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Статті в журналах з теми "Residential Aged Care Facilities (RACFs)"
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Ling, Rod, Andrew Searles, Jacqueline Hewitt, Robyn Considine, Catherine Turner, Susan Thomas, Kelly Thomas, et al. "Cost analysis of an integrated aged care program for residential aged care facilities." Australian Health Review 43, no. 3 (2019): 261. http://dx.doi.org/10.1071/ah16297.
Повний текст джерелаАнотація:
Objective To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents. Methods This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June–September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided. Results Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE saved an estimated A$921214. Conclusions The ACE service supported a reduction in avoidable ED presentations and ambulance transfers among RACF residents. It generated a cost saving to health service providers, allowing reallocation of healthcare resources. What is known about the topic? Residents from RACFs are at risk of further deterioration when admitted to hospital, with high rates of delirium, falls, and medication errors. For this cohort, some conditions can be managed in the RACF without hospital transfer. By addressing avoidable presentations to EDs there is an opportunity to improve ED efficiency as well as providing care that is consistent with the resident’s goals of care. RACFs generate some avoidable ED presentations for residents who may be more appropriately treated in situ. What does this paper add? Telephone triaging with nursing support and training is a means by which ED presentations from RACFs can be reduced. One of the consequences of this intervention is ‘cost avoided’, largely through savings on ambulance costs. What are the implications for practitioners? Unnecessary transfer from RACFs to ED can be avoided through a multicomponent program that includes telephone support with cost-saving implications for EDs and ambulance services.
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Pachana, Nancy A., Edward Helmes, Gerard J. A. Byrne, Barry A. Edelstein, Candace A. Konnert, and Anne Margriet Pot. "Screening for mental disorders in residential aged care facilities." International Psychogeriatrics 22, no. 7 (April 6, 2010): 1107–20. http://dx.doi.org/10.1017/s1041610210000128.
Повний текст джерелаАнотація:
ABSTRACTIntroduction: The International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care Facilities seeks to improve care of persons in residential aged care facilities (RACFs). As part of that effort the current authors have contributed an overview and discussion of the uses of brief screening instruments in RACFs.Methods: While no current guidelines on the use of screening instruments in nursing homes were found, relevant extant guidelines were consulted. The literature on measurement development, testing standards, psychometric considerations and the nursing home environment were consulted.Results: Cognitive, psychiatric, behavioral, functional and omnibus screening instruments are described at a category level, along with specifics about their use in a RACF environment. Issues surrounding the selection, administration, interpretation and uses of screening instruments in RACFs are discussed. Issues of international interest (such as translation of measures) or clinical concern (e.g. impact of severe cognitive decline on assessment) are addressed. Practical points surrounding who can administer, score and interpret such screens, as well as their psychometric and clinical strengths more broadly, are articulated.Conclusions: Guidelines for use of screening instruments in the RACF environment are offered, together with broad recommendations concerning the appropriate use of brief screening instruments in RACFs. Directions for future research and policy directions are outlined, with particular reference to the international context.
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Hibbert, Peter D., Louise K. Wiles, Ian D. Cameron, Alison Kitson, Richard L. Reed, Andrew Georgiou, Len Gray, et al. "CareTrack Aged: the appropriateness of care delivered to Australians living in residential aged care facilities: a study protocol." BMJ Open 9, no. 6 (June 2019): e030988. http://dx.doi.org/10.1136/bmjopen-2019-030988.
Повний текст джерелаАнотація:
IntroductionThe aged population is increasing rapidly across the world and this is expected to continue. People living in residential aged care facilities (RACFs) represent amongst the sickest and frailest cohort of the aged population, with a high prevalence of chronic conditions and complex comorbidities. Given the vulnerability of RACF residents and the demands on the system, there is a need to determine the extent that care is delivered in line with best practice (‘appropriate care’) in RACFs. There is also a recognition that systems should provide care that optimises quality of life (QoL), which includes support for physical and psychological well-being, independence, social relationships, personal beliefs and a caring external environment. The aims ofCareTrack Agedare to develop sets of indicators for appropriate care and processes of care for commonly managed conditions, and then assess the appropriateness of care delivered and QoL of residents in RACFs in Australia.Methods and analysisWe will extract recommendations from clinical practice guidelines and, using expert review, convert these into sets of indicators for 15 common conditions and processes of care for people living in RACFs. We will recruit RACFs in three Australian states, and residents within these RACFs, using a stratified multistage sampling method. Experienced nurses, trained in theCareTrack Agedmethods (‘surveyors’), will review care records of recruited residents within a 1-month period in 2019 and 2020, and assess the care documented against the indicators of appropriate care. Surveyors will concurrently assess residents’ QoL using validated questionnaires.Ethics and disseminationThe study has been reviewed and approved by the Human Research Ethics Committee of Macquarie University (5201800386). The research findings will be published in international and national journals and disseminated through conferences and presentations to interested stakeholder groups, including consumers, national agencies, healthcare professionals, policymakers and researchers.
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Hearn, Lydia, and Linda Slack-Smith. "Engaging dental professionals in residential aged-care facilities: staff perspectives regarding access to oral care." Australian Journal of Primary Health 22, no. 5 (2016): 445. http://dx.doi.org/10.1071/py15028.
Повний текст джерелаАнотація:
The limited access to oral care for older people living in residential aged care facilities (RACFs) has been noted repeatedly in the literature. The aim of this study was to explore RACF staff perspectives on how to engage dental professionals in the provision of oral care for RACF residents. Semi-structured interviews were conducted with 30 staff from six purposively selected RACFs located in high socioeconomic areas to gain understanding of the multidimensional issues that influenced the engagement of dental professionals from a carer perspective. Analysis revealed that staff perceived tensions regarding affordability, availability, accessibility and flexibility of dental professionals as significant barriers to better oral care for their residents. Participants raised a series of options for how to better engage dental professionals and reduce these barriers. Their ideas included: the engagement of RACF staff in collaborative discussions with representatives of public and private dental services, dental associations, corporate partners and academics; the use of hygienists/oral health therapists to educate and motivate RACF staff; the promotion of oral health information for troubleshooting and advice on how to deal with residents’ dental pain while waiting for support; the encouragement of onsite training for dental professionals; and the importance of gerodontology (geriatric dentistry). Findings highlighted the need to explore alternative approaches to delivering oral care that transcend the model of private clinical practice to focus instead on the needs of RACFs and take into account quality of end-of-life oral care.
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Adebayo, Bola, Pam Nichols, Karen Heslop, and Bianca Brijnath. "Migrant Care Workers’ Perceptions of Their Working Conditions in Australian Residential Aged Care Facilities." Journal of Transcultural Nursing 34, no. 3 (April 18, 2023): 229–37. http://dx.doi.org/10.1177/10436596231152204.
Повний текст джерелаАнотація:
Introduction: Staff shortages and retention are the major challenges in residential aged care facilities (RACFs). This study aimed to explore migrant care workers’ perceptions of job demands, their coping strategies, and employment intentions to leave or stay in the sector. Methods: Using a descriptive qualitative research design, semi-structured interviews were conducted with n = 20, RACF migrant care workers from Filipino, Indian, and Nigerian backgrounds in Perth, Western Australia, from April to December 2019. Data were thematically analyzed. Results: Motivating factors included the availability of care work in RACFs, and positive cultural norms associated with caring for older family members. Participants experienced a combination of resettlement and workplace challenges specifically, limited support network, communication challenges, and racial discrimination. Relevance to Practice: Work challenges that are compounded by post-migration stressors should be recognized and addressed in the design and implementation of the aged care workforce reforms to attract and retain migrant care workers.
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Goh, Anita M. Y., Samantha M. Loi, Alissa Westphal, and Nicola T. Lautenschlager. "Person-centered care and engagement via technology of residents with dementia in aged care facilities." International Psychogeriatrics 29, no. 12 (August 8, 2017): 2099–103. http://dx.doi.org/10.1017/s1041610217001375.
Повний текст джерелаАнотація:
ABSTRACTTouchscreen technology (TT) is a resource that can improve the quality of life of residents with dementia, and care staff, in residential aged care facilities (RACF) through a person-centered care approach. To enable the use of TTs to engage and benefit people with dementia in RACFs, education is needed to explore how these devices may be used, what facilitates use, and how to address barriers. We sought to provide education and explore RACF staff views and barriers on using TT to engage their residents with dementia. An educational session on using TT with residents with dementia was given to staff from three long-term RACFs in Melbourne, Australia. A cross-sectional convenience sample of 17 staff members (personal care attendants, registered nurses, enrolled nurses, allied health clinicians, and domestic staff) who attended were administered questionnaires pre- and post-sessions. As a result of the education seminar, they were significantly more confident in their ability to use TT devices with residents. TT, and education to staff about its use with residents with dementia, is a useful strategy to enhance RACF staff knowledge and confidence, thereby enhancing the use of technology in RACFs in order to improve care standards in people with dementia.
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Dai, Yunyun, Jia Zhao, Shenmei Li, Chaochao Zhao, Yan Gao, and Claire Elizabeth Johnson. "Caregivers’ Dementia Knowledge and Care Approach in Residential Aged Care Facilities in China." American Journal of Alzheimer's Disease & Other Dementiasr 35 (January 1, 2020): 153331752093709. http://dx.doi.org/10.1177/1533317520937096.
Повний текст джерелаАнотація:
Objective: To investigate the dementia knowledge and care approach used by caregivers in residential aged care facilities (RACFs) in China. Method: A cross-sectional survey of 785 caregivers from a random sample of 34 RACFs in China. Caregivers’ knowledge and care approach were assessed using the Chinese version of the Dementia Knowledge Assessment Tool 2 and Advanced Dementia Care Questionnaire. Results: The majority of caregivers showed limited knowledge of dementia and tended not to adopt a person-centered approach to care. Educational level, dementia care training, and years of work experience were positively associated with dementia knowledge. Educational level and years of work experience were also associated with a person-centered approach to care. Conclusions: This study provides insight into the care available to people with dementia in RACFs in China. The results suggest dementia care education programs as well as person-centered care training are urgently needed for caregivers in China.
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Moore, Kirsten J., Keith D. Hill, Andrew L. Robinson, Terry P. Haines, Betty Haralambous, and Jennifer C. Nitz. "The state of physical environments in Australian residential aged care facilities." Australian Health Review 35, no. 4 (2011): 412. http://dx.doi.org/10.1071/ah10932.
Повний текст джерелаАнотація:
Objective. This paper examines the quality and safety of the physical environment in Australian residential aged care facilities (RACFs). Design. Cross-sectional study. One assessor completed environmental audits to identify areas of the physical environment that needed to be addressed to improve the wellbeing and safety of residents. Setting. Nine RACFs participating in a broader falls prevention project were audited. RACFs were located in Queensland, Tasmania or Victoria and were chosen by convenience to represent high level, low level, dementia and psychogeriatric care, regional and metropolitan facilities, small and large facilities and a culturally specific facility. Main outcome measure. An environmental audit tool was adapted from a tool designed to foster older person friendly hospital environments. The tool consisted of 147 items. Results. Across all sites 450 items (34%) required action. This ranged from 21 to 44% across sites. The audit domains most commonly requiring action included signage, visual perception and lighting, and outdoor areas. Conclusions. Although not representative of all residential facilities in Australia, this audit process has identified common environmental problems across a diverse mix of residential care facilities. Results highlight the need for further investigation into the quality of physical environments, and interventions to improve physical environments in Australian RACFs. What is known about the topic? Despite the importance of the physical environment on the health, wellbeing and safety of older people in residential aged care facilities, few studies have comprehensively evaluated the physical environment in facilities in Australia. What does this paper add? This paper provides findings from comprehensive audits of nine residential aged care facilities representing a broad range of facility settings in terms of location, level and type of care and target population. Findings indicate that each facility had at least 21% of items requiring action with an average of 34% of items requiring action across all facilities. What are the implications for practitioners? There is a need to undertake intermittent, thorough assessments of the physical environments in which residents live and, if applicable, implement strategies or modifications to improve the environment. Areas requiring particular consideration may be lighting, colour contrasts, signage and outdoor areas.
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Montalto, Michael, Simon Shay, and Andy Le. "Evaluation of a mobile X-ray service for elderly residents of residential aged care facilities." Australian Health Review 39, no. 5 (2015): 517. http://dx.doi.org/10.1071/ah15059.
Повний текст джерелаАнотація:
Objective The Royal Melbourne Hospital established a mobile X-ray service (MXS) in 2013. The goal of the MXS is to address the radiology needs of frail, elderly or demented residents of residential aged care facilities (RACFs) who would otherwise require transportation to attend for X-ray. The present study describes the activity of the MXS, and the impact of the MXS on emergency department (ED) attendances by residents of RACFs. Methods The study is a descriptive study and uses a before-and-after cohort approach. Activity for the first year of operation was collected and described. At the end of the first year of operation, the top 30 RACF users of the MXS were identified. The hospital Department of Radiology database was examined to find all plain X-rays performed on any patient presenting from the same 30 RACFs for the 1 year before commencement of the MXS (1 July 2012–30 June 2013) and for the 1 year period after the commencement of the MXS (1 July 2013–30 June 2014). Attendances were compared. Results The MXS delivered 1532 service attendances to 109 different RACFs. The mean age of patients receiving MXS services was 86 years (range 16–107 years). In all, 1124 services (73.4%) were delivered to patients in high-care RACFs. Most patients (n = 634; 41.4%) were bed or wheelchair bound, followed by those who required assistance to ambulate (n = 457; 29.8%). The most common X-ray examinations performed were chest, hip and pelvis, spine and abdomen. There were 919 service attendances to the top 30 RACFs using the MXS (60.0% of all attendances). There was an 11.5% reduction in ED presentations requiring plain X-ray in the year following the commencement of the MXS (95% confidence interval 0.62–3.98; P = 0.019). Conclusion The present study suggests a reduction in hospital ED attendances for high users of the MXS. This has benefits for hospitals, patients and nursing homes. It also allows the extension of other programs designed to treat patients in their RACFs. Special rebates for home-based radiology service provision should be considered. What is already known about this subject? Digital processing has changed the way radiology delivers services. The Australian community is in the middle of a shift towards an aging population, with a greater numbers of residents in RACFs. It has been suggested in previous studies that mobile X-ray reduces the rate of delirium in patients who require X-ray. What does this paper add? There is an unmet demand for MXS to residents of RACFs. MXS may reduce presentations by elderly residents of RACFs to hospital EDs for X-rays. MXS may assist general practitioners, and other innovative programs, such as Hospital in the Home and Inreach, to better manage care for patients in RACFs. What are the implications for practitioners? Providers of radiology services should examine the opportunities and benefits of establishing MXS. Funders of services should examine ways of rebating MXS to encourage further development. Hospitals (Hospital in the Home and Inreach services), RACFs and general practitioners should use mobile X-ray and integrate these services into their management of aged care delivered in RACFs.
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Batten, Miranda, Sam Kosari, Joanne Lewis, Mark Naunton, and Karen Strickland. "Exploration of an On-Site Pharmacist Intervention within Australian Residential Aged Care Facilities Using Normalisation Process Theory: A Mixed-Methods Study." Health & Social Care in the Community 2023 (September 19, 2023): 1–19. http://dx.doi.org/10.1155/2023/4370884.
Повний текст джерелаАнотація:
Residents living in residential aged care facilities (RACFs) continue to experience medication-related harm. There is ongoing interest in expanding the role of pharmacists, including on-site pharmacists (OSPs), to help improve medication management in RACFs. The objectives of this mixed-methods study were to explore the extent and ways in which on-site pharmacists (OSPs) were normalised within RACFs as part of a complex intervention seeking to improve medication management. This study consisted of semistructured interviews informed by normalisation process theory (NPT) and a quantitative survey adapted from the normalisation measure development questionnaire (NoMAD) instrument which is underpinned by NPT. Semistructured interviews with prescribers, RACF managers, RACF nursing staff, OSPs, residents, and family members (n = 47) indicated that most participants supported OSPs within RACFs that having OSPs in RACFs made sense and was perceived as beneficial and that participants were invested in working with OSPs who often became part of routine practice, i.e., “normalised.” Prescribers, RACF managers, and nursing staff (health care team members) completed the adapted survey, and their responses (n = 16) strongly complemented the positive qualitative findings. Overall, OSPs were positively appraised by health care team members as well as residents and family members and were generally considered to be normalised within their respective RACFs. This study explored the normalisation of OSPs within RACFs. From the perspective of residents, family members, health care team members, and OSPs, OSPs could become part of routine practice within Australian RACFs. The findings of this study also highlighted the value of using theory to guide the evaluation of a pharmacist intervention in RACFs and the utility of applying NPT in a new setting, Australian RACFs. Importantly, the findings of this study could help inform the future role of OSPs working and the rollout of OSPs within Australian RACFs.
Дисертації з теми "Residential Aged Care Facilities (RACFs)"
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Shohel, Mohammad. "Antibiotic Stewardship in Residential Aged Care Facilities." Thesis, Curtin University, 2019. http://hdl.handle.net/20.500.11937/86378.
Повний текст джерелаАнотація:
Aged care residents are at increased risk of infections due to their frailty and comorbidities. This study aimed to identify and reduce the risk of antibiotic-related misadventure in this population. Particular medicines were associated with use of antibiotics, suggesting compromised immunity via numerous mechanisms. Potential interactions between antibiotics and residents’ other medicines were also identified, and may increase morbidity in this vulnerable group. Expanded scope of antimicrobial stewardship in aged care facilities is recommended.
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DeBeyer, Carrie Jeanette. "Diabetes care : the status of diabetes care in Queensland residential aged facilities." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/2627.
Повний текст джерелаАнотація:
Diabetes care of the elderly in residential aged care facilities has often been unstructured and non-standardised, with disparities in both the practice and knowledge of health care workers caring for this vulnerable group. Poorly controlled diabetes can contribute to a range of adverse events, including impaired wound health and cardiovascular events. The purpose of this study was to establish if current Australian diabetes management guidelines for the elderly are being met in residential aged care facilities in Queensland and identify areas for clinical practice improvement.A cross-sectional, descriptive design was employed to measure demographic data, perceived and actual diabetes-related knowledge, availability of diabetes management and care guidelines, and facilitators and barriers to meeting diabetes related care. A sample of 109 health care workers from residential aged care facilities completed a postal survey.Diabetes guidelines shown to be available in residential aged care facilities were aimed at care planning, with guidelines for both screening and monitoring of diabetes and diabetes care specific skills more available in private aged care and high care classified facilities. Limited monitoring of outcomes of diabetes care were evident. Overall, participants perceived their diabetes knowledge as “good”, however deficits were found in the level of actual knowledge on diabetes complications and medication management. Ratings for perceived and actual diabetes knowledge was higher with older aged health care workers by those employed in their current position the longest.Furthermore, a positive relationship was shown between perceived and actual diabetes knowledge with years of experience in aged care, employment status (RNs/ENs, AINs and other health care workers) and education status (grade 12 schooling, Technology and Further Education and university award). Diabetes – related knowledge was shown to be the most significant facilitator as well as barrier to diabetes care provision. Factors affecting perceived level of confidence in providing diabetes self-management education included experience in aged care, employment position and level of education.The contribution of this research to the area of study was to provide important data on the availability of diabetes guidelines and protocols and diabetes knowledge base. Data has also been provided for the availability of diabetes guidelines and protocols in different facility types and with different classifications of care as well as data for the perceived level of confidence in providing diabetes care in residential aged care facilities. Study findings indicate a need for an increased focus on diabetes care in residential aged care to improve health outcomes.
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Grenade, Linda Elise. "Accreditation of residential aged care facilities: experiences of service providers." Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1306.
Повний текст джерелаАнотація:
The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.
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Grenade, Linda Elise. "Accreditation of residential aged care facilities : experiences of service providers /." Curtin University of Technology, School of Public Health, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15068.
Повний текст джерелаАнотація:
The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study.Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.
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Bagul, Deepali Sanved. "Culturally appropriate dementia care for older Indian migrants living in residential aged care facilities in Sydney, Australia." Thesis, The University of Sydney, 2020. https://hdl.handle.net/2123/24868.
Повний текст джерелаАнотація:
This thesis explores dementia care for migrants living in residential care facilities. To begin, this thesis considers how culturally sensitive dementia care influences the participation and engagement of migrants with dementia. Using mixed studies - systematic review, barriers, and facilitators supporting the engagement and participation of migrants with dementia are considered. The review findings highlight the need to consider that culturally sensitive care must extend beyond issues of language and should also incorporate broader aspects of culture, such as environmental design and culturally based activities.
The second study considers the case of Indian migrants with dementia living in Australia. To this end, an exploratory mixed methods design was adopted to explore critical elements for providing culturally sensitive dementia care for older Indian migrants living in Sydney’s residential aged care facilities. Three different participant groups were involved in the research discussion by means of the nominal group technique (NGT). Each group discussion was then summarised and prioritised with the six key ideas by using participants’ votes. Research study findings were represented by summarising common key ideas and opinions provided by participants involved in the NGT. Results indicated that language, provision of traditional food, multilingual staff, and cultural activities comprise the key elements for providing culturally appropriate dementia care to older Indian migrants living in aged care facilities.
Overall, this thesis suggests that, when it comes to providing dementia care, aged care facilities should understand that every culture possesses its own ways of providing care to loved ones. Rather than providing general care to everyone, aged care facilities should instead cater their care by recognising residents’ choices and preferences.
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Banks, Merrilyn Dell. "Economic analysis of malnutrition and pressure ulcers in Queensland hospitals and residential aged care facilities." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/16966/1/Merrilyn_D_Banks_Thesis.pdf.
Повний текст джерелаАнотація:
Malnutrition is reported to be common in hospitals (10-60%), residential aged care facilities (up to 50% or more) and in free living individuals with severe or multiple disease (>10%) (Stratton et al., 2003). Published Australian studies
indicate similar results (Beck et al., 2001, Ferguson et al., 1997, Lazarus and Hamlyn, 2005, Middleton et al., 2001, Visvanathan et al., 2003), but are generally limited in number, with none conducted across multiple centres or in residential aged care facilities. In Australia, there is a general lack of awareness and recognition of the problem of malnutrition, with currently no policy, standards or guidelines related to the identification, prevention and treatment of malnutrition. Malnutrition has been found to be associated with the development of pressure ulcers, but studies are limited. The consequences of the development of pressure ulcers include pain and discomfort for the patient, and considerable costs associated with treatment and increased length of stay. Pressure ulcers
are considered largely preventable, and the demand for the establishment of appropriate policy, standards and guidelines regarding pressure ulcers has
recently become important because the incidence and prevalence of pressure ulcers is increasingly being considered a parameter of quality of care. The aims of this study program were to firstly determine the prevalence of malnutrition and its association with pressure ulcers in Queensland Health hospitals and residential aged care facilities; and secondly to estimate the potential economic consequences of malnutrition by determining the costs
arising from pressure ulcer attributable to malnutrition; and the economic
outcomes of an intervention to address malnutrition in the prevention of pressure ulcers. The study program was conducted in two phases: an epidemiological study phase and an economic modelling study phase. In phase one, a multi centre, cross sectional audit of a convenience sample of subjects was carried out as part of a larger audit of pressure ulcers in
Queensland public acute and residential aged care facilities in 2002 and again in 2003. Dietitians in 20 hospitals and six aged care facilities conducted single day nutritional status audits of 2208 acute and 839 aged care subjects using the Subjective Global Assessment, in either or both audits. Subjects excluded were obstetric, same day, paediatric and mental health patients. Weighted average proportions of nutritional status categories for acute and residential aged care facilities across the two audits were determined and compared. The effects of gender, age, facility location and medical specialty on malnutrition were determined via logistic regression. The effect of nutritional status on the presence of pressure ulcer was also determined via logistic regression. Logistic regression analyses were carried out using an analysis of correlated data approach with SUDAAN statistical package (Research Triangle Institute, USA) to account for the potential clustering effect of different facilities in the model. In phase two, an exploratory economic modelling framework was used to estimate the number of cases of pressure ulcer, total bed days lost to pressure ulcer and the economic cost of these lost bed days which could be attributed to malnutrition in Queensland public hospitals in 2002/2003. Data was obtained on the number of relevant separations, the incidence rate of pressure ulcer, the independent effect of pressure ulcers on length of stay, the cost of a bed day, and the attributable fraction of malnutrition in the development of pressure ulcers determined using the prevalence of malnutrition, the incidence rate of developing a pressure ulcer and the odds risk of developing a pressure ulcer when malnourished (as determined previously). A probabilistic sensitivity analysis approach was undertaken whereby probability distributions to the specified ranges for the key input parameters were assigned and 1000 Monte Carlo samples made from the input parameters. In an extension of the above model, an economic modelling framework was
also used to predict the number of cases of pressure ulcer avoided, number of bed days not lost to pressure ulcer and economic costs if an intensive nutrition support intervention was provided to all nutritionally at risk patients in Queensland public hospitals in 2002/2003 compared to standard care. In
addition to the above input parameters, data was obtained on the change in risk in developing a pressure ulcer associated with an intensive nutrition support intervention compared to standard care. The annual monetary cost of the provision of an intensive nutrition support intervention to at risk patients was
modelled at a cost of AU$ 3.8-$5.4 million for additional food and nutritional supplements and staffing resources to assist patients with nutritional intake. A probabilistic sensitivity analysis approach was again taken.
A mean of 34.7 + 4.0% and 31.4 + 9.5% of acute subjects and a median of 50.0% and 49.2% of residents of aged care facilities were found to be malnourished in Audits 1 and 2, respectively. Variables found to be significantly associated with an increased odds risk of malnutrition included: older age groups, metropolitan location of facility and medical specialty, in particular oncology and critical care. Malnutrition was found to be significantly associated with an increased odds
risk of having a pressure ulcer, with the odds risk increasing with severity of malnutrition. In acute facilities moderate malnutrition had an odds risk of 2.2 (95% CI 1.6-3.0, p<0.001) and severe malnutrition had an odds risk of 4.8 (95% CI 3.2-7.2, p<0.001) of having a pressure ulcer. The overall adjusted odds risk
of having a pressure ulcer when malnourished (total malnutrition) in an acute facility was 2.6 (95% CI 1.8-3.5, p<0.001). In residential facilities, where the audit results were presented separately, the same pattern applied with moderate malnutrition having an odds risk of 1.7 (95% CI 1.2-2.2, p<0.001) and 2.0 (95% CI 1.5-2.8, p<0.001); and severe malnutrition having an odds risk of 2.8 (95% CI1.2-6.6, p=0.02) and 2.2 (95% CI 1.5-3.1, p<0.001), for Audits 1 and 2 respectively. There was no statistical difference between these odds risk
ratios between the audits. The overall adjusted odds risk of having a pressure ulcer when malnourished (total malnutrition) in a residential aged care facility was 1.9 (95% CI 1.3-2.7, p<0.001) and 2.0 (95% CI 1.5-2.7, p<0.001) for Audits
1 and 2 respectively. Being malnourished was also found to be significantly associated with an increased odds risk of having a higher stage and higher number of pressure ulcers, with the odds risk increasing with severity of malnutrition.
The economic model predicted a mean of 3666 (Standard deviation 555) cases
of pressure ulcer attributable to malnutrition out of a total mean of 11162 (Standard deviation 1210), or approximately 33%, in Queensland public acute hospitals in 2002/2003. The mean number of bed days lost to pressure ulcer that were attributable to malnutrition was predicted to be 16050, which represents approximately 0.67% of total patient bed days in Queensland public
hospitals in 2002/2003. The corresponding mean economic costs of pressure ulcer attributable to malnutrition in Queensland public acute hospitals in 2002/2003 were estimated to be almost AU$13 million, out of a total mean estimated cost of pressure ulcer of AU$ 38 526 601. In the extension of the economic model, the mean economic cost of the implementation of an intensive nutrition support intervention was predicted to be a negative value ( -AU$ 5.4 million) with a standard deviation of $AU3.9 million, and interquartile range of –AU$ 7.7 million to –AU$ 2.5 million. Overall there were 951 of the 1000 re-samples where the economic cost is a negative value. This means there was a 95% chance that implementing an intensive nutrition support intervention was overall cost saving, due to reducing the cases
of pressure ulcer and hospital bed days lost to pressure ulcer. This research program has demonstrated an independent association between malnutrition and pressure ulcers, on a background of a high prevalence of malnutrition, providing evidence to justify the elevation of malnutrition to a safety and quality issue for Australian healthcare organisations, similarly to pressure ulcers. In addition this research provides preliminary economic
evidence to justify the requirement for consideration of healthcare policy, standards and guidelines regarding systems to identify, prevent and treat malnutrition, at least in the case of pressure ulcers in Australia.
7
Banks, Merrilyn Dell. "Economic analysis of malnutrition and pressure ulcers in Queensland hospitals and residential aged care facilities." Queensland University of Technology, 2008. http://eprints.qut.edu.au/16966/.
Повний текст джерелаАнотація:
Malnutrition is reported to be common in hospitals (10-60%), residential aged care facilities (up to 50% or more) and in free living individuals with severe or multiple disease (>10%) (Stratton et al., 2003). Published Australian studies
indicate similar results (Beck et al., 2001, Ferguson et al., 1997, Lazarus and Hamlyn, 2005, Middleton et al., 2001, Visvanathan et al., 2003), but are generally limited in number, with none conducted across multiple centres or in residential aged care facilities. In Australia, there is a general lack of awareness and recognition of the problem of malnutrition, with currently no policy, standards or guidelines related to the identification, prevention and treatment of malnutrition. Malnutrition has been found to be associated with the development of pressure ulcers, but studies are limited. The consequences of the development of pressure ulcers include pain and discomfort for the patient, and considerable costs associated with treatment and increased length of stay. Pressure ulcers
are considered largely preventable, and the demand for the establishment of appropriate policy, standards and guidelines regarding pressure ulcers has
recently become important because the incidence and prevalence of pressure ulcers is increasingly being considered a parameter of quality of care. The aims of this study program were to firstly determine the prevalence of malnutrition and its association with pressure ulcers in Queensland Health hospitals and residential aged care facilities; and secondly to estimate the potential economic consequences of malnutrition by determining the costs
arising from pressure ulcer attributable to malnutrition; and the economic
outcomes of an intervention to address malnutrition in the prevention of pressure ulcers. The study program was conducted in two phases: an epidemiological study phase and an economic modelling study phase. In phase one, a multi centre, cross sectional audit of a convenience sample of subjects was carried out as part of a larger audit of pressure ulcers in
Queensland public acute and residential aged care facilities in 2002 and again in 2003. Dietitians in 20 hospitals and six aged care facilities conducted single day nutritional status audits of 2208 acute and 839 aged care subjects using the Subjective Global Assessment, in either or both audits. Subjects excluded were obstetric, same day, paediatric and mental health patients. Weighted average proportions of nutritional status categories for acute and residential aged care facilities across the two audits were determined and compared. The effects of gender, age, facility location and medical specialty on malnutrition were determined via logistic regression. The effect of nutritional status on the presence of pressure ulcer was also determined via logistic regression. Logistic regression analyses were carried out using an analysis of correlated data approach with SUDAAN statistical package (Research Triangle Institute, USA) to account for the potential clustering effect of different facilities in the model. In phase two, an exploratory economic modelling framework was used to estimate the number of cases of pressure ulcer, total bed days lost to pressure ulcer and the economic cost of these lost bed days which could be attributed to malnutrition in Queensland public hospitals in 2002/2003. Data was obtained on the number of relevant separations, the incidence rate of pressure ulcer, the independent effect of pressure ulcers on length of stay, the cost of a bed day, and the attributable fraction of malnutrition in the development of pressure ulcers determined using the prevalence of malnutrition, the incidence rate of developing a pressure ulcer and the odds risk of developing a pressure ulcer when malnourished (as determined previously). A probabilistic sensitivity analysis approach was undertaken whereby probability distributions to the specified ranges for the key input parameters were assigned and 1000 Monte Carlo samples made from the input parameters. In an extension of the above model, an economic modelling framework was
also used to predict the number of cases of pressure ulcer avoided, number of bed days not lost to pressure ulcer and economic costs if an intensive nutrition support intervention was provided to all nutritionally at risk patients in Queensland public hospitals in 2002/2003 compared to standard care. In
addition to the above input parameters, data was obtained on the change in risk in developing a pressure ulcer associated with an intensive nutrition support intervention compared to standard care. The annual monetary cost of the provision of an intensive nutrition support intervention to at risk patients was
modelled at a cost of AU$ 3.8-$5.4 million for additional food and nutritional supplements and staffing resources to assist patients with nutritional intake. A probabilistic sensitivity analysis approach was again taken.
A mean of 34.7 + 4.0% and 31.4 + 9.5% of acute subjects and a median of 50.0% and 49.2% of residents of aged care facilities were found to be malnourished in Audits 1 and 2, respectively. Variables found to be significantly associated with an increased odds risk of malnutrition included: older age groups, metropolitan location of facility and medical specialty, in particular oncology and critical care. Malnutrition was found to be significantly associated with an increased odds
risk of having a pressure ulcer, with the odds risk increasing with severity of malnutrition. In acute facilities moderate malnutrition had an odds risk of 2.2 (95% CI 1.6-3.0, p<0.001) and severe malnutrition had an odds risk of 4.8 (95% CI 3.2-7.2, p<0.001) of having a pressure ulcer. The overall adjusted odds risk
of having a pressure ulcer when malnourished (total malnutrition) in an acute facility was 2.6 (95% CI 1.8-3.5, p<0.001). In residential facilities, where the audit results were presented separately, the same pattern applied with moderate malnutrition having an odds risk of 1.7 (95% CI 1.2-2.2, p<0.001) and 2.0 (95% CI 1.5-2.8, p<0.001); and severe malnutrition having an odds risk of 2.8 (95% CI1.2-6.6, p=0.02) and 2.2 (95% CI 1.5-3.1, p<0.001), for Audits 1 and 2 respectively. There was no statistical difference between these odds risk
ratios between the audits. The overall adjusted odds risk of having a pressure ulcer when malnourished (total malnutrition) in a residential aged care facility was 1.9 (95% CI 1.3-2.7, p<0.001) and 2.0 (95% CI 1.5-2.7, p<0.001) for Audits
1 and 2 respectively. Being malnourished was also found to be significantly associated with an increased odds risk of having a higher stage and higher number of pressure ulcers, with the odds risk increasing with severity of malnutrition.
The economic model predicted a mean of 3666 (Standard deviation 555) cases
of pressure ulcer attributable to malnutrition out of a total mean of 11162 (Standard deviation 1210), or approximately 33%, in Queensland public acute hospitals in 2002/2003. The mean number of bed days lost to pressure ulcer that were attributable to malnutrition was predicted to be 16050, which represents approximately 0.67% of total patient bed days in Queensland public
hospitals in 2002/2003. The corresponding mean economic costs of pressure ulcer attributable to malnutrition in Queensland public acute hospitals in 2002/2003 were estimated to be almost AU$13 million, out of a total mean estimated cost of pressure ulcer of AU$ 38 526 601. In the extension of the economic model, the mean economic cost of the implementation of an intensive nutrition support intervention was predicted to be a negative value ( -AU$ 5.4 million) with a standard deviation of $AU3.9 million, and interquartile range of –AU$ 7.7 million to –AU$ 2.5 million. Overall there were 951 of the 1000 re-samples where the economic cost is a negative value. This means there was a 95% chance that implementing an intensive nutrition support intervention was overall cost saving, due to reducing the cases
of pressure ulcer and hospital bed days lost to pressure ulcer. This research program has demonstrated an independent association between malnutrition and pressure ulcers, on a background of a high prevalence of malnutrition, providing evidence to justify the elevation of malnutrition to a safety and quality issue for Australian healthcare organisations, similarly to pressure ulcers. In addition this research provides preliminary economic
evidence to justify the requirement for consideration of healthcare policy, standards and guidelines regarding systems to identify, prevent and treat malnutrition, at least in the case of pressure ulcers in Australia.
8
Walker, Helen M. "The experience of care assistants who care for residents in the final stage of life in residential aged care facilities." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/278.
Повний текст джерелаАнотація:
This thesis presents the results of a study that explores the experience of care assistants who care for residents in the final stages of life in residential aged care facilities in metropolitan Perth. Care assistants, with little formal training and no regulation, play a pivotal role in the direct care of dying residents in these facilities. Yet little was known about the palliative care role and the impact that caring for residents in the final stage of life has on this health care group. The literature relating to end of life care in residential aged care facilities revealed limited research in this area. In particular, there is a lack of studies that relate specifically to the care assistants' role and their experiences of end of life care. Research to date has focused on the context of palliative care in residential aged care facilities, the workplace environment, how to provide a dignified death, relationships and the central role of the care assistant. This study used a qualitative narrative inquiry research design.
9
O'Reilly, Maria Therese. "Clinical indicators of quality for Australian residential aged care facilities : establishing reliability, validity, and quality thresholds." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/40314/1/Maria_O%27Reilly_Thesis.pdf.
Повний текст джерелаАнотація:
Background: In response to the need for more comprehensive quality assessment within Australian residential aged care facilities, the Clinical Care Indicator (CCI) Tool was developed to collect outcome data as a means of making inferences about quality. A national trial of its effectiveness and a Brisbane-based trial of its use within the quality improvement context determined the CCI Tool represented a potentially valuable addition to the Australian aged care system. This document describes the next phase in the CCI Tool.s development; the aims of which were to establish validity and reliability of the CCI Tool, and to develop quality indicator thresholds (benchmarks) for use in Australia. The CCI Tool is now known as the ResCareQA (Residential Care Quality Assessment). Methods: The study aims were achieved through a combination of quantitative data analysis, and expert panel consultations using modified Delphi process. The expert panel consisted of experienced aged care clinicians, managers, and academics; they were initially consulted to determine face and content validity of the ResCareQA, and later to develop thresholds of quality. To analyse its psychometric properties, ResCareQA forms were completed for all residents (N=498) of nine aged care facilities throughout Queensland. Kappa statistics were used to assess inter-rater and test-retest reliability, and Cronbach.s alpha coefficient calculated to determine internal consistency. For concurrent validity, equivalent items on the ResCareQA and the Resident Classification Scales (RCS) were compared using Spearman.s rank order correlations, while discriminative validity was assessed using known-groups technique, comparing ResCareQA results between groups with differing care needs, as well as between male and female residents. Rank-ordered facility results for each clinical care indicator (CCI) were circulated to the panel; upper and lower thresholds for each CCI were nominated by panel members and refined through a Delphi process. These thresholds indicate excellent care at one extreme and questionable care at the other. Results: Minor modifications were made to the assessment, and it was renamed the ResCareQA. Agreement on its content was reached after two Delphi rounds; the final version contains 24 questions across four domains, enabling generation of 36 CCIs. Both test-retest and inter-rater reliability were sound with median kappa values of 0.74 (test-retest) and 0.91 (inter-rater); internal consistency was not as strong, with a Chronbach.s alpha of 0.46. Because the ResCareQA does not provide a single combined score, comparisons for concurrent validity were made with the RCS on an item by item basis, with most resultant correlations being quite low. Discriminative validity analyses, however, revealed highly significant differences in total number of CCIs between high care and low care groups (t199=10.77, p=0.000), while the differences between male and female residents were not significant (t414=0.56, p=0.58). Clinical outcomes varied both within and between facilities; agreed upper and lower thresholds were finalised after three Delphi rounds. Conclusions: The ResCareQA provides a comprehensive, easily administered means of monitoring quality in residential aged care facilities that can be reliably used on multiple occasions. The relatively modest internal consistency score was likely due to the multi-factorial nature of quality, and the absence of an aggregate result for the assessment. Measurement of concurrent validity proved difficult in the absence of a gold standard, but the sound discriminative validity results suggest that the ResCareQA has acceptable validity and could be confidently used as an indication of care quality within Australian residential aged care facilities. The thresholds, while preliminary due to small sample size, enable users to make judgements about quality within and between facilities. Thus it is recommended the ResCareQA be adopted for wider use.
10
Shen, Xizi. "Unveiling the Concept of Person-centered Dementia Care within Occupational Therapy in Residential Aged Care Facilities: A Critical Interpretive Synthesis." Thesis, Discipline of Occupational Therapy, 2017. http://hdl.handle.net/2123/16256.
Повний текст джерелаАнотація:
Background: People with dementia living in residential aged care facilities are at risk of being deprived of occupational engagement. The link between occupational therapy and meaningful engagement of residents with moderate to advanced dementia has been established. Concepts regarding person-centered dementia care are adopted as the guiding principle for service providers in this field. However, it is unclear how occupational therapists embrace the essence of person-centered dementia care when promoting meaningful engagement of residents with moderate to advanced dementia. This study thus aims to explore how person-centered dementia care is presented from an occupational therapy perspective. Methods: Thirty peer-reviewed articles were used as the source sample for this study. A critical interpretive synthesis was conducted to critically consider the power structure underpinning occupational therapy practice in residential dementia care. Evidence pertaining to occupational therapy practice was integrated and analyzed using concepts regarding occupational justice and themes of doing, being, becoming, belonging, and co-occupation to generate synthesis. Results: This synthesis indicated that occupational therapists enhance occupational justice in residential dementia care by increasing access to meaningful engagement and enabling participation of residents in doing, being and belonging at the level of co-occupation where interdependence between residents and mainly staff members is 28 fostered. However, the becoming domain of occupation has not been comprehensively addressed. Thus, the needs of residents for continual growth and development as occupational beings have not been fully addressed by the current occupational therapy practice in residential dementia care. Conclusion: This finding suggests expanding the role of occupational therapists to empower people with moderate to advanced dementia to enact and build on continuing opportunities for agency.
Книги з теми "Residential Aged Care Facilities (RACFs)"
1
Canadian Centre for Health Information. and Centre canadien d'information sur la santé., eds. Health reports. Supplement. No. 18, Residential care facilities, aged. Ottawa, Ont: Statistics Canada = Statistique Canada, 1990.
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2
Australian Institute of Health and Welfare. and Australia. Dept. of Health and Aged Care., eds. Residential aged care facilities in Australia 1998: A statistical overview. Canberra: Australian Institute of Health and Welfare, 1999.
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3
Australian Institute of Health and Welfare., ed. Residential aged care facilities in Australia 1998-99: A statistical overview. Canberra: Australian Institute of Health and Welfare, 2000.
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4
Canadian Centre for Health Information. and Centre canadien d'information sur la santé., eds. Residential care facilities - aged =: Établissements de soins spéciaux pour bénéficiaires internes - âgées. Ottawa, Ont: Statistics Canada = Statistique Canada, 1993.
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5
Roger, Clough, ed. The abuse of care in residential institutions. London: Whiting and Birch, 1996.
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6
Sonne, Lemke, ed. Evaluating residential facilities: The multiphasic environmental assessment procedure. Thousand Oaks: Sage Publications, 1996.
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7
Ontario Association of Non-Profit Homes and Services for Seniors. and Ontario. Ministry of Community and Social Services., eds. Report on the validation of the Homes for the Aged Residential Services Review. Woodbridge, Ont: OANHSS, 1989.
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8
Manitoba. Interdepartmental Steering Committee for the Review of Seniors Care Facilities: Residential Care Facilities for the Infirm Aged and Personal Care Homes. Report of the Interdepartmental Steering Committee for the Review of Seniors Care Facilities--Residential Care Facilities for the Infirm Aged and Personal Care Homes. [Manitoba: The Committee, 1995.
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9
Branch, Ontario Elderly Services. Living in the community: New directions in residential services for frail elderly people : a consultation paper. [Toronto]: The Ministry, 1989.
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10
M, Cready Cynthia, and Noelker Linda S, eds. Empowered work teams in long-term care: Strategies for improving outcomes for residents and staff. Baltimore: Health Professions Press, 2008.
Знайти повний текст джерелаЧастини книг з теми "Residential Aged Care Facilities (RACFs)"
1
Wardle, Sabine, and Cary Bennett. "Spiritual inclusiveness at end-of-life for Punjabi Indians: experience with Regional Residential Aged Care Facilities." In Changing Cultures of Ageing and Spirituality, 59–75. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003433996-7.
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2
Hourigan, Susan R. "Exercise prescription in residential aged care facilities." In Physiotherapy Practice in Residential Aged Care, 209–38. Elsevier, 2004. http://dx.doi.org/10.1016/b978-0-7506-8772-0.50014-2.
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3
Becker, Clemens, Kilian Rapp, and Patrick Roigk. "Fall Prevention in Residential Aged Care Facilities." In Falls in Older People, 410–24. 3rd ed. Cambridge University Press, 2021. http://dx.doi.org/10.1017/9781108594455.028.
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4
Rahmann, Ann. "Aquatic physiotherapy for residents in aged care facilities." In Physiotherapy Practice in Residential Aged Care, 251–73. Elsevier, 2004. http://dx.doi.org/10.1016/b978-0-7506-8772-0.50016-6.
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5
Alkhalaf, Mohammad, Mengyang Yin, Chao Deng, Hui-Chen (Rita) Chang, and Ping Yu. "Machine Learning Model to Extract Malnutrition Data from Nursing Notes." In Studies in Health Technology and Informatics. IOS Press, 2024. http://dx.doi.org/10.3233/shti231240.
Повний текст джерелаАнотація:
Malnutrition is a severe health problem that is prevalent in older people residing in residential aged care facilities. Recent advancements in machine learning have made it possible to extract key insight from electronic health records. To date, few researchers applied these techniques to classify nursing notes automatically. Therefore, we propose a model based on ClinicalBioBert to identify malnutrition notes. We evaluated our approach with two mainstream approaches. Our approach had the highest F1-score of 0.90.
6
Vithanage, Dinithi, Yunshu Zhu, Zhenyu Zhang, Chao Deng, Mengyang Yin, and Ping Yu. "Extracting Symptoms of Agitation in Dementia from Free-Text Nursing Notes Using Advanced Natural Language Processing." In Studies in Health Technology and Informatics. IOS Press, 2024. http://dx.doi.org/10.3233/shti231055.
Повний текст джерелаАнотація:
Nursing staff record observations about older people under their care in free-text nursing notes. These notes contain older people’s care needs, disease symptoms, frequency of symptom occurrence, nursing actions, etc. Therefore, it is vital to develop a technique to uncover important data from these notes. This study developed and evaluated a deep learning and transfer learning-based named entity recognition (NER) model for extracting symptoms of agitation in dementia from the nursing notes. We employed a Clinical BioBERT model for word embedding. Then we applied bidirectional long-short-term memory (BiLSTM) and conditional random field (CRF) models for NER on nursing notes from Australian residential aged care facilities. The proposed NER model achieves satisfactory performance in extracting symptoms of agitation in dementia with a 75% F1 score and 78% accuracy. We will further develop machine learning models to recommend the optimal nursing actions to manage agitation.
7
Zhu, Yunshu, Ting Song, Zhenyu Zhang, Mengyang Yin, and Ping Yu. "A Five-Step Workflow to Manually Annotate Unstructured Data into Training Dataset for Natural Language Processing." In Studies in Health Technology and Informatics. IOS Press, 2024. http://dx.doi.org/10.3233/shti230937.
Повний текст джерелаАнотація:
Natural Language Processing (NLP) is a powerful technique for extracting valuable information from unstructured electronic health records (EHRs). However, a prerequisite for NLP is the availability of high-quality annotated datasets. To date, there is a lack of effective methods to guide the research effort of manually annotating unstructured datasets, which can hinder NLP performance. Therefore, this study develops a five-step workflow for manually annotating unstructured datasets, including (1) annotator training and familiarising with the text corpus, (2) vocabulary identification, (3) annotation schema development, (4) annotation execution, and (5) result validation. This framework was then applied to annotate agitation symptoms from the unstructured EHRs of 40 Australian residential aged care facilities. The annotated corpus achieved an accuracy rate of 96%. This suggests that our proposed annotation workflow can be used in manual data processing to develop annotated training corpus for developing NLP algorithms.
Тези доповідей конференцій з теми "Residential Aged Care Facilities (RACFs)"
1
Paul O’Brien, Anthony, Michelle Giles, Lisa Lisa, Sushilla Wagener, Linda Ross, Kamana Bantawa, Kerry Cooper, et al. "Exploring the Ambulatory transitional care experience from Residential Aged Care Facilities (RACF) to Ambulatory Care Services." In Annual Worldwide Nursing Conference. Global Science & Technology Forum (GSTF), 2015. http://dx.doi.org/10.5176/2315-4330_wnc15.96.
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2
Celler, Branko G., Jim Basilakis, Marc Budge, and Nigel H. Lovell. "A Clinical Monitoring and Management System for Residential Aged Care Facilities." In Conference Proceedings. Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 2006. http://dx.doi.org/10.1109/iembs.2006.259974.
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3
Celler, Branko G., Jim Basilakis, Marc Budge, and Nigel H. Lovell. "A Clinical Monitoring and Management System for Residential Aged Care Facilities." In Conference Proceedings. Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 2006. http://dx.doi.org/10.1109/iembs.2006.4398153.
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4
BOLDY, D., L. GRENADE, and SHU-CHIUNG CHOU. "CONSUMER INPUT RELATED TO MONITORING, EVALUATING AND PLANNING RESIDENTIAL AGED CARE FACILITIES." In Proceedings of the 24th Meeting of the European Working Group on Operational Research Applied to Health Services. WORLD SCIENTIFIC, 1999. http://dx.doi.org/10.1142/9789812817839_0008.
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5
Tariq, Amina, Andrew Georgiou, and Johanna Westbrook. "Complexity of Collaborative Work in Residential Aged Care Facilities: An Analysis of Information Exchange for Medication Management." In 2012 45th Hawaii International Conference on System Sciences (HICSS). IEEE, 2012. http://dx.doi.org/10.1109/hicss.2012.170.
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6
Singh, Saniya, Chris Degeling, Frank Deane, Amy Montgomery, Peta Drury, and Peter Caputi. "8 What influences antibiotic initiation? Developing a scale to measure nursing behaviour in residential aged-care facilities." In Preventing Overdiagnosis meeting Abstracts 2023. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/ebm-2023-pod.106.
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Cho, Gwilae, Sarah Jeong, Margaret McMillan, Jane Conway, Isabel Higgins, and Kyoungja Kwon. "Future Directions for Care of Older People in Residential Aged Care Facilities in South Korea: Nation-wide data:categorization of Long-Term Care Insurance benefits for older people." In 1st Annual Worldwide Nursing Conference (WNC 2013). Global Science and Technology Forum Pte Ltd, 2013. http://dx.doi.org/10.5176/2315-4330_wnc13.49.
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8
Singh, Saniya, Peter Caputi, Chris Degeling, Peta Drury, Amy Montgomery, and Frank Deane. "89 Nurses’ anxiety as a mediator for the relationship between clinical tolerance to uncertainty and antibiotic initiation in residential aged-care facilities." In Preventing Overdiagnosis meeting Abstracts 2023. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/ebm-2023-pod.105.
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9
Penman, Joy, and Kerre A Willsher. "New Horizons for Immigrant Nurses Through a Mental Health Self-Management Program: A Pre- and Post-Test Mixed-Method Approach." In InSITE 2021: Informing Science + IT Education Conferences. Informing Science Institute, 2021. http://dx.doi.org/10.28945/4759.
Повний текст джерелаАнотація:
Aim/Purpose: This research paper reports on the evaluation of a mental health self-management program provided to immigrant nurses working at various rural South Australian aged care services. Background: The residential aged care staffing crisis is severe in rural areas. To improve immigrant nurses’ employment experiences, a mental health self-management program was developed and conducted in rural and regional health care services in South Australia. Methodology: A mixed approach of pre- and post-surveys and post workshop focus groups was utilized with the objectives of exploring the experiences of 25 immigrant nurses and the impact of the mental health program. Feminist standpoint theory was used to interpret the qualitative data. Contribution: A new learning environment was created for immigrant nurses to learn about the theory and practice of maintaining and promoting mental health. Findings: Statistical tests showed a marked difference in responses before and after the intervention, especially regarding knowledge of mental health. The results of this study indicated that a change in thinking was triggered, followed by a change in behaviour enabling participants to undertake self-management strategies. Recommendations for Practitioners: Include expanding the workshops to cover more health care practitioners. Recommendations for Researchers: Feminist researchers must actively listen and examine their own beliefs and those of others to create knowledge. Extending the program to metropolitan areas and examining differences in data. E technology such as zoom, skype or virtual classrooms could be used. Impact on Society: The new awareness and knowledge would be beneficial in the family and community because issues at work can impact on the ability to care for the family, and there are often problems around family separation. Future Research: Extending the research to include men and staff of metropolitan aged care facilities.
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Zegarac Leskovar, Vesna, and Vanja Skalicky Klemenčič. "Inclusive design: comparing models of living environments for older people." In 14th International Conference on Applied Human Factors and Ergonomics (AHFE 2023). AHFE International, 2023. http://dx.doi.org/10.54941/ahfe1003339.
Повний текст джерелаАнотація:
Many older adults who are no longer able to live independently due to a combination of impairments need to live in living environments that are adapted to their health conditions. Generally, these are various types of housing, such as nursing or retirement homes, skilled nursing facilities, assisted living facilities, residential care homes, palliative or rehabilitation centres, etc., which can be referred to as long-term care living environments. Although the recent trend in Europe has been to allow older adults to remain living at home as long as possible, the demand for institutionalised forms of long-term care living environments is quite high, and many older adults spend a significant portion of their lives in these settings. In general, the quality of the living environment has a significant impact on the physical and mental health of residents. Therefore, it is important to explore living environments for older adults that not only allow basic existential needs to be met, but also provide humane living conditions. Concepts of long-term care living environments vary from country to country and depend largely on the characteristics of each social and health care system. Among the various concepts of living environments for older adults, nursing homes house a relatively large proportion of the world's population aged 65 and older. The development of nursing home typologies has evolved from traditional to alternative forms which could be illustrated by five-generations model of nursing homes in Europe, whereby alternative types, fourth- and fifth-generation models provide residents with a higher quality of life due to specific architectural features and functional adaptations. The aim of this paper is to introduce some concepts of long-term care living environments in the U.S. and Europe and to analyse models of third-, fourth- and fifth-generation nursing homes, especially the architectural design features that can strongly influence the quality of life of older adults.
Звіти організацій з теми "Residential Aged Care Facilities (RACFs)"
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Moore, Gabriel, Anton du Toit, Susie Thompson, and Jillian Hutchinson. Effectiveness of secondary triage models for residents of aged care facilities. The Sax Institute, March 2021. http://dx.doi.org/10.57022/uvfy9478.
Повний текст джерелаАнотація:
This Evidence Snapshot provides a rapid review of the evidence around the effectiveness of secondary triage models for residents of aged care facilities. Models analysed included those with or without medical support, those with additional intervention in the residential aged care facilities (RACFs), and those with referral to vs collaboration with alternative services. Outcomes included were ED presentations, hospital admissions and ambulance demand. While the strength of the overall evidence is low, the strongest evidence was found for interventions in RACFs and a community-based early pre-hospital assessment model. The authors also looked at other outcomes of interest including cost-effectiveness; staffing, training and qualifications; and resident and patient participation in decision-making.
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Jauny, Ray, and John Parsons. Delirium Assessment and Management: A qualitative study on aged-care nurses’ experiences. Unitec ePress, November 2017. http://dx.doi.org/10.34074/ocds.72017.
Повний текст джерелаАнотація:
Aged residential care (ARC) residents with morbid health conditions frequently experience delirium. This condition is associated with diminished quality of life, preventable morbidity and untimely death. It is challenging and costly to manage delirium because of the complex interplay of physical and psychiatric symptoms associated with this condition in both primary and secondary services. With awareness of risk factors and knowledge about delirium, ARC nurses can play a vital role in early identification, assessment and treatment, but most importantly in preventing delirium in aged-care residents as well as improving health outcomes. Focus groups were carried out with ARC nurses to ascertain their opinions on how they assess and manage delirium in ARC facilities in South Auckland, New Zealand. Findings identified that there were strengths and weaknesses, as well as gaps in assessment and management of delirium. Nurses would benefit from delirium education, appropriate tools and adequate resources to help them manage delirium. Issues with diagnosing delirium, anxiety about challenging behaviours, family dynamics, lack of training and absence of IV treatment were noticeable features in this study.