Vitamin D response of older people in residential aged care to sunlight-derived ultraviolet radiation

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Seeta Durvasula ◽  
Peter Gies ◽  
Rebecca S. Mason ◽  
Jian Sheng Chen ◽  
Stuart Henderson ◽  
...  
Keyword(s):  
Vitamin D ◽  
Ultraviolet Radiation ◽  
Older People ◽  
Aged Care ◽  
Residential Aged Care

scholarly journals Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit

2017 ◽  
Vol 41 (1) ◽  
pp. 13 ◽  
Author(s):  
Jacqueline Francis-Coad ◽  
Christopher Etherton-Beer ◽  
Caroline Bulsara ◽  
Debbie Nobre ◽  
Anne-Marie Hill
Keyword(s):  
Vitamin D ◽  
Community Of Practice ◽  
Clinical Audit ◽  
Aged Care ◽  
Falls Prevention ◽  
Residential Aged Care ◽  
Prevention Policy ◽  
Shared Interest ◽  
Prevention Activity ◽  
Clinical Audits

Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action. Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention. Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy. Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice. What is known about the topic? Audit and feedback is an effective way of measuring clinical quality and safety. CoPs have been established in healthcare using workplace staff to address clinical problems but little is known about their ability to audit and influence practice change. What does this paper add? This study contributes to the body of knowledge on CoPs in healthcare by evaluating the performance of one in the domain of falls prevention audit action. What are the implications for practitioners? A CoP is an effective model to engage staff in the clinical audit process. Clinical audits can raise staff awareness of gaps in practice and motivate staff to plan and action change as recommended in best practice guidelines.

scholarly journals Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pippy Walker ◽  
Annette Kifley ◽  
Susan Kurrle ◽  
Ian D. Cameron
Keyword(s):  
Vitamin D ◽  
Best Practice ◽  
Aged Care ◽  
Residential Aged Care ◽  
Supplement Use ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Facility Level ◽  
Vitamin D Supplement

Abstract Background Adequate (≥800 IU/day) vitamin D supplement use in Australian residential aged care facilities (RACFs) is variable and non-optimal. The vitamin D implementation (ViDAus) study aimed to employ a range of strategies to support the uptake of this best practice in participating facilities. The aim of this paper is to report on facility level prevalence outcomes and factors associated with vitamin D supplement use. Methods This trial followed a stepped wedge cluster, non-randomised design with 41 individual facilities serving as clusters pragmatically allocated into two wedges that commenced the intervention six months apart. This multifaceted, interdisciplinary knowledge translation intervention was led by a project officer, who worked with nominated champions at participating facilities to provide education and undertake quality improvement (QI) planning. Local barriers and responsive strategies were identified to engage stakeholders and promote widespread uptake of vitamin D supplement use. Results This study found no significant difference in the change of vitamin D supplement use between the intervention (17 facilities with approx. 1500 residents) and control group (24 facilities with approx. 1900 residents) at six months (difference in prevalence change between groups was 1.10, 95% CI − 3.8 to 6.0, p = 0.6). The average overall facility change in adequate (≥800 IU/day) vitamin D supplement use over 12 months was 3.86% (95% CI 0.6 to 7.2, p = 0.02), which achieved a facility level average prevalence of 59.6%. The variation in uptake at 12 months ranged from 25 to 88% of residents at each facility. In terms of the types of strategies employed for implementation, there were no statistical differences between facilities that achieved a clinically meaningful improvement (≥10%) or a desired prevalence of vitamin D supplement use (80% of residents) compared to those that did not. Conclusions This work confirms the complex nature of implementation of best practice in the RACF setting and indicates that more needs to be done to ensure best practice is translated into action. Whilst some strategies appeared to be associated with better outcomes, the statistical insignificance of these findings and the overall limited impact of the intervention suggests that the role of broader organisational and governmental support for implementation should be investigated further. Trial registration Retrospectively registered (ANZCTR ID: ACTRN12616000782437).

scholarly journals Poor oral hygiene, oral microorganisms and aspiration pneumonia risk in older people in residential aged care: a systematic review

2020 ◽  
Author(s):  
Sangeeta Khadka ◽  
Shahrukh Khan ◽  
Anna King ◽  
Lynette R Goldberg ◽  
Leonard Crocombe ◽  
...  
Keyword(s):  
Oral Health ◽  
Older People ◽  
Aspiration Pneumonia ◽  
Oral Hygiene ◽  
Oral Care ◽  
Aged Care ◽  
Oral Microbiome ◽  
Residential Aged Care ◽  
Pathogenic Microorganisms ◽  
Oral Microorganisms

Abstract Background aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. Objectives determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. Data Sources PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. Study Eligibility Criteria published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. Participants people 60 years and older in residential aged care. Study Appraisal and Synthesis Methods the Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. Results twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. Limitations more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included sampling size, no power and effect size calculations; different oral health assessments; how oral specimens were analysed and how aspiration pneumonia was diagnosed. Conclusions and Implications of Key Findings pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care; professional oral hygiene care is useful in reducing aspiration pneumonia risk.

scholarly journals Australian social work research on ageing and aged care: A scoping review

2016 ◽  
Vol 18 (4) ◽  
pp. 431-450 ◽  
Author(s):  
Mark Hughes ◽  
Christine Bigby ◽  
Clare Tilbury
Keyword(s):  
Social Work ◽  
Older People ◽  
Scoping Review ◽  
Asset Management ◽  
Social Work Practice ◽  
Aged Care ◽  
Community Services ◽  
Residential Aged Care ◽  
Bibliographic Databases ◽  
Social Work Research

Summary Little is known about the quantity, nature and range of Australian social work research on ageing and aged care. This scoping review involved a comprehensive search of seven online bibliographic databases. The review identified 108 peer-reviewed journal articles, published between January 2007 and June 2014, that reported Australian social work research on ageing and aged care. Findings The average number of authors per paper was 2.10 with most social work researchers co-authoring papers with non-social workers. The main topics of research focus were health and rehabilitation, elder abuse, asset management, community services and caregiving, housing and residential aged care, and ageing with an intellectual disability. The findings highlight the contribution social work researchers make to multidisciplinary gerontological research, and to understanding the lived experiences of older people and the provision of services. However, they also point to the relative paucity of research focusing on direct social work practice with older people, and the little evidence of the participation of older people and carers in the design and delivery of research. Applications The findings indicate the need for capacity-building strategies, such as developing networks of Australian social work researchers on ageing and aged care, to improve research outputs in this area.

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