Ageing as part of the curriculum for health-care professionals: A Queensland Survey

Frailty knowledge, training and barriers to frailty management: A national cross-sectional survey of health professionals in Australia

OBJECTIVE(S)

To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice.

METHODS

A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training. Responses were analysed using descriptive statistics.

RESULTS

The survey was taken by 736 health professionals. Less than half of respondents (44%, 321/733) reported receiving any training on frailty, with 14% (105/733) receiving training specifically focussed on frailty. Most respondents (78%, 556/712) reported 'good' or 'fair' understanding of frailty. The majority (64%, 448/694) reported being 'fairly' or 'somewhat' confident with identifying frailty. Almost all respondents (>90%) recognised frailty as having an important impact on outcomes and believed that there are beneficial interventions for frailty. Commonly reported barriers to frailty assessment in practice included 'lack of defined protocol for managing frailty' and 'lack of consensus about which frailty assessment tool to use'. Most respondents (88%, 521/595) were interested in receiving further education on frailty, with a high preference for online training.

CONCLUSIONS

The findings suggest frailty is important to health professionals in Australia, and there is a need for and interest in further frailty education.

Dementia ECHO: Evaluation of a telementoring programme to increase dementia knowledge and skills in First Nations-led health services

Introduction

High rates of dementia among Australian First Nations’ peoples have resulted in an increased demand for dementia knowledge and skills among the primary health care professionals in these communities. The Dementia Extension for Community Healthcare Outcomes (ECHO) program aims to be a culturally safe way of increasing local health workforce capacity by facilitating dementia knowledge, skills and confidence among primary care professionals in First Nations community settings. Dementia ECHO is based on the international evidence-based telementoring programme, Project Extension for Community Healthcare Outcomes. Every Dementia ECHO session is delivered by videoconference and comprises a specialist-led presentation and a case discussion from a primary care health service participant. The aims of this study were to assess the uptake and reach of Dementia ECHO; examine the perceived importance of dementia care and dementia education among Aboriginal and Torres Strait Islander Community Controlled Health Service staff; and evaluate the potential impact of Dementia ECHO on health service staff pertaining to dementia knowledge, confidence to provide dementia care and professional isolation.

Method

Dementia ECHO service activity data maintained by the programme providers was reviewed to determine uptake and reach. A pre-implementation survey examined Aboriginal and Torres Strait Islander Community Controlled Health Service staff perspectives on the importance of dementia education and the priority of a range of health issues. After each Dementia ECHO session, a brief online survey gathered quantitative and qualitative data regarding the potential impact of the session.

Results

Of 30 completed pre-implementation surveys, all staff rated dementia education as either very important or important. Salient themes highlighting why it is important are presented. When asked to rank six different health priorities, dementia ( n = 10) and chronic disease ( n = 10) were placed as the top priority. The brief post-session feedback provided 44 complete survey responses demonstrating: perceived improvement in dementia knowledge and skills (88.4%); increased confidence to provide dementia care (83%); and a reduction in professional isolation (88%).

Conclusion

Dementia ECHO addresses a gap in dementia education that is much needed in health professionals with increasing numbers of First Nations people living with dementia. This current study shows that attending an evidence-based telementoring programme, such as Dementia ECHO, can increase dementia knowledge and confidence to care for someone living with dementia and their families.

Qualitative analysis of challenges and enablers to providing age friendly hospital care in an Australian health system

BACKGROUND

With ageing global populations, hospitals need to adapt to ensure high quality hospital care for older inpatients. Age friendly hospitals (AFH) aim to establish systems and evidence-based practices which support high quality care for older people, but many of these practices remain poorly implemented. This study aimed to understand barriers and enablers to implementing AFH from the perspective of key stakeholders working within an Australian academic health system.

METHODS

In this interpretive phenomenenological study, open-ended interviews were conducted with experienced clinicians, managers, academics and consumer representatives who had peer-recognised interest in improving care of older people in hospital. Initial coding was guided by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Coding and charting was cross checked by three researchers, and themes validated by an expert reference group. Reporting was guided by COREQ guidelines.

RESULTS

Twenty interviews were completed (8 clinicians, 7 academics, 4 clinical managers, 1 consumer representative). Key elements of AFH were that older people and their families are recognized and valued in care; skilled compassionate staff work in effective teams; and care models and environments support older people across the system. Valuing care of older people underpinned three other key enablers: empowering local leadership, investing in implementation and monitoring, and training and supporting a skilled workforce.

CONCLUSIONS

Progress towards AFH will require collaborative action from health system managers, clinicians, consumer representatives, policy makers and academic organisations, and reframing the value of caring for older people in hospital.