BUILDING BETTER AGED CARE
HOSPITAL AVOIDANCE TO PRESERVE QUALITY OF LIFE KEEPING RESIDENTS OUT OF HOSPITAL SHOULD BE A KEY FOCUS FOR AGED CARE PROVIDERS
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few years ago, I had a resident pass away in the corridor of the Royal Adelaide Hospital. They were alone and had been transferred for a non-critical condition. The kind of death they died was avoidable, and right then I decided that I wanted to stop this from happening again.” These are the words of Lerwin’s Clinical Care Manager Nicole Healey, who has made it her mission to reduce avoidable hospital transfers, and keep people in the comfort of their aged care homes, for as long as possible. “Transfers can be traumatic, especially for people with dementia or psychological impairment,” says Nicole, who worked as a critical care nurse for seven years prior to entering aged care.
relationship between the Extended Care Paramedics (ECPs) and the aged care home. Staff were educated on the instances they should call the ECPs instead of an ambulance, and they also made use of mobile x-ray services, increasing the level of care provided in-house and stopping unnecessary transfers to the acute setting. Nicole also arranged training in cannulation for nursing staff, and spearheaded the purchase of a Baxter Infusion Pump, so residents who needed intravenous infusions could have them on-site. “By supporting aged care nurses with the right training and by providing the right equipment, there are many conditions we can accommodate and manage in-house,” says Nicole.
“The hospital environment can be an uncomfortable place, people don’t know them, or their preferences, or tastes. “Their age does not make them a priority, especially when the condition that triggers the transfer is usually non-urgent. “We can do better if we upskill our workforce and we have access to diagnostic equipment on-site.” Some of the most common reasons residents are transferred to hospital are for intravenous antibiotics or fluids, pain management, or end-of-life care. All of these can be managed very effectively by appropriately trained in-house nurses. Upskilling all aged care nurses with training in cannulation, male and SPC catheters, suturing and assessments should be a priority, and end-of-life care is something most aged care homes do better than hospitals, says Nicole. She also says having an on-call doctor or paramedic should be a must, in order to support the Registered Nurse responsible for making determinations on transfers. In her previous role as Clinical Services Manager at St Pauls Lutheran Homes in Hahndorf, Nicole built a strong working
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Lerwin resident Anita Green and Clinical Care Manager Nicole Healey. Continued on page 47
