Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
BMJ Open. 2019 Jun 25;9(6):e030988. doi: 10.1136/bmjopen-2019-030988.
The aged population is increasing rapidly across the world and this is expected to continue. People living in residential aged care facilities (RACFs) represent amongst the sickest and frailest cohort of the aged population, with a high prevalence of chronic conditions and complex comorbidities. Given the vulnerability of RACF residents and the demands on the system, there is a need to determine the extent that care is delivered in line with best practice ('appropriate care') in RACFs. There is also a recognition that systems should provide care that optimises quality of life (QoL), which includes support for physical and psychological well-being, independence, social relationships, personal beliefs and a caring external environment. The aims of are to develop sets of indicators for appropriate care and processes of care for commonly managed conditions, and then assess the appropriateness of care delivered and QoL of residents in RACFs in Australia.
We will extract recommendations from clinical practice guidelines and, using expert review, convert these into sets of indicators for 15 common conditions and processes of care for people living in RACFs. We will recruit RACFs in three Australian states, and residents within these RACFs, using a stratified multistage sampling method. Experienced nurses, trained in the methods ('surveyors'), will review care records of recruited residents within a 1-month period in 2019 and 2020, and assess the care documented against the indicators of appropriate care. Surveyors will concurrently assess residents' QoL using validated questionnaires.
The study has been reviewed and approved by the Human Research Ethics Committee of Macquarie University (5201800386). The research findings will be published in international and national journals and disseminated through conferences and presentations to interested stakeholder groups, including consumers, national agencies, healthcare professionals, policymakers and researchers.
全球人口老龄化速度正在加快，预计这种趋势将持续下去。居住在养老院的老年人是人口老龄化中最脆弱和最脆弱的群体之一，他们患有慢性疾病和复杂的合并症的比例很高。鉴于养老院居民的脆弱性和系统的需求，需要确定养老院提供的护理在多大程度上符合最佳实践（“适当护理”）。人们也认识到，系统应该提供能够优化生活质量（QoL）的护理，这包括对身体和心理健康、独立性、社会关系、个人信仰和关怀的外部环境的支持。本研究的目的是为常见管理疾病制定适当护理和护理过程的指标集，然后评估澳大利亚养老院中提供的护理的适当性和居民的生活质量。
我们将从临床实践指南中提取建议，并通过专家审查，将这些建议转化为适用于 15 种常见疾病和养老院居民护理过程的指标集。我们将使用分层多阶段抽样方法在澳大利亚的三个州招募养老院，并在这些养老院中招募居民。经验丰富的护士，经过培训，将在 2019 年和 2020 年的一个月内审查招募居民的护理记录，并根据适当护理的指标评估记录的护理。调查员将同时使用经过验证的问卷评估居民的生活质量。
该研究已得到麦考瑞大学人类研究伦理委员会的审查和批准（5201800386）。研究结果将发表在国际和国家期刊上，并通过会议和演讲传播给感兴趣的利益相关者群体，包括消费者、国家机构、医疗保健专业人员、政策制定者和研究人员。
