ORCID Profile
0000-0002-9892-103X
Current Organisation
University of Western Australia
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Analysis of Algorithms and Complexity | Information Systems | Applied Discrete Mathematics | Database Management |
Expanding Knowledge in the Information and Computing Sciences | Information Processing Services (incl. Data Entry and Capture) | Electronic Information Storage and Retrieval Services
Publisher: Hindawi Limited
Date: 26-04-2020
DOI: 10.1111/HSC.12996
Publisher: Frontiers Media SA
Date: 03-08-2021
DOI: 10.3389/FPUBH.2021.683723
Abstract: Recently hospitalized older people are at risk of falls and face barriers to undertaking fall prevention strategies after they return home from hospital. The authors examined the effects of tailored education delivered by physiotherapists on the knowledge (capability) and the motivation of older people to engage in fall prevention after hospital discharge. Utilizing data gathered from a recent trial, data was analyzed from 390 people who were 60 years and over without impaired cognition (& /10 abbreviated mental test score) and discharged from three Australian hospitals. Motivation and capability were measured at baseline in the hospital and at 6-months after hospital discharge by blinded assistants using structured surveys. Bivariate analysis using generalized linear modeling explored the impact of education on the capability and motivation. Engagement in fall prevention strategies was entered as an independent variable during analysis to determine associations with capability and motivation. The education significantly improved capability [−0.4, 95% CI (−0.7, −0.2), p & 0.01] and motivation [−0.8, 95% CI (−1.1, −0.5), p & 0.01] compared with social-control at the time of hospital discharge. In contrast, social-control participants gained capability and motivation over the 6-months, and no significant differences were found between groups in capability [0.001, 95% CI (−0.2, 0.2), p = 0.9] and motivation [−0.01, 95% CI (−0.3, 0.3), p = 0.9] at follow-up. Tailored fall prevention education is recommended around hospital discharge. Participants still needed to overcome barriers to falls prevention engagement post hospitalization. Thus, tailored education along with direct clinical services such as physiotherapy and social supports is warranted for older people to avoid falls and regain function following hospitalization.
Publisher: Wiley
Date: 28-07-2021
DOI: 10.1111/OPN.12408
Abstract: Although Transition Care Programmes (TCP) are designed to assist older adults to regain functional ability after hospitalisation, it is unclear whether TCP improve older adults’ health‐related outcomes. The objective of the review was to synthesise the best available evidence for the effectiveness of TCP on health‐related outcomes for older adults admitted to a transition care facility after hospitalisation. Searches were conducted using the databases PubMed, AMED (Ovid), Embase (Ovid), PscyINFO (Ovid) and CINAHL (Full text) and grey literature from January 2000 to May 2020 in English only. Studies that reported health‐related outcomes of older adults (aged 65 and above) who received TCP in a facility setting were deemed eligible for inclusion following critical appraisal by two reviewers. Data were pooled in meta‐analysis where possible, or reported narratively. A total of 21 studies from seven countries [( n = 5 RCT, n = 16 observational cohort studies) participants’ mean age 80.2 (±8.3)] were included. Pooled analysis (2069 participants, 7 studies) demonstrated that 80% of older adults undertaking TCP were discharged home [95% CI (0.78–0.82, p 0.001), I 2 = 21.99%, very low GRADE evidence]. Proportions of older adults discharged home varied widely between countries (33.3%–86.4%). There was a significant improvement in ability to perform activities of daily living (2001 participants, 7 studies) as measured by the Modified Barthel Index [17.65 points (95% CI 5.68–29.62, p = 0.004), I 2 = 0.00%, very low GRADE evidence]. The proportion of older adults discharged home from TCP compared to other discharge destinations differs between countries. This could be due to the intensity of the rehabilitation delivered and the maximum length of stay allowed prior to discharge. Future studies that comprehensively evaluate the efficacy of TCP on health‐related outcomes including quality of life are required. Further investigation is required to identify which aspects of TCP affect successful discharge home.
Publisher: Informa UK Limited
Date: 07-2020
DOI: 10.2147/CIA.S251516
Publisher: SAGE Publications
Date: 23-07-2021
DOI: 10.1177/00178969211032711
Abstract: Falls are a significant problem for many older patients after hospital discharge. The purpose of this study was to evaluate the fidelity and impact of a tailored patient fall prevention education programme from the perspective of the educators who delivered the programme. Qualitative sequential design. Three rehabilitation hospitals in Western Australia. Three experienced physiotherapists trained as ‘educators’ to deliver a tailored fall prevention education programme to 195 older patients prior to hospital discharge, together with monthly telephone follow-up for 3 months after discharge. Educator–patient interactions were recorded in a standardised educator diary. Post-intervention, educators participated in a mini-focus group, providing their perspectives regarding education delivery and its impact on patient abilities to engage in fall prevention strategies. Data were analysed using deductive content analysis. Educators followed up 184 (94%) patients, identifying multiple barriers and enablers affecting patient engagement in planned fall prevention strategies. Key barriers included unresolved medical conditions, reluctance to accept assistance on discharge, delays in assistive service provision, patient beliefs and perceptions about falls and, in some cases, patients’ absolving responsibility for recovery. Enablers were related to programme design, the completion of hospital discharge processes and support networks following discharge. Educators identified several barriers and enablers to programme delivery, receipt and enactment by older patients that contributed to the fidelity of the education programme. The consistent need for more patient support to enable improved enactment of plans and assist with safe recovery long after discharge warrants further attention at policy and health system levels.
Publisher: Oxford University Press (OUP)
Date: 23-03-2018
Abstract: older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® sixteen studies (total s le size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. We found home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished.
Publisher: Wiley
Date: 25-07-2023
DOI: 10.1002/HPJA.774
Abstract: There is limited evidence about how physical activity (PA) programs should be provided for older Aboriginal and Torres Strait Islander peoples. Recently two groups of Aboriginal Elders on Noongar Boodja (Country) in Western Australia participated in the Ironbark PA program. The objective of this study was to explore the views of key stakeholders about the barriers and enablers to delivering a successful PA program and provide feedback for future program delivery. The research took a ‘Nih (listening), Waangkiny (learning), Kaadatjiny (knowing)’ approach. The lead researcher, a Noongar Wadjuk woman, conducted semi‐structured interviews ( n = 17) with key stakeholders: Aboriginal and non‐Aboriginal workers who assisted to deliver the program, and family and local members of the communities. Data were also collected through weekly program notes and researcher diary entries. Data were analysed thematically. The overarching theme highlighted that stakeholders felt a sense of building a PA program that was culturally appropriate. They reflected that the program attracted older Aboriginal people because it was designed to make them feel welcomed with a sense of belonging. Five major themes were identified: Relationships , Belonging, Program structure, Benefits of the program and Future planning . Positive changes observed in Elders' health and well‐being were a source of inspiration for team workers. Key enablers to delivering a PA program for older Aboriginal people are building a culturally strong program that creates a sense of belonging for the participants. Practitioners who are planning PA programs for older Aboriginal people should prioritise the development of cultural safety and security.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-09-2021
Publisher: Wiley
Date: 27-02-2019
DOI: 10.1111/OPN.12224
Abstract: To explore care staff knowledge about falls and confidence, motivation and opportunity to undertake fall prevention strategies, in residential aged care (RAC) along with preferences for fall prevention education. Falls account for the majority of adverse clinical events in RAC settings. Care staff in RAC settings are in a key position to influence residents' actions to prevent falls, provided they have the necessary knowledge and skills. A cross-sectional survey design with a purposive s le of 147 care staff at eight RAC facilities was undertaken in 2015. A custom-designed questionnaire examining knowledge, confidence, motivation and opportunity to undertake falls prevention strategies was used. Only 39 (26.5%) care staff were aware that the residents they cared for were at high risk of falls. Care staff knowledge of intrinsic falls risk factors was very limited, for ex le, only 18 (13.53%) observed for side effects of medication and just four (1.04%) were aware of continence issues. Conflicting duties also limited care staff time to undertake falls prevention strategies. Preferences for falls prevention education indicated face-to-face interactive discussions in the workplace (n = 98, [66.7%]) with reminder posters displayed around the facility (n = 80, [70.8%]). Residential aged care organisations need to engage with care staff to provide tailored falls education incorporating learning preferences and targeting knowledge gaps, to improve awareness of intrinsic risk factor impact and uptake of evidence-based prevention strategies. Despite care staff being highly motivated, they have limited opportunity to assist residents with fall prevention within their workload. RAC management and funding bodies must address opportunity for care staff to fulfil this crucial role to benefit resident safety. This study identified gaps in care staffs' knowledge and skills in undertaking falls prevention strategies in residential aged care settings. These findings will assist residential aged care organisations and health professional educators to design evidence-based falls prevention education tailored to their care staffs' needs and preferences to facilitate adoption.
Publisher: BMJ
Date: 07-2016
Publisher: Frontiers Media SA
Date: 28-06-2021
DOI: 10.3389/FPUBH.2021.688640
Abstract: Introduction: Continued evaluation of Transition Care Programs (TCP) is essential to improving older adults' outcomes and can guide which older adults may benefit from undertaking TCP. The aim of this study was to audit a transition care service to identify the association between the characteristics of older adults undertaking a facility-based TCP and (i) discharge destination and (ii) functional improvement. Materials and methods: An audit ( n = 169) of older adults aged 60 years and above who completed a facility-based TCP in Australia was conducted. Outcomes audited were performance of activities of daily living (ADL) measured using the Modified Barthel Index (MBI) and discharge destination. Data were analyzed using logistic regression and linear mixed modeling. Results: Older adults [mean age 84.2 (±8.3) years] had a median TCP stay of 38 days. Fifty-four older adults (32.0%) were discharged home, 20 (11.8%) were readmitted to hospital and 93 (55%) were admitted to permanent residential aged care. Having no cognitive impairment [OR = 0.41 (95% CI 0.18-0.93)], being independent with ADL at admission [OR = 0.41 (95% CI 0.16-1.00)] and a pre-planned team goal of home discharge [OR = 24.98 (95% CI 5.47-114.15)] was significantly associated with discharge home. Cases discharged home showed greater improvement in functional ability [MBI 21.3 points (95% CI 17.0-25.6)] compared to cases discharged to other destinations [MBI 9.6 points (95% CI 6.5-12.7)]. Conclusion: Auditing a facility-based TCP identified that older adults who were independent in ADL and had good cognitive levels were more likely to be discharged home. Older adults with cognitive impairment also made clinically significant functional improvements.
Publisher: Wiley
Date: 23-03-2022
DOI: 10.1002/HPJA.582
Abstract: Issue addressed: Culturally appropriate physical activity (PA) programs have values and principles that respect local community culture and knowledge. However, in Western Australia (WA) there were no opportunities for older Aboriginal peoples to engage in a culturally appropriate PA program. The study objective was to explore how engaging in a culturally appropriate PA program impacted on the lived experiences of Aboriginal Elders. A qualitative exploratory study was conducted using an Indigenous methodology. Participants were Aboriginal Elders in Noongar Country in WA . Two groups, engaged in the Ironbark program, which consisted of weekly exercise and a yarning circle. The program was developed in NSW specifically for older Aboriginal and Torres Strait peoples and adapted for use in WA. Semi‐structured interviews utilising a yarning approach were facilitated by a Noongar Wadjuk researcher. Inductive thematic analysis was undertaken. Nineteen Elders were interviewed. The overarching theme was that participation led to connecting and reconnecting to community with a sense of belonging . Elders affirmed the program as being appropriate and comfortable. They described experiences that were grouped into three main themes of Positive mental and emotional changes, Physical improvements and Social benefits . Aboriginal Elders valued the opportunity to engage in a culturally appropriate PA program. Benefits were appreciated as holistic in nature, with Elders seeing improvements in their mental, physical and emotional health. Increasing access to culturally appropriate, decolonised PA programs is a fundamental health promotion approach for working with older Aboriginal and Torres Strait Islander peoples.
Publisher: The Beryl Institute
Date: 28-04-2021
Publisher: BMJ
Date: 02-2017
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.GERINURSE.2016.06.019
Abstract: Falls are a serious problem in residential aged care settings. The aims of the study were to determine the feasibility of surveying care staff regarding falls prevention, and describe care staff levels of knowledge and awareness of residents' risk of falls, knowledge about falls prevention, motivation and confidence to implement falls prevention strategies. A custom designed questionnaire was administered to care staff at one site of a large residential aged care organization in Australia. The survey response was 58.8%. Feedback from staff was used to inform the administration of the survey to the wider organization. Seven (29.2%) care staff reported they were unsure or thought residents were at low risk of falls. Only five (20.8%) care staff were able to suggest more than three preventive strategies. These preliminary findings suggest that education to change care staff behavior regarding falls prevention should target improving care staff knowledge and awareness of falls.
Publisher: BMJ
Date: 12-2016
Publisher: Wiley
Date: 1996
DOI: 10.1111/JAN.12725
Abstract: The aim of this study was to facilitate the implementation and operation of a falls prevention Community of Practice in a residential aged-care organization and evaluate its effect on falls outcomes. Falls are a substantial concern across the residential aged-care sector with half its older population falling annually. Preventing falls requires tailoring of current evidence for reducing falls and adoption into daily activity, which is challenging for ersely skilled staff caring for a frailer population. Forming a community of practice could provide staff with the opportunity to share and develop their expertise in falls prevention and innovate change. A mixed methods design based on a realist approach conducted across 13 residential care facilities (N = 779 beds). Staff will be invited to become a member of the community of practice with all sites represented. The community of practice will be supported to audit falls prevention activity and identify gaps in practice for intervention. The impact of the community of practice will be evaluated at three levels: in idual member level, facility level and organizational level. A pre-post design using a range of standardized measures supported by audits, surveys, focus groups and interviews will determine its effect on falls prevention practice. Falls outcomes will be compared at five time intervals using negative binomial regression and logistic regression. The study is funded 2013-2017. Findings from this research will assist residential aged-care providers to understand how to effectively translate evidence about falls prevention into clinical practice.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.GERINURSE.2016.09.001
Abstract: The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training.
Publisher: Springer Science and Business Media LLC
Date: 19-07-2022
DOI: 10.1186/S12877-022-03255-5
Abstract: The study aimed to evaluate the feasibility of using a comprehensive geriatric assessment (CGA) in a residential transition care setting to measure older adults’ functional outcomes. A convenience s le of older adults ( n = 10) and staff ( n = 4) was recruited. The feasibility of using assessment tools that comprise a CGA to comprehensively measure function in physical, cognitive, social and emotional domains was evaluated pre- and post-rehabilitation. 10 older adults (mean ± SD age = 78.9 ± 9.1, n = 6 male) completed a CGA performed using assessments across physical, cognitive, social and emotional domains. The CGA took 55.9 ± 7.3 min to complete. Staff found CGA using the selected assessment tools to be acceptable and suitable for the transition care population. Older adults found the procedure to be timely and 60% found the assessments easy to comprehend. Participating in CGA also assisted older adults in understanding their present state of health. The older adults demonstrated improvements across all assessed domains including functional mobility (de Morton Mobility Index baseline 41.5 ± 23.0, discharge 55.0 ± 24.0, p = 0.01) and quality of life (EQ-5D-5L baseline 59.0 ± 21.7, discharge 78.0 ± 16.0, p 0.01). Incorporating CGA to evaluate functional outcomes in transition care using a suite of assessment tools was feasible and enabled a holistic assessment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2018
DOI: 10.11124/JBISRIR-2017-003485
Abstract: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I 2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26 95% CI [−3.72, −0.80]). Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.
Publisher: Oxford University Press (OUP)
Date: 05-02-2019
Abstract: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing in idualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. A randomized clinical trial at three hospitals in Western Australia: participants followed for 6 months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: aged 60 years and over, admitted for rehabilitation. Eligibility included: cognitively able to undertake education (Abbreviated mental test score & /10). Intervention: tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: falls in the 6 months after discharge proportion of participants sustaining one or more falls. There were 382 (194 intervention 188 control) participants (mean age 77.7 [SD 8.7] years). There were 378 falls (fall rate per 1,000 patient-days, 5.9 intervention 5.9 control) reported by 164 (42.9%) participants in the 6 months following hospital discharge 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: (adjusted IRR, 1.09 95% CI [0.78 to 1.52]) or the proportion of participants who fell once or more (adjusted OR, 1.37 95% CI [0.90 to 2.07]). Providing in idualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high-risk transition period.
Publisher: Cambridge University Press (CUP)
Date: 27-06-2019
DOI: 10.1017/S0144686X18000697
Abstract: Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people's knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes in Perth, Australia and six RAC homes in Swansea, Wales, United Kingdom. Participants had limited knowledge about intrinsic falls risk factors and strategies to address these and frequently expressed self-blame regarding falling. Almost all (N = 67, 95.7%) participants felt highly motivated to maintain their current functional mobility and independence in everyday tasks. Key preferences for receiving falls prevention messages favoured a positive approach promoting wellness and independence (N = 41, 58.6%) via pictorial posters or brochures (N = 37, 52.9%) and small group discussions preferably with demonstrations (N = 18, 25.7%). Findings from this study may assist organisations and staff to more effectively engage with older people living in RAC about falls prevention and design targeted resources to address the motivations and preferences of this population.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.GERINURSE.2015.02.025
Abstract: Optimum recovery from hip fracture has been linked to the provision of effective rehabilitation, but levels of adherence vary among older patients. In this feasibility study a novel personalized DVD was designed for four participants, which delivered a 5 week tailored home exercise program (HEP), with the participant being videoed completing their exercises. Treatment fidelity of the DVD HEP was evaluated, including participants' perceptions of and response to the DVD-HEP, which was explored using diaries and interviews and analyzed thematically. Secondary outcome measures including exercise adherence and self-efficacy for exercise were analyzed using descriptive statistics. Levels of adherence to the HEP were 1.2-3.5 times more than the minimum prescribed dose and participants demonstrated higher levels of self-efficacy for exercise. Adherence was found to be enhanced by physical improvement, positive self-reflection about engagement in the DVD-HEP, the format of the DVD, and increased self-efficacy. Personalized DVDs may be a feasible method of promoting adherence to home exercise programs among older patients.
Publisher: Content Ed Net Taiwan Limited
Date: 31-03-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
DOI: 10.11124/JBISRIR-2016-002952
Abstract: The objective of this review is to synthesize the best available evidence on the effectiveness of falls prevention interventions provided just prior or immediately after discharge from hospital on falls rates and falls injuries among older adults living in the community in the first 6 months after discharge from hospital.
Publisher: Emerald
Date: 21-03-2022
Abstract: The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling. A two-phase mixed methods participatory design using a resident ( n = 6) and care staff ( n = 5) consumer engagement panel, pre- and post-programme resident ( n = 35) survey and semi-structured care staff interviews ( n = 8) was undertaken in two countries. A poster, brochure, video and staff education guide featuring 12 safety messages depicting fall prevention behaviours were co-designed. Residents, supported by staff, perceived the falls prevention education programme as enjoyable and informative, but there were no significant differences in capability, opportunity or motivation. However, several residents were observed enacting fall prevention behaviours such as “If I feel unwell, I'll ring the bell” and waiting for staff assistance. Challenges to programme demand, acceptability and implementation which may have impacted residents' exposure and engagement with the programme were identified, along with recommendations to improve feasibility. When developing falls prevention education programmes partnering with residents and staff, providing choices to meet personal and aesthetic preferences along with frequent, shorter duration learning opportunities are important for translating education messages into actions. The use of bespoke resources, novel rhymes, positive messages emphasising safety and co-designing with residents themselves was a welcomed point of programme difference.
Publisher: BMJ
Date: 12-2015
Publisher: CSIRO Publishing
Date: 04-04-2023
DOI: 10.1071/AH22226
Abstract: Objectives There is limited evidence regarding the effectiveness of transition care programs (TCP) in improving health-related outcomes and discharge destination for older adults. This study aimed to (i) identify changes in health-related outcomes in older adults undergoing a facility-based TCP between admission and discharge and (ii) compare health-related outcomes between participants discharged home and those discharged to permanent residential care. Method A prospective, observational study was conducted with older adults aged ≥60 years who participated in a facility-based TCP that provided short-term rehabilitation including mobility training, group exercise and cognitive activities. Physical, cognitive and social outcomes were measured at admission and discharge. Data were analysed using linear mixed modelling. Results Of the 41 participants (mean age 80.1 (±8.9) years), 26 (63.4%) were discharged home compared with 14 (34.2%) to residential care. Participants showed statistically significantly improvement in performance of activities of daily living (ADL), mobility and health-related quality of life, with a statistically and clinically significant decline in performance of instrumental ADL. Participants discharged home had statistically and clinically significant greater improvement in mobility compared with those discharged to residential care (de Morton mobility index: home, 13.6 (95% CI: 9.8, 17.4) vs residential, 6.9 (95% CI: 1.7, 12.0), Pinteraction = 0.04) and statistically and clinically significant less decline in instrumental ADL (Lawton’s scale: home, −0.8 (95% CI: −1.3, −0.2) vs residential, −2.1 (95% CI: −2.9, −1.4), Pinteraction = 0.002). Conclusion Older adults participating in a facility-based TCP had improvements in physical, cognitive and social functional abilities. However, those who returned home still had residual mobility deficits and decreased performance of instrumental ADL when compared with normative community level recommendations, which could impact on longer term community living. Further research investigating which program service components could be modified to further improve rehabilitation outcomes could benefit older adults in returning and remaining at home.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-07-2020
Publisher: Oxford University Press (OUP)
Date: 11-03-2020
Abstract: Hospital falls remain common and approximately 30% of falls in hospital result in injury. The aims of the study were the following: (i) to identify the association between fall interventions present at the time of the injurious fall and injurious faller characteristics and (ii) to identify the association between fall preventive interventions present at the time of the injurious fall and the injurious fall circumstances. Secondary data analysis of deidentified case series of injurious falls across 24 acute medical/surgical units in the United States. Variables of interest were falls prevention interventions (physical therapy, bed alarm, physical restraint, room change, or a sitter) in place at the time of fall. Data were analyzed using logistic regression and hazard ratios. There were 1,033 patients with an injurious fall, occurrence peaked between Day 1 and Day 4, with 46.8% of injurious falls having occurred by Day 3 of admission. Injurious fallers with a recorded mental state change 24 hours prior to the fall were more likely to have a bed alarm provided (adjusted odds ratio [OR] 2.56, 95% confidence interval [CI] 1.61, 4.08) and receive a physical restraint as fall prevention interventions (adjusted OR 6.36, 95% CI 4.35, 9.30). Injurious fallers restrained fell later (stay Day 6) than those without a restraint (stay Day 4) (p = .007) and had significantly longer lengths of stay (13 days vs 9 days). On medical/surgical units, injurious falls occur early following admission suggesting interventions should be commenced immediately. Injurious fallers who had a physical restraint as an intervention had longer lengths of stay.
Publisher: Wiley
Date: 02-07-2019
DOI: 10.1111/JGS.16053
Publisher: BMJ
Date: 04-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12877-019-1344-3
Abstract: Falls risk increases sharply with older age but many older people are unaware or underestimate their risk of falling. Increased population-based efforts to influence older people’s falls prevention behavior are urgently needed. The aim of this study was to obtain a group of older people’s collective perspectives on newly developed prototypes of audio-visual (AV) falls prevention messages, and evaluate changes in their falls prevention behaviour after watching and discussing these. A mixed-method study using a community World Café forum approach. Although the forum participants ( n = 38) mostly responded positively to the three AV messages and showed a significant increase in their falls prevention capability and motivation after the forum, the participants collectively felt the AV messages needed a more inspirational call to action. The forum suggested this could be achieved by means of targeting the message and increasing the personal connection. Participants further suggested several alternatives to online falls prevention information, such as printed information in places in the community, as a means to increase opportunity to seek out falls prevention information. Falls prevention promotion messages need to be carefully tailored if they are to be more motivating to older people to take action to do something about their falls risk. A wider variety of revised and tailored AV messages, as one component of a community-wide falls prevention c aign, could be considered in an effort to persuade older people to take decisive action to do something about their falls risk. This study was registered prospectively: NCT03154788 . Registered 11 May 2017.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/AH15189
Abstract: 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.
Publisher: SAGE Publications
Date: 24-10-2023
Publisher: Springer Science and Business Media LLC
Date: 15-01-2018
Publisher: Cambridge University Press (CUP)
Date: 21-04-2022
DOI: 10.1017/S0144686X22000253
Abstract: Transition care programmes (TCP) provide older adults with goal-oriented rehabilitation after hospitalisation. However, limited research has focused on understanding older adults' experiences when undertaking TCP. Using a phenomenological approach, we explored the lived experience of older adults undertaking a TCP at a transition care facility in Australia. A purposive s le (N = 33 participants: 16 older adults, four family members and 13 staff) was recruited. Semi-structured interviews were undertaken at three time-points during admission and inductive thematic analysis was utilised. Older adults reflected on their TCP experiences through an emotional lens through which they deliberated, ‘is my destination home?’ Fear of losing independence and uncertainty about their discharge destination strongly influenced older adults' perspectives regarding their TCP experience. Emotional responses, both positive and negative, were influenced by expectations prior to admission, level of family support and staff behaviour. Staff and family concurred that many older adults were confused about their admission to the facility and initially were unprepared to engage in the rehabilitation provided. Older adults experienced TCP as a time of great uncertainty and feared the unknown when discharged from hospital to transition care. They expressed grief at the loss of existing life roles and anxiety about the possibility of being unable to return home. Health professionals need to inform and tailor rehabilitation for older adults to better support this transient time of life.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2017
DOI: 10.11124/JBISRIR-2016-002938
Abstract: The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident. Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?
Start Date: 2011
End Date: 12-2013
Amount: $210,000.00
Funder: Australian Research Council
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