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 Evaluating the impact of a falls prevention community of practice in a residential aged care setting: a realist approach

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jacqueline Francis-Coad ◽  
Christopher Etherton-Beer ◽  
Caroline Bulsara ◽  
Nicole Blackburn ◽  
Paola Chivers ◽  
...  
Keyword(s):  
Community Of Practice ◽  
Care Setting ◽  
Aged Care ◽  
Falls Prevention ◽  
Residential Aged Care ◽  
Realist Approach ◽  
The Impact

scholarly journals Vitamin D status and its predictors in New Zealand aged-care residents eligible for a government-funded universal vitamin D supplementation programme

2016 ◽  
Vol 19 (18) ◽  
pp. 3349-3360 ◽  
Author(s):  
Sue O MacDonell ◽  
Jody C Miller ◽  
Michelle J Harper ◽  
Debra L Waters ◽  
Lisa A Houghton
Keyword(s):  
Vitamin D ◽  
New Zealand ◽  
Aged Care ◽  
Falls Prevention ◽  
Lower Latitude ◽  
Residential Aged Care ◽  
Vitamin D Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Supplemental Vitamin

AbstractObjectiveThe provision of prescribed vitamin D to all aged-care residents has been implemented in New Zealand as part of a government-led falls prevention programme. To our knowledge, there has been no evaluation of this universal programme on vitamin D status and functional and health outcomes. Thus, we aimed to determine 25-hydroxyvitamin D (25(OH)D) concentrations and their predictors in aged-care residents across the country and to investigate whether the government-funded programme was associated with adequate vitamin D status.DesignCross-sectional survey of sociodemographic, biochemical, anthropometric, dietary and health characteristics. Blood samples were analysed for serum 25(OH)D and other biochemical measures. Multiple regression was used to examine predictors of vitamin D status.SettingSixteen residential aged-care facilities throughout New Zealand.SubjectsResidents aged ≥60 years with residency duration >12 weeks (n309).ResultsMean serum 25(OH)D was 89·9 (95 % CI 85·2, 94·5) nmol/l and monthly supplements (1250 µg (50 000 IU)) were taken by 75 % of all residents. Of those not taking a funded supplement, 65·3 % had serum 25(OH)D <50 nmol/l compared with only 1·5 % of supplement users. Being female, residing at lower latitude, increasing duration of aged-care residency and raised serum α1-acid glycoprotein were positively associated with higher 25(OH)D concentrations. Supplemental vitamin D from all sources was the strongest predictor, increasing serum 25(OH)D levels by more than 70 nmol/l. Furthermore, 25 % of participants had serum 25(OH)D levels >125 nmol/l.ConclusionsResidents taking supplemental vitamin D had adequate vitamin D status; however monitoring of long-term supplementation should be considered, due to the high proportion of participants with high serum 25(OH)D levels.

Investigating the impact of a falls prevention community of practice in a residential aged-care setting: a mixed methods study protocol

2015 ◽  
Vol 71 (12) ◽  
pp. 2977-2986 ◽  
Author(s):  
Jacqueline Francis-Coad ◽  
Christopher Etherton-Beer ◽  
Caroline Bulsara ◽  
Debbie Nobre ◽  
Anne-Marie Hill
Keyword(s):  
Mixed Methods ◽  
Community Of Practice ◽  
Study Protocol ◽  
Care Setting ◽  
Aged Care ◽  
Mixed Methods Study ◽  
Falls Prevention ◽  
Residential Aged Care ◽  
The Impact

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).

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

Outdoor areas of Australian residential aged care facilities do not facilitate appropriate sun exposure

2015 ◽  
Vol 39 (4) ◽  
pp. 406 ◽  
Author(s):  
Seeta Durvasula ◽  
Rebecca S. Mason ◽  
Cindy Kok ◽  
Monique Macara ◽  
Trevor R. Parmenter ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sun Exposure ◽  
Aged Care ◽  
Residential Aged Care ◽  
Attendance Rates ◽  
Design Features ◽  
Outdoor Spaces ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Objective The aim of the present study was to assess whether the outdoor areas of residential aged care facilities used for a sunlight intervention trial had the design features that encouraged participants’ use of these spaces. Methods The design principles recommended in the ‘Vitamin D and the Built Environment in Victoria’ guidelines were used to assess the outdoor spaces of residential aged care facilities that were used in a randomised controlled trial (RCT) of sunlight exposure. Attendance rates in the sunlight RCT were analysed in relation to global impression scores of the facilities using one-way analysis of variance. Results Thirty-six outdoor areas of 31 facilities were assessed. The facilities met the guidelines for sun exposure, and were generally safe and accessible. However, many lacked privacy, security and aesthetic appeal. Most of the outdoor spaces were not used for regularly scheduled activities. Attendance rates were higher in those facilities with the highest global impression scores compared with those with the lowest scores (F(2,367) = 3.262, P = 0.039). Conclusions The physical environment of the outdoor areas of residential aged care facilities was associated with their use for sunlight exposure. Suitably designed or modified spaces have the potential to encourage their greater use, and residential aged care facilities should also plan regular activities in those areas. These measures can facilitate safe sun exposure, as well as physical activity and social interaction in older people. What is known about the topic? Older people living in aged care facilities have inadequate outdoor sun exposure and vitamin D deficiency. The outdoor spaces of aged care facilities are not well used by residents. Design features that encourage greater use of outdoor spaces have been identified. What does this paper add? Participation rates in a trial of outdoor sun exposure in residents of aged care facilities were found to be higher in those facilities with better design features in their outdoor spaces. Most facilities do not schedule their regular activities outdoors. What are the implications for practitioners? Suitable design or modification of outdoor spaces of residential aged care facilities can encourage their greater use. Regular scheduling of leisure and social activities can further promote their utilisation.

Supporting residential aged care through a Community of Practice

2021 ◽  
Author(s):  
Carolyn Hullick ◽  
Jane Conway ◽  
Roslyn Barker ◽  
Jacqueline Hewitt ◽  
Leigh Darcy ◽  
...  
Keyword(s):  
Community Of Practice ◽  
Aged Care ◽  
Residential Aged Care
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