Highlights
Task
The Aged Care Royal Commission Final Report titled Care, Dignity and Respect has now been released. The report calls for significant reforms to Australia’s aged care system. The final report also makes 148 recommendations for reform.
In this task our focus is the National Aged Care Quality Indicator Program. This program requires aged care homes to collect and report of data on 5 particular areas, every three months. From July 2021, these five indicators are:
Pressure injuries
Use of physical restraint
Unplanned weight loss
Falls and major injury
Medication management
For this assessment task, you have been asked by the government to put forward a discussion paper to recommend a 6th indicator. The goal of this task is to assist you to understand quality and one of the ways in which we can measure the quality of care we provide. The task will require to think deeply about what we can measure and why we might want to measure the care we provide in all sectors, not only aged care.
You will need to explore the scholarly literature to justify your decision to include this indicator in the National Aged Care Mandatory Quality Indicator.
In this paper you are required to make a recommendation to the federal government for the inclusion of an additional quality indicator for the mandatory reporting.
Program: You will also need to provide plan on how performance against the indicator will be measured.
Criteria:
Display insight into the topic with reference to scholarly literature.
Justifies the decision to include the selected indicator.
Constructs a plan to measure the selected indicator.
Adhere to presentation conventions.
EXAMPLE OF THIS TASK: (Follow the Template)
Proposed Quality Indicator
The prevalence of squeaking wheels on rollator frames.
Overview
The use of mobility aids in the aged care sector is increasingly common, with many individuals entering care facilities with an established mobility device (Stevens, 2020). Mobility aids provide a source of stability and may assist in preventing falls and providing individuals with confidence and independence (Sampson, 2019).
The literature acknowledges the value of physical activity in the older population, and furthermore that physical activity is a modifiable risk factor (Smith & Branson, 2020; Crawley, 2019; Barrow, 2017). Mobility aids are therefore a valuable tool in improving quality of life of those living in the residential aged care sector. However, the noise from the squeaking wheels of rollators causes environmental noise pollution which is known to cause a range of health issues, such as stress, hearing loss, poor concentration, fatigue, sleep problems and communication difficulties (Lawiller, 2019). For this reason, the proposed sixth quality indicator for national mandatory reporting is the prevalence of squeaking wheels on rollator frames.
Definition and key terms
Mobility devices can include wheelchairs, crutches, canes/walking sticks, rollators, and walking frames.
This quality indicator only applies to rollators, also referred to as seated walkers. Rollators have four wheels and handles positioned to allow the rollator to be steered using the hands. They also have a seat and often have under-seat storage. Rollators have hand brakes for safety and come in a variety of colours, including flat (matt) and glitter finishes.
Justification
Given the increased popularity and prevalence of rollator frames in Residential Aged Care Facilities (RACFs), it is important to identify the potential of environment noise pollution from the squeaking wheels of rollators.
The excessive noise from squeaking wheels has a negative impact on quality of life (Jones & Smith, 2016). Both physical and mental health have been shown to suffer from environmental noise pollution. The effects are wide-reaching and include interruption of leisure activities, behavioural management caused by distress, reduced social interaction and poor sleep quality (Lawiller, 2019).
Aged care recipients/consumers need to be able to participate in a wide variety of leisure activities (Dowager, 2021). Unfortunately, quieter pursuits such as reading, playing chess and jigsaw puzzles are all at risk of interruption from the squeaking wheels of rollator frames. Concentration is lost and the joy of participation in the activity is significantly diminished (Talbot et al. 2016). In a 2020 systematic review conducted by Edith & Grantham they identified the relationship between squeaking wheels and the well-known “fingernails down the blackboard” theory first put forward by O’Brien in 1957. O’Brien’s work is germinal and provides a clear pathway for the inclusion of this proposed indicator in mandatory reporting requirements.
Further research conducted by Bates & Bartlett (2017) compared squeaking wheels to several other noise interruptions such as ringing phones, doors slamming, toilets flushing, and staff talking, and found the effect of squeaking wheels to cause the greatest increase in neural activity and increased cortisol levels.
The rising number of individuals living with dementia is further justification for mandatory reporting of squeaking wheels. When care recipients become stressed and upset, the noise from squeaking rollators exacerbates the issue and Thomas (2021) notes this leads to increased medication use.
Poor sleep quality caused by the noise from squeaking wheels in rollators has long term effects on both physical and mental health. Sleep is a basic human requirement and been woken at night by unpleasant high-pitched noises can be distressing and disrupt sleep patterns (Castle 2015). Poor sleep quality at night caused by the persistent squeaking of wheels can lead to increased daytime sleepiness, irritable behaviour, and general fatigue (Smith & Jones 2019). This in turn results in less social engagement and interaction and negatively effects the overall tone and ambiance of the RACF.
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