scholarly journals An Evaluation of Texture Modified Diets Compliant with the International Dysphagia Diet Standardisation Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

2021 ◽  
Author(s):  
Xiaojing Sharon Wu ◽  
Anna Miles ◽  
Andrea Braakhuis
Keyword(s):  
Quality Of Care ◽  
Implementation Research ◽  
Aged Care ◽  
Successful Implementation ◽  
Site Specific ◽  
Barriers And Enablers ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Specific Implementation

Abstract Background: Texture modified diets (TMDs) are commonly prescribed for older adults with swallowing difficulties to improve swallowing safety. The International Dysphagia Diet Standardization Initiative (IDDSI) provides a framework for terminology, definitions and testing of TMDs. This observational mixed-method study used the Consolidated Framework for Implementation Research (CFIR) to establish the barriers and enablers to IDDSI adoption in aged-care facilities (ACFs).Methods: Five New Zealand ACFs who had adopted IDDSI >12 months previously were recruited. Evaluation tools were developed based on CFIR constructs, integrating data from i) mealtime observations; ii) manager interviews and iii) staff (nursing, carers and kitchen) self-administrated surveys. Results: All facility and kitchen managers were IDDSI-aware and had access to online resources. Three sites had changed to commercially compliant products post-IDDSI adoption, which had cost implications. Awareness of IDDSI amongst staff ranged from 5-79% and <50% of staff surveyed felt sufficiently trained. Awareness was greater in large sites and where IDDSI was mandated by head office. Managers had not mandated auditing and they felt this had led to reduced perceived importance. Managers felt staff required more training and staff wanted more training, believing it would improve food safety and quality of care. Lack of a dedicated project leader and no speech pathologist onsite were perceived barriers. Collaboration between healthcare assistants, kitchen staff and allied health assisted implementation. Conclusion: ACF staff were aware of IDDSI but staff awareness was low. Using the CFIR, site-specific and generic barriers and enablers were identified to improve future implementation effectiveness. Managers and staff want access to regular training. Multidisciplinary collaboration and improving communication are essential. ACFs should consider TMD auditing regularly. Successful implementation of IDDSI allows improvement of quality of care and patient safety but requires a systematic, site-specific implementation plan.

scholarly journals Using the Consolidated Framework for Implementation Research (CFIR) to Evaluate the Implementation of the International Dysphagia Diet Standardisation Initiative (IDDSI) and Provision of Texture Modified Diets (TMDs) in age-care Facilities: Barriers and Enablers to Implementation

2021 ◽  
Author(s):  
Xiaojing Sharon Wu ◽  
Anna Miles ◽  
Andrea Braakhuis
Keyword(s):  
Quality Of Care ◽  
Implementation Research ◽  
Aged Care ◽  
Successful Implementation ◽  
Site Specific ◽  
Barriers And Enablers ◽  
Care Facilities ◽  
Swallowing Difficulties ◽  
Specific Implementation

Abstract BackgroundTexture modified diets (TMDs) are a common intervention for older adults with swallowing difficulties as they improve swallowing safety. The International Dysphagia Diet Standardization Initiative (IDDSI) provides a framework for terminology, definitions and testing of TMDs. This observational mixed methods study used the Consolidated Framework for Implementation Research (CFIR) to evaluate the effectiveness of IDDSI adoption in aged-care facilities (ACFs) and identify barriers and enablers to facilitate future implementation.MethodsFive New Zealand ACFs who had adopted IDDSI >12 months previously were recruited. Evaluation tools were developed based on CFIR constructs, integrating data from i) mealtime observations; ii) manager interviews and iii) staff (nursing, carers and kitchen) self-administrated surveys. ResultsAll facility and kitchen managers were IDDSI-aware and had access to online resources. Three sites had changed to commercially compliant products post-IDDSI adoption, which had cost implications. Awareness of IDDSI amongst staff ranged from 5-79% and <50% of staff surveyed felt sufficiently trained. Awareness was greater in large sites and where IDDSI was mandated by head office. Managers had not mandated auditing and they felt this had led to reduced perceived importance. Managers felt staff required more training and staff wanted more training, believing it would improve food safety and quality of care. Lack of a dedicated project lead and no speech pathologist onsite were perceived barriers. Collaboration between healthcare assistants, kitchen staff and allied health assisted implementation. ConclusionACF staff were aware of IDDSI but staff knowledge was low. Using the CFIR, site-specific and generic barriers and enablers were identified to improve future implementation effectiveness. Managers and staff want access to regular training. Multidisciplinary collaboration and improving communication are essential. ACFs should consider TMD auditing regularly. Successful implementation of IDDSI allows improvement of quality of care and patient safety but requires a systematic, site-specific implementation plan.

scholarly journals The Australian Royal Commission into the Aged Care Industry 2019

2019 ◽  
Vol 2 (4) ◽  
pp. 1-6
Author(s):  
Peter W. Harvey
Keyword(s):  
Quality Of Care ◽  
Older People ◽  
Living Arrangements ◽  
South Australia ◽  
Aged Care ◽  
Royal Commission ◽  
Healthcare Needs ◽  
Care Facilities ◽  
Aged Care Facilities

In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.

Enhancing palliative care in rural Australia: the residential aged care setting

2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Advance Care

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

Elder Sexual Abuse and Sexual Freedom in Faith-based Residential Care Facilities: Ethical Dilemmas, and Institutional Integrity

2021 ◽  
Vol 15 (2) ◽  
pp. 253-273
Author(s):  
Virginia Miller ◽  
Seumas Miller ◽  
Bruce Stevens
Keyword(s):  
Sexual Abuse ◽  
Residential Care ◽  
Aged Care ◽  
Sexual Freedom ◽  
Residential Care Facilities ◽  
Faith Based ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Marital Sex

Abstract The issues of elder sexual abuse and sexual freedom in residential care facilities are complicated by the existence of many residents with cognitive impairments of a kind that compromise their ability to make decisions based on informed consent. The issues of elder sexual abuse and sexual freedom in faith-based residential care facilities, in particular, are further complicated by restrictive, theologically based, ethical principles pertaining to sexual activity – for instance, prohibitions on extra-marital sex and the use of prostitutes by residents. The tension that arises must necessarily deal with the integrity of faith-based aged-care facilities and current legislation that promotes the rights of age-care residents to sexual freedoms. In the midst of much public concern about the level and quality of institutional age care this particular aspect seldom attracts notice. It nevertheless exposes a quandary to do with how ought public theology and ethics respond.

Views of Greenery and Psychological Well-Being in Residential Aged Care Facilities: Longitudinal Associations

2021 ◽  
pp. 193758672110597
Author(s):  
Takemi Sugiyama ◽  
Alison Carver ◽  
Masaaki Sugiyama ◽  
Alanna Lorenzon ◽  
Tanya E. Davison
Keyword(s):  
Well Being ◽  
Aged Care ◽  
Residential Aged Care ◽  
Psychological Well Being ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Objectively Measured

Objectives: This study examined associations of objectively measured views of greenery in residential aged care facilities (RACFs) with changes in multiple psychological well-being measures among residents who were newly admitted to RACFs. Methods: Data were collected from 52 residents (mean age: 84, 73% women) of 13 RACFs, located in Melbourne, Australia. The outcomes were changes in depression, stress, anxiety, and quality of life (QoL) between baseline and 8-week follow-up. The exposure measures were the amount and presence of greenery visible from participant’s bedroom and common areas (lounge, dining). Greenery was categorized as being either within or beyond the RACF perimeter. Results: Regression analyses found that greenery visible from participant’s bedroom was not associated with any outcomes. The amount of greenery visible from common areas within the RACF perimeter was adversely related to stress, unexpectedly: Each additional 1 m2 of greenery was associated with a greater increase in stress ( b = 0.05; 95% CI [0.07, 0.94]). However, greenery visible from common areas beyond the perimeter contributed favorably to stress and QoL. The presence of such greenery was associated with a lower increase in stress ( b = −3.99; 95% CI [−7.75, −0.23]; reference: no greenery), and a 1 m2 increment was associated with a greater increase in QoL ( b = 0.07; 95% CI [0.02, 0.11]). Conclusion: Views of greenery outside of the RACF from lounge and dining areas may be protective against residents’ stress increase and improve their QoL. Locating residents in areas with such outdoor views may prevent their psychological condition from worsening.

How does accreditation influence staff perceptions of quality in residential aged care?

2017 ◽  
Vol 18 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Anne Hogden ◽  
David Greenfield ◽  
Mark Brandon ◽  
Deborah Debono ◽  
Virginia Mumford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Service Quality ◽  
Aged Care ◽  
Residential Aged Care ◽  
Content Type ◽  
Consumer Expectations ◽  
Care Facilities ◽  
Accreditation Programme ◽  
Aged Care Facilities

Purpose Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme. Design/methodology/approach Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views. Findings Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life. Research limitations/implications For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question. Originality/value This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.

Sign in / Sign up

Export Citation Format

Share Document