A Scoping Review of Adverse Incidents Research in Aged Care Homes: Learnings, Gaps, and Challenges

Clair, Bella St; Jorgensen, Mikaela; Nguyen, Amy; Georgiou, Andrew

doi:10.1177/23337214221144192

Cited by 5 publications

(1 citation statement)

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“…Many aged care services have a limited capacity to offer the care that older people and carers need and want. Internationally, this was demonstrated by reviews that found a high prevalence of elder abuse in institutions (Yon et al, 2019) and a range of adverse incidents in aged care homes, including falls, pressure injuries and loneliness (St Clair et al, 2022). Similarly, in Australia, the Royal Commission into Aged Care Quality and Safety revealed 'many flaws ', with 'substandard care … widespread' (2021, pp.…”

Section: (Diana)mentioning

confidence: 99%

What constitutes brilliant aged care? A qualitative study of practices that exceed expectation

Kearns

Harris‐Roxas

Chróinín

et al. 2023

Journal of Clinical Nursing

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AimThis study aimed to explore what constitutes brilliant aged care.BackgroundAlthough many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care—practices that exceeded expectation.DesignThe methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning.MethodsThis study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency.ResultsAccording to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise.ConclusionsThis study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation.Relevance to Clinical PracticeFor those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms.Patient or Public ContributionThe nominees, who included carers, were invited to participate in workshops with other carers and older people to co‐design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data.

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Section: (Diana)mentioning

confidence: 99%

What constitutes brilliant aged care? A qualitative study of practices that exceed expectation

Kearns

Harris‐Roxas

Chróinín

et al. 2023

Journal of Clinical Nursing

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Post-fall outcomes of aged care residents that did not transfer to hospital following referral to a specialised hospital outreach service: A retrospective cohort study

Venaglia,

Fox,

MacAndrew

2024

Collegian

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Unsafe care in residential settings for older adults: a content analysis of accreditation reports

Hibbert,

Ash,

Molloy

et al. 2023

International Journal for Quality in Health Care

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Background Residents of aged care services can experience safety incidents resulting in preventable serious harm. Accreditation is a commonly used strategy to improve the quality of care; however, narrative information within accreditation reports is not generally analysed as a source of safety information to inform learning. In Australia, the Aged Care Quality and Safety Commission (ACQSC), the sector regulator, undertakes over 500 accreditation assessments of residential aged care services against national standards every year. From these assessments, the ACQSC generates detailed Site Audit Reports. In over one-third (37%) of Site Audit Reports, standards relating to Personal and Clinical Care (Standard 3) are not being met. The aim of this study was to identify the types of resident Safety Risks that relate to Personal and Clinical Care Standards not being met during accreditation or re-accreditation. These data could inform priority setting at policy, regulatory and service levels. Methods An analytical framework was developed based on the World Health Organization’s International Classification for Patient Safety (ICPS) and other fields including Clinical Issue (the issue related to the incident impacting on the resident e.g., wound/skin or pain). Information relating to safety incidents in the Site Audit Reports was extracted and a content analysis undertaken using the analytical framework. Clinical Issue and the ICPS-based classification were combined to describe a clinically intuitive category (“Safety Risks”) to describe ways in which residents could experience unsafe care e.g., diagnosis/assessment of pain. The resulting data were descriptively analysed. Results The analysis included 65 Site Audit Reports that were undertaken between September 2020 – March 2021. There were 2,267 incidents classified into 274 types of resident Safety Risks. The twelve most frequently occurring Safety Risks account for only 32.3% of all incidents. Relatively frequently occurring Safety Risks were organisation management of infection control; diagnosis/assessment of pain, restraint, resident behaviours, falls; and multiple stages of wounds/skin management e.g., diagnosis/assessment, documentation, treatment, and deterioration. Conclusion The analysis has shown that accreditation reports contain valuable data that may inform prioritisation of resident Safety Risks in the Australian residential aged care sector. A large number of low frequency resident Safety Risks were detected in the accreditation reports. To address these, organisations may use implementation science approaches to facilitate evidence-based strategies to improve the quality of care delivered to residents. Improving the aged care workforces’ clinical skills base may address some of the Safety Risks associated with diagnosis/assessment and wound management.

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A Scoping Review of Adverse Incidents Research in Aged Care Homes: Learnings, Gaps, and Challenges

Cited by 5 publications

References 100 publications

What constitutes brilliant aged care? A qualitative study of practices that exceed expectation

What constitutes brilliant aged care? A qualitative study of practices that exceed expectation

Post-fall outcomes of aged care residents that did not transfer to hospital following referral to a specialised hospital outreach service: A retrospective cohort study

Unsafe care in residential settings for older adults: a content analysis of accreditation reports

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