilities within the regional Hunter New England (HNE) district of NSW. Main outcome measures Percentage of staff and residents vaccinated against influenza in 2013; availability and use of a surveillance system to detect outbreaks; knowledge of national outbreak resources; and presence of a facility outbreak management plan. Results Across the 20 facilities more than 85% of residents were vaccinated against influenza in 2013. Staff influenza vaccination rates varied from less than 50% in six facilities to greater than 80% in nine facilities. Overall, 18/20 (90%) facilities reported having outbreak management plans available; however only 5/20 (25%) facilities reported having an outbreak surveillance system in place. Conclusion RACFs in this sample reported varying levels of outbreak prevention and preparedness strategies. Nursing staff working in RACFs need to ensure strategies are in place to prevent and respond to communicable disease outbreaks. In particular all facilities are encouraged to have an outbreak surveillance system in operation, especially during the peak seasons. RACF accreditation should consider including outbreak prevention, preparedness and management outcomes in the review measures to ensure all RACFs have strategies in place to protect vulnerable residents from common communicable disease outbreaks.
Tynan, A., Deeth, L., & McKenzie, D. (2018). An integrated oral health program for rural residential aged care facilities: a mixed methods comparative study. BMC Health Services Research, 18(1), 1-13 pages. Background: People in residential aged care facilities (RACF) are at very high risk of developing complex oral diseases and dental problems. A multidisciplinary approach incorporating oral health professionals and RACF staff is important for improving and sustaining oral health in RACFs. However, difficulties exist with access to oral health services for RACFs, particularly those in regional and rural areas. This study investigated the impact and experience of an integrated oral health program utilising tele-dentistry and Oral Health Therapists (OHT) in RACFs in a rural setting within Australia. Methods: A mixed method comparison study was undertaken. Two hundred fifty-two clinical audits were completed across nine facilities with and without access to the integrated oral health program. Twenty-seven oral health quality of life surveys were completed with eligible residents. One focus group discussions (FGD) and eight interviews were completed with RACF staff. Thematic analysis was conducted on the transcribed FGDs and IDIs. Quantitative data were analysed using descriptive statistics. Results: Audits showed an improved compliance to Australian Aged Care Quality Accreditation Standards for oral health in the facilities with access to the integrated program compared to those without the program. Thematic analysis revealed that facilities with the integrated program reported improvements in importance placed on OH, better access to OH services and training, and decreased disruption of residents, particularly those with high care needs. Conclusions: The integrated oral health program incorporating OHTs and tele-dentistry shows potential to improve the oral health outcomes of residents of RACFs. Improvements for managing oral health of residents with high care needs were observed. RACFs without easy access to an oral health service will also likely benefit from the increased support and training opportunities that the program enables.
Valtorta, N. N., Collingridge Moore, D., Barron, L., Et al (2018). Older Adult's Social Relationships and Health Care Utilization: A Systematic Review. American Journal Of Public Health, 108(4), 1-10. Background. Deficiencies in older people's social relationships (including loneliness, social isolation and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. Objectives. To determine whether social relationships are associated with older adult's use of health services, independently of health-related needs. Search Methods. We searched 8 electronic databases (MEDLINE, Embase, CINAHL,Webof Science, PsycINFO, Scopus, the Cochrane Library and the Centre for Reviews and Dissemination) for data published between 1983 and 2016. We also identified relevant sources from scanning the reference lists of included studies and review articles, contacting authors to identify additional studies and searching the tables of contents of key journals. Selection Criteria. Studies met inclusion criteria if more than 50% of participants were older than 60 years or meanage was older than 60 years; they included a measure of social networks, received social support, or perceived support and they reported quantitative data on the association between social relationships and older adult's health service utilization. Data Collection and Analysis. Two researchers independently screened studies for inclusion. They extracted data and appraised study quality by using standardized forms. In a narrative synthesis, we grouped the studies according to the outcome of interest (physician visits, hospital admissions, hospital readmissions, emergency department use, hospital length of stay, utilization of home and community-based services, contact with general health services and mental health service use) and the domain of social relationships covered (social networks, received social support, or perceived support). For each service type and social relationship domain, we assessed the strength of the evidence across studies according to the quantity and quality of studies and consistency of findings. Main Results. The literature search retrieved 26 077 citations, 126 of which met inclusion criteria. Data were reported across 226 678 participants from 19 countries. We identified strong evidence of an association between weaker social relationships and increased rates of readmission to hospital (75% of high-quality studies reported evidence of an association in the same direction). In evidence of moderate strength, according to 2 high-quality and 3 medium-quality studies, smaller social networks were associated with longer hospital stays. When we considered received and perceived social support separately, they were not linked to health care use. Overall, the evidence did not indicate that older patients with weaker social relationships place greater demands on ambulatory care (including physician visits and community- or home-based services) than warranted by their needs. Author's Conclusions. Current evidence does not support the view that, independently of health status, older patients with lower levels of social support place greater demands on ambulatory care. Future research on social relationships would benefit from a consensus on clinically relevant concepts to measure
von Treuer, K., Karantzas, G., McCabe, M., Mellor, D., Konis, A., Davison, T. E., & O'Connor, D. (2018). Organizational factors associated with readiness for change in residential aged care settings. BMC Health Services Research, 181-6. Background: Organizational change is inevitable in any workplace. Previous research has shown that leadership and a number of organizational climate and contextual variables can affect the adoption of change initiatives. The effect of these workplace variables is particularly important in stressful work sectors such as aged care where employees work with challenging older clients who frequently exhibit dementia and depression. Methods: This study sought to examine the effect of organizational climate and leadership variables on organizational readiness for change across 21 residential aged care facilities. Staff from each facility (N = 255) completed a self-report measure assessing organizational factors including organizational climate, leadership and readiness for change. Results: A hierarchical regression model revealed that the organizational climate variables of work pressure, innovation, and transformational leadership were predictive of employee perceptions of organizational readiness for change. Conclusion: These findings suggest that within aged care facilities an organization's capacity to change their organizational climate and leadership practices may enhance an organization's readiness for change.
Yu, P., & Qian, S. (2018). Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care. PLoS ONE, 13(1), 1–18. Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variables—training, self-efficacy, system quality and information quality—on the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time.
Cantwell, K., Morgans, A., Smith, K., Et al (2017). Differences in emergency ambulance demand between older adults living in residential aged care facilities and those living in the community in Melbourne, Australia. Australasian Journal on Ageing, 36(3), Objective To describe the clinical presentation and temporal variation in ambulance service cases involving patients aged 65 years or older (older adults) from residential aged care facilities and those who are community dwelling ( CD). Methods This study used four years of electronic case records from Ambulance Victoria in Melbourne, Australia. Trigonometric regression was used to analyse demand patterns. Results Residential aged care facility cases included proportionally more falls and infection-related problems and fewer circulatory-related incidents than CD cases. Community dwelling demand patterns differed between weekdays and weekends and peaked late morning. Residential aged care facility cases peaked late morning, with a secondary peak early evening, but with no significant difference between days. Conclusions Older adult ambulance demand has distinct temporal patterns that differ by place of residence and are associated with different clinical presentations. These results provide a basis for informing ambulance planning and the identification of alternate health services.
Hillen, J. B., Vitry, A., & Caughey, G. E. (2017). Evaluating medication-related quality of care in Australian aged care: a role for collaborative health services. Journal of Pharmacy Practice & Research, 47(1), 63–66. The article discusses the role of collaborative health services in evaluating medication-related quality of care (MRQOC) in residential aged care in Australia. Topics covered include the challenges with evaluating MRQOC in Australian aged care, collaborative health services available to residents in Australian aged care facilities, and enhanced roles for pharmacists in collaborative health services.
Hodgkin, S., Warburton, J., Savy, P., & Moore, M. (2017). Workforce Crisis in Residential Aged Care: Insights from Rural, Older Workers. Australian Journal of Public Administration, 76(1), 93–105. In Australia, workforce shortages in residential aged care present a significant challenge for the aged care industry. The growing demand for workers in aged care, combined with the shrinking supply of younger workers entering the field, highlights a future workforce crisis. The current shortfalls are set to worsen with the retirement of a generation of women who have provided the backbone of the workforce. Although targeted retention of this group may alleviate this issue, few studies have explored the retirement decisions of this cohort. This paper reports on a qualitative study of this cohort of Victorian public sector residential aged care staff. Although current government rhetoric promotes intrinsic rewards (altruism, moral fulfilment) over extrinsic rewards (excessive workload, pay and conditions), a combination of these factors was associated with job satisfaction. It would seem timely to revisit some of these concerns to ensure an adequate and sufficiently skilled workforce.
Pringle, S., Simpson, M., Nielsen, S., Cooper, C., & Vanniasinkam, T. (2017). Antibiotic prescribing practices in aged care facilities in regional NSW and the ACT. Journal of Pharmacy Practice & Research, 47(5), 1–374 Background: Antibiotic resistance is a major global threat to mankind. Inappropriate antibiotic use has been identified as one of the greatest contributors to antibiotic resistance. There is currently a paucity of data on antibiotic use in aged care facilities, globally and in the Australian setting. Aim: To investigate the current antibiotic prescribing practices and use in aged care facilities in the Riverina, New South Wales (NSW), and metropolitan Australian Capital Territory (ACT). Method: Care managers of aged care facilities in the ACT and Riverina, as well as pharmacists who service aged care facilities in regional NSW and ACT, were asked to complete a questionnaire relating to antibiotic use in aged care facilities. Data obtained were subjected to statistical analysis. Results: Most facilities in the ACT (85%) and NSW (90%) had some form of protocol in place for the prescribing and obtaining of antibiotics for residents. The most commonly prescribed antibiotic across participating facilities was cephalexin and the most common indication for antibiotic use was urinary tract infection. No statistically significant differences in antibiotic use and antibiotic prescribing practices were observed between metropolitan ACT and regional NSW aged care facilities. There was a statistically significant association between facilities with residents taking antibiotics for ongoing conditions and those that have experienced situations in the past 12 months in which the initially prescribed antibiotic did not work and another had to be used (p = 0.004944). Conclusion: The data from this study can inform further studies that may be used to inform the development of antimicrobial stewardship initiatives in aged care facilities.
Prgomet, M., Douglas, H. E., Tariq, A., Et al (2017). The Work of Front Line Community Aged Care Staff and the Impact of a Changing Policy Landscape and Consumer-Directed Care. British Journal of Social Work, 47(1), 106–124. Community aged care in Australia is facing both challenges and opportunities with the introduction of consumer-directed care and its goal to provide clients with greater choice and control over their care services. Such policy changes impact not only aged care organisations, but front line staff who manage and deliver care. This study investigated the work of front line staff and their perceptions of the impact of a changing policy landscape. Focus groups were conducted with thirteen care workers and six case managers from one Australian aged care organisation. The data revealed valuable information about the: daily activities of front line staff; information exchange mechanisms facilitating front line work; management of clients and client relationships; and implications of policy and organisational changes on front line work and clients. Front line staff highlighted the importance of care coordination, communication and continuity of care delivery, all of which impact on client relationships and quality of care. For aged care organisations and policy makers, the findings identify important areas for consideration when making decisions about changes to community care, including the key role of front line staff in fostering client relationships, providing consistency and continuity, balancing the needs and expectations of clients, and providing support and advocacy of care options.
Seaman, K., Williams, E., Harrup-Gregory, J., Et al (2017). An examination of students’ perceptions of their interprofessional placements in residential aged care. Journal of Interprofessional Care, 31(2), 147–153 It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely “teamwork & collaboration” (42.1–44.0; (p = 0.000)) and “positive professional identity” (18.2–19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student’s attitudes towards the older adult as well as increase student’s readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.
Sjögren, K., Lindkvist, M., Sandman, P.-O., Zingmark, K., & Edvardsson, D. (2017). Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study. BMC Nursing, 16, 1–9. Background: Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. Methods: A cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents. Descriptive and comparative statistics, independent samples t-test, Chi² test, Eta Squared and Phi coefficient were used to analyse data. Results: Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of personcentred care. Conclusions: It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.
Teshuva, K., & Wells, Y. (2017). Aged care managers’ perceptions of staff preparedness for caring for older survivors of genocide and mass trauma in Australia: How prepared are aged care workers? Australasian Journal on Ageing, 36(1), E20–E22. Objective To investigate aged care managers' perceptions of staff preparedness for working with older people who experienced genocide or mass trauma earlier in their lives (referred to in this paper as 'older survivors'). Methods A survey of 60 aged care service managers was conducted (50% response rate). Trauma knowledge and skills scales with Cronbach's alpha scores of 0.74 and 0.90 respectively, were used. Scores across groups were compared using Student's t-tests. Results Three-quarters of the respondents reported that their agency had provided aged care services for older survivors. The majority of these managers perceived their staff to be moderately informed about trauma-related issues and half rated staff trauma-related skills positively. These ratings were positively associated with trauma-related staff training, service type and service location. Conclusion Results suggest that, overall, managers perceive a need to improve aged care staff's preparedness for providing care for older survivors.

Useful websites

Information/Fact Sheets :Australian Nursing & Midwifery Federation
ANMF fact sheets regarding aged care.
About aged care : Department of Health
Australian Government website about aged care.
Aging and aged care : Health.vic
Victorian State Government hub for health information.
Australian Institute of Health and Welfare
Reports and statistics on aged care.