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Nurse‐Led Innovations for Optimising the Quality and Safety of Care for the Older Person in Residential Aged Care: A Warrant for Action

ABSTRACT

Aim

To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.

Design

Position paper.

Methods

This paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.

Results

This position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID-19 and incoming reforms. It calls for nurse-led research and innovation to deliver tools to address these challenges.

Conclusion

The paper proposes an appropriate holistic, evidence-based nursing framework to optimise the quality and safety of residential aged care in Australia.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

Carer Involvement in Rehabilitation for People Living With Dementia: A Systematic Review

ABSTRACT

Aims

To examine the role and impact of carer involvement in rehabilitation for community-dwelling individuals with dementia, focusing on cognitive stimulation therapy, cognitive rehabilitation, cognitive training, cognitive behavioural therapy, and exercise.

Design

A systematic review and synthesis without meta-analysis.

Data Sources

Five electronic databases, reference lists, and citations were searched (2017–2024), targeting primary research that reported results concerning one or more of those five focused rehabilitation interventions for people with dementia and their carers.

Methods

Results were synthesised using narrative approaches. The Cochrane Risk of Bias Tool and the Mixed Methods Appraisal Tool were used to appraise the quality of included studies.

Results

Forty-one studies (12 main trials, 22 pilot studies, and 7 sub-studies) were included. While the patterns between carer involvement level and types of rehabilitation were observed, their relationship to intervention effectiveness was unclear. High carer involvement in cognitive stimulation therapy and exercise was associated with improved cognition and quality of life for people with dementia and better health-related quality of life for carers. Pilot studies showed mixed but generally positive trends, with increased depressive symptoms in carers needing further investigation. Qualitative findings highlighted social interaction and improved caregiving knowledge as key enablers to positive experiences, whereas lack of motivation was the main barrier to rehabilitation engagement.

Conclusion

This review identified several patterns between the level of carer involvement and intervention types. However, the mechanism underlying different involvement levels and rehabilitation success remains unclear. More rigorous research is needed to determine the relationship between carer involvement and the effects of rehabilitation interventions on supporting the independence of people with dementia.

Impact

This review enhanced the understanding of carers' roles and impacts in supporting dementia rehabilitation and possible links to optimal health outcomes.

Reporting Method

Synthesis Without Meta-analysis (SWiM) reporting guideline.

Patient or Public Contribution

No patient/public contribution.

Framing Person‐Centred Leadership in Residential Care: A Cross‐Cultural Adaptation of the Aged‐Care Clinical Leadership Qualities Framework

ABSTRACT

Aim

To cross-culturally adapt a framework for person-centred leadership in residential care for older people in Sweden.

Design

This study has an exploratory and descriptive design.

Methods

The translation procedure followed a cyclic process of translation into Swedish and back-translation into English by two independent bilingual linguists. An evaluation of conceptual and semantic equivalence and comprehensiveness between the original English version and the translated Swedish version was performed by an expert committee. The translated version of the framework was validated by leaders (n = 34) in residential care, who assessed its relevance through a web form. The adaptation of the framework followed recommended guidelines for cross-cultural adaptation.

Results

The translation procedure resulted in two minor changes related to the wording in two descriptors. The results of the validation procedure showed that the framework is relevant for leaders in Swedish residential care for older people.

Conclusion

The cross-culturally adapted framework is useful and suitable for leaders in Swedish residential care for older people. The framework clarifies the leader's role and identifies leadership attributes and requirements for person-centred leadership in residential care, thereby providing support to leaders by framing person-centred leadership.

Implications for the Profession and/or Patient Care

The framework can be used as a guide for leadership training and/or development initiatives in residential care. It can be further extended to nursing curriculums, leadership development programs, and organisational performance and development processes. It may also provide a foundation for policy and guidelines by establishing the activities required for leaders to promote person-centredness in the care of older people.

Reporting Method

This study followed the STROBE checklist for cross-sectional studies.

Patient and Public Contribution

There was no patient or public contribution.

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