Resources

Trying to improve care in human services can be overwhelming. We start out with great aspirations to fix a care quality issue. But as we get closer to the problem it appears to loom ever larger, and we wonder what we’ve got ourselves into. Most care quality issues are entrenched and multifaceted and can’t be solved by a single solution or big-bang change. Often our initial enthusiasm wanes and we default to revising the procedure and running training because everything else seems too hard. Essentially, we’ve wasted time and effort on maintaining the problem, rather than finding the solution.

Pain is a complex and multifactorial phenomenon, and chronic pain can rarely be eliminated. While pain can be nociceptive or neuropathic in nature – relatable to an identifiable organic cause – a third category of pain, described as ‘nociplastic’, is less well defined, and treatment particularly challenging.

Psychological safety is an important tenet of safe and quality care - as is ‘physical’ safety.  In addition to injury from manual tasks, healthcare workers also face a risk of violence and aggression from patients themselves, particularly in emergency departments, mental health services, drug and alcohol settings, ambulance services and remote clinics.

Restrictive practices are often used to manage the behavioural and psychological symptoms of dementia (BPSD) in aged care. However while restrictive practices may have a clinical foundation in this sense, they are not necessarily driven by clinical need.

Regulatory changes to the use of restraint in aged care (now referred to as restrictive practices, in line with the NDIS Standards) came into effect on 1 July 2021. These amendments require that aged care providers ensure restrictive practices ‘must only be used in a way that supports good clinical practice and provides safe and improved care for consumers’.