Encouraging Best Practice in Residential Aged Care Program
The Encouraging Best Practice in Residential Care (EBPRAC) program is funded by the Australian Government Department of Health and Ageing. The program aims to improve the level of clinical care for residents in aged care homes. EBPRAC supports the uptake of existing evidence-based guidelines by funding organisations to translate the best available evidence into easy approaches for staff to use in their everyday practice. While there are a number of existing evidence-based guidelines to assist aged care staff in providing appropriate care for residents, it is recognised that there is a need to establish strategies to translate the evidence into everyday practice. The focus of the program is to implement cost-effective and sustainable strategies for evidence-based care for residents, using existing knowledge and tools. Projects established consortia of residential aged care homes, educators and researchers to implement up to date, evidence-based clinical care practice in targeted clinical areas for residents of aged care homes. The main change-management strategies used in Round 1 and 2 projects include: education and training; champions / link nurses; audit and feedback; action research; care planning; environmental changes; and policies, procedures and protocols.
To date, there have been two rounds of EBPRAC and 13 projects have been funded. Rounds 1 and 2 have focused on key clinical areas for which there are existing bodies of knowledge to support evidence-based practice as well as existing tools and resources to support implementation.
Five projects were funded under Round 1 of EBPRAC and focused on the clinical areas of nutrition and hydration, PRN (‘as required’) medication management, oral health care, falls management and pain management. Projects ran from September 2007 to December 2009.
Eight projects were funded under Round 2 of EBPRAC, focusing on the clinical areas of palliative care (3 projects), behaviour management (3 projects), wound management and infection control. Round 2 projects run from December 2008 to December 2010.
A national evaluator is engaged to undertake an evaluation of projects under Round 1 and Round 2 as well as review the EBPRAC Program overall.
Local Project
This EBPRAC project is one of eight projects funded under the second round by the Australian Department of Health and Ageing. The project aims to encourage best practice in Palliative Care in Residential Aged Care Facilities (RACF's) with a focus on rural communities. The University of Wollongong's Centre for Health Service Development has been appointed as evaluator of the overall program.
Project delivery is a partnership approach, led by the Murrumbidgee General Practice Network (NSW). Partners include:
- Mallee Division of General Practice (Vic);
- Murray Plains Division of General Practice (Vic);
- Riverland Division of General Practice (SA); and
- Mater, University of Queensland Centre for Primary Health Care Innovation (Qld).
The purpose of the project is to address the identified theory-practice gaps that exist between the Guidelines for a Palliative Approach in Residential Aged Care, and what is actually delivered within aged care homes across rural and remote communities in NSW, Victoria and South Australia. 16 Residential Aged Care Facilities are participating in the project. Particular emphasis is placed on the following:
- a palliative approach provided in the resident's familiar surroundings if adequately skilled care is available. This reduces the need for transfer to an acute care setting and avoids potential distress to the reident and their family/carer;
- a palliative approach is best provided through multidisciplinary, coordinated care;
- systematic implementation of advanced care planning involving communication between the resident, family and doctor increases satisfaction with the care provided; and
- developing comprehensive advanced care plans that include ongoing assessments responds to changes in the resident's health and increase satisfaction with care.
Project activities include:
- to showcase a model of sound multi-agency governance in rural and remote health care;
- to enhance the palliative care clinical competencies within the current provider workforce servicing residential aged care facilities;
- to derive and trial a multi-professional evidence-based framework for coordinated end-of-life care;
- to demonstrate a commitment to quality improvement processes in service development; and
- to implement a multi-faceted communication strategy relevant for consortium members, providers, residents and families/carers.
The project publishes a quarterly communication newsletter for distribution to RACF staff, residents, families & carers.
Issue 4: November 2009
Further information on this project can be obtained be contacting the EBPRAC Project Cordinator, Erin Wright on 02 6953 6454.