First Round Projects

Information about the first round projects for EBPRAC.

In this section:

Five projects have each established a consortium which comprises a number of residential aged care homes, researchers and educators. Around 40 aged care homes across all states are involved.

Clinical Area - Oral Health

Lead Organisation - Central Northern Adelaide Health Service, South Australian Dental Service

Aged care homes involved in the project are located in South Australia, Victoria and New South Wales.

The project – Better Oral Health in Residential Care – will identify better practice to enable residents of aged care homes to have oral health assessments on a regular basis and an implemented health care plan which identifies if there is a need for dental treatment.

This project is developing an evidence based oral health model that utilises a portfolio of resources, including educational resources being developed as part of the project as well as the existing Oral Health Assessment Toolkit for GPs.

The project will look at a sustainable framework and pathway for referral for dental care when necessary and raise the profile of oral health and its interaction with general health within the residential aged care sector.

The project will include:

oral health assessments to be undertaken by GPs and RNs;
the evaluation of oral health care planning activities;
the development of an oral health educational program to be delivered by non-dental professionals;
expert dental consultants' assistance with developing a resource portfolio; and
consenting residents receiving dental care provided by the dental providers in each of the three states where the participating homes are located.

Capacity building is being achieved through a number of mechanisms including: team building with the assistance of an organisational psychologist; oral health education and skills training, using a train the trainer approach; and involvement of aged care nurse educators.

Clinical Area - Medication Management

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Lead Organisation - Repatriation General Hospital Drugs and Therapeutics Information Service (DATIS)

Aged care homes involved in the project are located in South Australia and Victoria.

The project addresses holistic management of medication administration through the implementation of best practice in medication management guidelines in aged care facilities with a focus on 'as required' (PRN) medicines. The project is called Time for evidenced based Action around PRN Medicines in Aged Care (TEAM Aged Care).

The project focuses on medication management of PRN medicines in the management of pain, constipation, behaviours of concern and sleep. Information and guidelines about appropriate medication use relating to analgesics, laxatives, antipsychotics and benzodiazepines from the medical literature have been reviewed by the project.

A range of existing evidenced-based resources have been identified for use. In addition, some resources have been developed by the project.

The implementation approach recognises multidisciplinary care and involves education to a range of aged care staff using an academic detailing approach (also known as educational visiting or outreach visits). The project staff and aged care home consortium members are working closely to identify opportunities to build capacity, acknowledging the differing roles and responsibilities of individual staff within the aged care setting.

Clinical Area - Falls Management

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Lead Organisation - National Ageing Research Institute (NARI)

Aged care homes involved in the project are located in Victoria, Queensland and Tasmania.

The STAR project aims to optimise the minimisation of falls and fall-related injuries in residential aged care homes, through an individualised, facilitated and sustainable approach, by implementing best practice guidelines in falls prevention in residential aged care facilities.

Falls prevention evidence, based particularly on the Victorian Quality Council guidelines (for hospitals and residential care settings) and the Australian Quality and Safety Council Guidelines (for hospitals and residential care settings) are being used as the basis for implementation. Action learning is being used as an approach to facilitate staff engagement and sustainability of the project within participating facilities.

The Project aims to:

scope current falls prevention activities within participating facilities;
implement evidence based falls prevention activities within participating facilities;
utilise an action research approach to tailor interventions and methods of implementation within each facility;
achieve improved falls prevention practices within participating facilities;
reduce falls rates within participating facilities; and
develop a framework and resources to support broader dissemination and uptake of the project approach.

The action research approach is a key element of building capacity in falls prevention. Other project components that will support this include training of falls resource nurses and general staff, and staff involvement in project activities such as audits.

Clinical Area - Nutrition Management

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Lead Organisation - University of Newcastle

Aged care homes involved in the project are located in New South Wales.

The project aims to improve nutrition and hydration practices in residential aged care facilities, to improve the health outcomes and quality of life for residents. The project will reference the Best Practice Food and Nutrition Manual for Aged Care Facilities. A manual and training package will be developed that can be distributed for implementation by other facilities across Australia.

Participating facilities are identifying nutrition / hydration problems they wish to focus on. These include:

improving the quality and appeal of pureed foods;
introducing access to cooking facilities for snack preparation, bread baking, soup making, compiling favourite recipes, taste testing sessions with food suppliers;
improving the process of cook-chill services for residents; and
systematic screening to identify at risk residents, and develop individual preventive action plans.

Clinical Area - Pain Management

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Lead Organisation - National Ageing Research Institute (NARI)

Aged care homes involved in the project are located in Victoria, Queensland and Western Australia.

This project is implementing sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities. Recent evidence based guidelines issued by the Australian Pain Society titled Pain in residential aged care facilities: management strategies (2005) are being implemented into the participating residential aged care facilities. The companion toolkit, The PMG kit for aged care (provided to all aged care homes), is also being used by the project.

This project will undertake a comprehensive education and training program aimed at embedding evidence-based practice in pain management into the routine clinical care practices of residential aged care facilities.

Other expected outcomes include:

improving the quality of pain management practice for residents with bothersome pain;
the education and training of aged care staff;
better integration of external pain management resources into residential aged care facilities; and
raised awareness about the importance of pain management in the residential aged care sector.

A one-week training course for the project clinical nurse educators has been held at the participating aged care homes in each state.
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