Behaviour-related harm is almost as likely to contribute to adverse events in aged care facilities as falls, indicating it is an overlooked indicator of quality care, Macquarie University research has found.

The three-year study linked data from medical and care records of 11,987 residents from 72 aged care facilities in New South Wales and the Australian Capital Territory to identify the types and rates of adverse events  in residential aged care facilities.

It identified 60,268 adverse incidents and around three in five residents experiencing an incident during the study, which was published in the Australian Health Review this month.

It found falls contributed to the majority of adverse incidents (36 per cent) closely followed by behaviour-related events, such as verbal and physical abuse, aggression, and resistance (33 per cent),then  impacts and injuries, such as cuts, bruises and pressure injuries (22 per cent) and medication errors (9 per cent).

Bella St Clair

Lead researcher Bella St Clair said the research showed that behaviour-related incidents were of great concern but often overlooked as an indicator of quality care.

“We were expecting that falls would be a fairly significant proportion, but I definitely didn’t necessarily think that behaviour-related incidents would be quite as large as it was,” Ms St Clair told Australian Ageing Agenda.

More than five in six behaviour-related incidents occurred in high care residents (85 per cent).

“[It] shows that it is a big challenge within residential aged care facilities,” said Ms St Clair, a PhD candidate from Macquarie University’s Australian Institute of Health Innovation.

She said she was surprised that mediation-related events were “fairly low”.

The number of adverse events per resident ranged from zero for 42 per cent of residents up to 171, with a median of two. Men were most likely to experience an adverse event while women and residents with low care needs were less likely, the study found.

“Even though [men] are a much smaller proportion of the residential aged population, they’re actually more likely to experience an event,” Ms St Clair said.

Providers encouraged to make better use of data

Aged care providers need to better utilise their data to understand the people they are caring for and implement targeted strategies, Ms St Clair said.

“Aged care facilities are collecting a lot of information. I think one of the big keys that this study points to is that you can use some information to understand the population within your facility and then target the areas that need to be targeted,” Ms St Clair said.

“Simply introducing a falls intervention program or a behaviour management program may be not necessarily be hitting the key areas that you need to make an improvement to the safety of  residents and staff as well,” Ms St Clair said.

Providers can use the data from this research as a benchmark to compare their own service, she said.

“If they do introduce changes and quality improvements, there is a starting point that we can compare against.”

Access the study.

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