Encouraging Best Practice in Residential Aged Care Program: Final Evaluation Report

2.2 - Links with other sources of evidence

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During the course of the EBPRAC program work on developing evidence for residential aged care has taken place in various forums, examples of which are included in the next three sections.

2.2.1 Falls prevention guidelines

The falls prevention project in Round 1 based its work on two main sources of evidence: Minimising the risk of falls and falls injuries: Guidelines for acute, sub-acute and residential care setting, published by the Victorian Quality Council in 2004 and Preventing falls and harm from falls in older people. Best Practice Guidelines for Australian Hospitals and RACFs, published by the Australian Safety and Quality Council in 2005. The latter has recently been updated (by the Australian Commission on Safety and Quality in Health Care in 2009) to produce three separate guidelines for hospitals, residential aged care and community care. The guidelines for residential aged care (Preventing falls and harm from falls in older people: best practice guidelines for Australian residential aged care facilities) are comprehensive, running to a total of 184 pages, supported by a guidebook, an implementation guide and separate fact sheets for support workers, nurses, doctors, health managers, allied health professionals and residents.

One of the outcomes of the falls prevention project was a web-based resource which provides a guide to implementing falls prevention interventions - Working together to prevent falls in residential aged care: resource package. The two publications have appeared in the same year, providing guidance on how to implement evidence-based falls prevention in residential aged care. The web-based resource is much simpler than the guidelines produced by the Australian Commission on Safety and Quality in Health Care and focuses on the methodology used by the EBPRAC project e.g. use of action research. In some ways the two resources are complementary (one a simple starting point, one a more comprehensive set of guidelines for those who need more detailed information). On the key issue of how best to conduct falls risk assessments the two resources are not consistent. The Australian Commission on Safety and Quality in Health Care guidelines note that there is no consensus on which factors to include in a tool for assessing the risk of falls but does include details of one particular tool. The resource developed by the EBPRAC project includes the tool developed as part of the project, labelled a draft tool. The two tools have some similarities but quite different systems for rating the risk of falls.

2.2.2 JBI COnNECT

Since 2008 various evidence summaries have been published on the JBI COnNECT (Clinical Online Network of Evidence for Care and Therapeutics) Aged Care website for the areas of clinical practice included in the EBPRAC program e.g. dementia, falls, wound management, medication management and mouth care. Not all of these evidence summaries are specifically targeted at residential aged care but all have some relevance to the care of older residents. JBI COnNECT Aged Care represents a system for generating, on a regular basis, evidence about best practice in aged care. Although the evidence summaries are quite cryptic and their use within residential aged care is not known there may be opportunities to link with this existing system for the further development, not only of evidence, but the evidence about how to implement the evidence.

2.2.3 How to translate knowledge into practice

The Australian Health Ministers’ Advisory Council Health Care of Older Australians Standing Committee commissioned the development of the publication in 2008 of The ‘how to’ guide: turning knowledge into practice in the care of older people which is targeted at project officers and project managers involved in quality improvement and implementation initiatives to improve the care of older people. Although the audience for the guide is wider than just residential aged care it includes very useful information about change management principles; matching implementation strategies to identified barriers to change; Plan-Do-Study-Act cycles; monitoring and evaluation. It includes a good summary of the relevant literature. The guide has the potential to augment the lessons learnt from the EBPRAC program and assist ongoing implementation of evidence-based practice. It is published by the Department of Health in Victoria and is available on its website.
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