Pervasive Networks and Ubiquitous Monitoring for Wellness Monitoring in Residential Aged Care

Author(s):  
Leroy Lai Yu Chan ◽  
Branko George Celler ◽  
James Zhaonan Zhang ◽  
Nigel Hamilton Lovell

It is becoming more critical for developed countries to deliver long-term and financially sustainable healthcare services to an expanding ageing population, especially in the area of residential aged care. There is a general consensus that innovations in the area of Wireless Sensor Networks (WSNs) are key enabling technologies for reaching this goal. The major focus of this chapter is on WSN design considerations for ubiquitous wellness monitoring systems in residential aged care facilities. The major enabling technologies for building a pervasive WSN will be explored, including details on sensor design, wireless communication protocols and network topologies. Also examined are various data processing methods and knowledge management tools to support the collection of sensor data and their subsequent analysis for health assessment. Future systems that incorporate the two aspects of wellness monitoring, vital signs and activities of daily living (ADL) monitoring, will also be introduced.

Author(s):  
Leroy Lai Yu Chan ◽  
Branko George Celler ◽  
James Zhaonan Zhang ◽  
Nigel Hamilton Lovell

With the increasing shift in the population profile to the older demographic and rising healthcare costs, it is more critical for developed countries to deliver long-term and financially sustainable healthcare services, especially in the area of residential aged care. A consensus exists that innovations in the area of Wireless Sensor Networks (WSNs) are key enabling technologies for reaching this goal. The major focus of this article is WSN design considerations for ubiquitous wellness monitoring systems in residential aged care facilities. Major enabling technologies for building a pervasive WSN will be detailed, including descriptions on sensor design, wireless communication protocols and network topologies. Also examined are data processing methods and knowledge management tools to support the collection of sensor data and their subsequent analysis for health assessment. To introduce future healthcare reform in residential aged care, two aspects of wellness monitoring, vital signs and activities of daily living (ADL) monitoring, will be discussed.


Author(s):  
Leroy Lai Yu Chan ◽  
Branko George Celler ◽  
James Zhaonan Zhang ◽  
Nigel Hamilton Lovell

With the increasing shift in the population profile to the older demographic and rising healthcare costs, it is more critical for developed countries to deliver long-term and financially sustainable healthcare services, especially in the area of residential aged care. A consensus exists that innovations in the area of Wireless Sensor Networks (WSNs) are key enabling technologies for reaching this goal. The major focus of this article is WSN design considerations for ubiquitous wellness monitoring systems in residential aged care facilities. Major enabling technologies for building a pervasive WSN will be detailed, including descriptions on sensor design, wireless communication protocols and network topologies. Also examined are data processing methods and knowledge management tools to support the collection of sensor data and their subsequent analysis for health assessment. To introduce future healthcare reform in residential aged care, two aspects of wellness monitoring, vital signs and activities of daily living (ADL) monitoring, will be discussed.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046142
Author(s):  
Natali Jokanovic ◽  
Terry Haines ◽  
Allen C Cheng ◽  
Kathryn E Holt ◽  
Sarah N Hilmer ◽  
...  

IntroductionAntimicrobial resistance is a growing global health threat, driven by increasing inappropriate use of antimicrobials. High prevalence of unnecessary use of antimicrobials in residential aged care facilities (RACFs) has driven demand for the development and implementation of antimicrobial stewardship (AMS) programmes. The Stepped-wedge Trial to increase antibiotic Appropriateness in Residential aged care facilities and model Transmission of antimicrobial resistance (START) will implement and evaluate the impact of a nurse-led AMS programme on antimicrobial use in 12 RACFs.Methods and analysisThe START trial will implement and evaluate a nurse-led AMS programme via a stepped-wedge cluster randomised controlled trial design in 12 RACFs over 16 months. The AMS programme will incorporate education, aged care-specific treatment guidelines, documentation forms, and audit and feedback strategies that will target aged care staff, general practitioners, pharmacists, and residents and their families. The intervention will primarily focus on urinary tract infections, lower respiratory tract infections, and skin and soft tissue infections. RACFs will transition from control to intervention phases in random order, two at a time, every 2 months, with a 2-month transition, wash-in period. The primary outcome is the cumulative proportion of residents within each facility prescribed an antibiotic during each month and total days of antibiotic use per 1000 occupied bed days. Secondary outcomes include the number of courses of systemic antimicrobial therapy, antimicrobial appropriateness, antimicrobial resistant organisms, Clostridioides difficile infection, change in antimicrobial susceptibility profiles, hospitalisations and all-cause mortality. Analyses will be conducted according to the intention-to-treat principle.Ethics and disseminationEthics approval has been granted by the Alfred Hospital Human Research Ethics Committee (HREC/18/Alfred/591). Research findings will be disseminated through peer-reviewed publications, conferences and summarised reports provided to participating RACFs.Trial registration numberNCT03941509.


2019 ◽  
Vol 20 (2) ◽  
pp. 171-179
Author(s):  
Bruce Hocking ◽  
Michael Lowe ◽  
Tricia Nagel ◽  
Caroline Phillips ◽  
Melissa Lindeman ◽  
...  

AbstractBackground:A high prevalence of dementia among Aboriginal and Torres Strait Islanders has been reported but knowledge of underlying causes and associations remains limited.Objective:To identify the prevalence of factors that may be associated with the categories of Major neurocognitive disorders (Major NCDs) in Aboriginal people living in residential aged care facilities in Alice Springs in the Northern Territory (NT).Design and Setting:This descriptive cross-sectional study analysed clinical file and cognitive assessment data of participants who were identified as having cognitive impairment between January and June 2016.Method:Screening for the presence of cognitive impairment using the Kimberley Indigenous Cognitive Assessment (KICA) was undertaken and 58 of 84 Aboriginal people were admitted to the study. Using a clinical file audit, diagnoses of Major NCDs consistent with the DSM-5 classification were made and the prevalence of factors possibly associated with these diagnoses described.Results:Fifty of the 58 participants were diagnosed with a Major NCD. The most frequent diagnoses were Major NCD due to vascular disease (30%), Major NCD due to Alzheimer’s Disease (26%) and Major NCD due to brain injury (20%). Hypertension, Type 2 Diabetes Mellitus and alcohol misuse were commonly reported together with hypothyroidism, hypoglycaemia and vitamin D deficiency.Conclusion(s):This study identified possible associations with Major NCDs in this population as well as a different spread of Major NCD diagnoses to previous studies in Aboriginal populations. There is a need for further research to understand the causes of dementia in Australian Aboriginal people and to use this information to appropriately tailor treatment and prevention programmes.


2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti

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.


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