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Encouraging Better Practice in Aged Care

This program has the aim of identifying and developing sustainable strategies to encourage residential aged care facilities to implement existing evidence-based best practice guidelines.

 

Background

The Encouraging Best Practice in Residential Aged Care (EBPRAC) program commenced in 2007 with the aim of identifying and developing sustainable strategies to encourage residential aged care facilities to implement existing evidence-based best practice guidelines. EBPRAC supported the uptake of evidence-based guidelines by funding organisations to translate the best available evidence into effective approaches for staff to use in their everyday practice.

 

Funding

To date, there have been two EBPRAC funding rounds involving 13 projects. Five projects were funded under Round 1 and commenced in December 2007 and concluded in December 2009. Eight projects were funded under Round 2 and commenced in December 2008 and concluded in December 2010.

Round 1 and Round 2 involved 111 residential aged care facilities in 108 locations across the six states in Australia. Projects consisted of a lead organisation working with a group of facilities to implement evidence in one of nine areas of clinical practice – pain management, falls prevention, ‘as required’ (PRN) medications, oral health, nutrition and hydration, behaviour management, palliative care, wound management and infection control. A wide range of strategies were used to implement evidence-based practice with a strong focus on education, use of local facilitators, feedback of data to staff and provision of resources. Lead organisations included five universities, three research centres, three divisions of general practice and two service providers.

In recognition of the importance of further developing evidence-based clinical practice across the aged care sector, the Australian Government expanded the scope of the Program to include community aged care in the 2010-11 Federal Budget. With this expansion, the name of the program changed from the EBPRAC program to the Encouraging Better Practice in Aged Care (EBPAC) initiative.

The EBPAC initiative aims to encourage and support the uptake of evidence-based, person-centred, better practice in Australian Government subsidised aged care services, through a focus on improving staff knowledge and skills and developing supporting resources, to improve outcomes for aged care recipients.

 

Round 3 Recipients

$6 million funding would be provided to eight organisations under the Encouraging Better Practice in Aged Care (EBPAC) initiative, which focuses on improving residential and community aged care through education, training and leadership.

Organisations receiving funds under round three of EBPAC are Metropolitan South Institute of TAFE (MSIT) in Queensland, Resthaven Inc in South Australia, Royal District Nursing Services (RDNS) in Victoria, The University of NSW, Chinese Community Social Services Centre Inc, Uniting Care Community Options (UCCO), South Australian Dental Service and Alzheimer’s Australia, Victoria

 

Round 2 Recipients

Infection Control

Lead Organisation – PivotWest Division of General Practice

The Infection Control in RACFs: Closing the gap between evidence and practice using the Collaborative methodology project was managed by Pivot West. The purpose of the Infection Control Collaborative was to translate best practice guidelines for infection control in residential aged care facilities by helping organisations adopt evidence based policies, practices and procedures through team based approaches; assist them to measure and record findings and then share their learning’s with other organisations to aid prevention and early intervention. The project provided an education and training program with participating facilities. Eight residential aged care facilities located in Victoria were involved in the project.

Wound Management

Lead Organisation – Queensland University of Technology

The Creating Champions for Skin Integrity project was administered by the School of Nursing & Midwifery, Institute of Health and Biomedical Innovation, Queensland University of Technology. This project aimed to implement sustainable evidence-based practice in wound management in demographically diverse residential aged care facilities. It focused on enabling staff from the participating residential aged care facilities to preserve skin integrity through the application of evidence-based practice to assessment, prevention, and management of wounds. Seven residential aged care facilities located in Queensland and New South Wales were involved in the project.

Behaviour Management

Three EBPRAC projects were funded in the area of behaviour management for residents with dementia. All of the projects had a person-centred approach and a focus on non-pharmacological interventions and education and training for staff in the residential aged care facilities involved in the projects. In addition, two of the projects focused on the environmental design of the facilities to create dementia friendly physical and social environments.

Lead Organisation – HammondCare

The Improving Social Interaction by working with staff, families and the physical environment project was specifically designed to be conducted in smaller facilities that have limited access to behavioural management resources. This project educated staff in person-centred care for people with dementia, developed a toolkit and DVD and undertook environmental audits and minor environmental changes to the seven facilities involved in the project. It has also established family support groups to enable families to be partners in the process of reducing behavioural disturbances.

Seven residential aged care facilities located in New South Wales and Victoria were involved in the project.

Lead Organisation – Monash/Flinders University

The Addressing Behaviours of Concern in the Bush: Sustainable evidence-based practice in rural and regional residential aged care project looked at ways to address issues relating to behaviours of concern associated with the built environment. This activity included improved orientation, training of staff and increased assessment and care for older people with behaviours of concern. Minor environmental changes were undertaken to the facilities involved in the projects. There were seven residential aged care facilities located in rural Victoria involved in the project.

Lead Organisation – University of Technology, Sydney

The EN-ABLE: Developing and testing a toolkit for the Implementation & Evaluation of Person-Centred Evidence-Based Responses to Need Driven Behaviours associated with Dementia (NDBs) project project focused on staff education and training and on the implemention of the EN-ABLE training program in the facilities involved in the project. In particular, staff learned to identify distressing expressions of unmet physical, psychological and emotional need in residents with dementia. There was a focus on the behaviours of agitation, apathy, aggression and risky wandering. The EN-ABLE Toolkit has been developed which includes training workshops, flow charts and interactive learning resources.

Six residential aged care facilities located in New South Wales, Victoria and Queensland were involved in the project.

Palliative Care

Three projects were funded in the area of palliative care. These projects focused on encouraging a palliative approach in residential aged care to address the palliative care needs of people residing in residential aged care facilities including the evidence- based use of medicines.

Lead Organisation – North East Valley Division of General Practice

A good death in residential aged care: optimising the use of medicines to manage symptoms in the end-of-life phase project aimed to implement evidence-based use of medications, to manage symptoms in the end-of-life phase for residents in aged care facilities. The project focused on end-of-life care in general and medication management. It built on existing relationships between participating facilities and divisions of general practice which resulted in improved collaboration within services involved. Activities included improvements in the knowledge and skills of general practitioners and facility staff; improved systems of care in the residential aged care facilities; and improved processes to support informed choice by residents and families at the time of prescribing and administration of medication. There were 14 residential aged care facilities located in South Australia and Victoria involved in the project..

Lead Organisation – Murrumbidgee General Practice Network

The Encouraging best practice palliative care in residential aged care facilities from rural and remote communities within NSW, South Australia and Victoria project aimed to encourage best practice in palliative care provided in residential aged care facilities with a focus on rural communities within NSW, South Australia and Victoria. Particular emphasis was placed on a multidisciplinary, palliative approach provided in the resident’s familiar surroundings if adequately skilled care was available, thus reducing the need for transfer to an acute setting. The project implemented End-of-life-Care Pathways and two models of advance care planning across the facilities as well as delivered palliative care education to staff that provided day to day care of residents. There were 14 residential aged care facilities involved in the project..

Lead Organisation – University of Queensland and Blue Care

The Implementation of a comprehensive evidence based palliative approach in Residential Aged Care (CEBPARAC) project aimed to implement a comprehensive evidence-based palliative approach in residential aged care. This was achieved through a range of activities including: providing education to nursing and care staff at all levels working in residential aged care facilities using existing training materials; establishing training and support link nurses in each residential aged care facility; and promoting the use of existing GP on-line training modules to support GPs in providing a palliative approach to residents in their care.

Nine residential aged care facilities located in Queensland, South Australia and Western Australia were involved in the project.

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