Assessment of powered mobility device use among older australians in residential aged care facilities
- Authors: Dickson, Natalie
- Date: 2023
- Type: Text , Thesis , Masters
- Full Text:
- Description: Autonomous mobility is fundamental for older Australians to participate in the activities that occupy and inspire daily life. Should a mobility difficulty arise, a powered mobility device (PMD) can assist to supplement or restore mobility, choice, and control. A PMD continues to be a valued resource once a person moves into residential aged care. However, increasing frailty among people within this group means that incidents can result in serious injury for PMD users or others living, visiting, or working in this environment. Guidelines for PMD use are available, however, there are no regulations or mandates to seek professional guidance for assessment of competence, equipment prescription, or training. Occupational therapy theory and practice can support all parts of this process. This thesis presents a three-part study using a mixed methods approach to (i) examine PMD use related incidents and injuries within residential aged care, (ii) to evaluate existing measurement tools, and (iii) to develop and undertake initial validation of a new screening tool developed for residents who use PMDs, based on classical test theory (De Vellis, 2006). The new screening tool will address a gap identified among screening tools for PMD capacity and performance skills specific to this population, to improve the balance between much needed autonomy and safety for all stakeholders.
- Description: Master of Health (Research)
- Authors: Dickson, Natalie
- Date: 2023
- Type: Text , Thesis , Masters
- Full Text:
- Description: Autonomous mobility is fundamental for older Australians to participate in the activities that occupy and inspire daily life. Should a mobility difficulty arise, a powered mobility device (PMD) can assist to supplement or restore mobility, choice, and control. A PMD continues to be a valued resource once a person moves into residential aged care. However, increasing frailty among people within this group means that incidents can result in serious injury for PMD users or others living, visiting, or working in this environment. Guidelines for PMD use are available, however, there are no regulations or mandates to seek professional guidance for assessment of competence, equipment prescription, or training. Occupational therapy theory and practice can support all parts of this process. This thesis presents a three-part study using a mixed methods approach to (i) examine PMD use related incidents and injuries within residential aged care, (ii) to evaluate existing measurement tools, and (iii) to develop and undertake initial validation of a new screening tool developed for residents who use PMDs, based on classical test theory (De Vellis, 2006). The new screening tool will address a gap identified among screening tools for PMD capacity and performance skills specific to this population, to improve the balance between much needed autonomy and safety for all stakeholders.
- Description: Master of Health (Research)
Powered mobility device use in residential aged care : a retrospective audit of incidents and injuries
- Dickson, Natalie, Gohil, Apeksha, Unsworth, Carolyn
- Authors: Dickson, Natalie , Gohil, Apeksha , Unsworth, Carolyn
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Powered wheelchairs and motorised mobility scooters, collectively called powered mobility devices (PMD), are highly valued by older Australians, including those living in residential care, to facilitate personal and community mobility. The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, however, there is very little literature on supporting residents to use PMDs safely. Prior to developing such supports, it is important to understand the frequency and nature of any incidents experienced by residents whilst using a PMD. The aim of this study was to determine the number and characteristics of PMD use related incidents occurring in a group of residential aged care facilities in a single year in one state in Australia including incident type, severity, assessment, or training received and outcomes on follow-up for PMD users living in residential aged care. Methods: Analysis of secondary data, including documentation of PMD incidents and injuries for one aged care provider group over 12 months retrospectively. Follow-up data were gathered 9–12 months post incident to review and record the outcome for each PMD user. Results: No fatalities were recorded as a direct result of PMD use and 55 incidents, including collisions, tips, and falls, were attributed to 30 residents. Examination of demographics and incident characteristics found that 67% of residents who had incurred incidents were male, 67% were over 80 years of age, 97% had multiple diagnoses and 53% had not received training to use a PMD. Results from this study were extrapolated to project that 4,453 PMD use related incidents occur every year within Australian residential aged care facilities, with the potential for outcomes such as extended recovery, fatality, litigation, or loss of income. Conclusion: This is the first time that detailed incident data on PMD use in residential aged care has been reviewed in an Australian context. Illuminating both the benefits and the potential risks of PMD use emphasizes the need to develop and improve support structures to promote safe PMD use in residential aged care. © 2023, Crown.
- Authors: Dickson, Natalie , Gohil, Apeksha , Unsworth, Carolyn
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Powered wheelchairs and motorised mobility scooters, collectively called powered mobility devices (PMD), are highly valued by older Australians, including those living in residential care, to facilitate personal and community mobility. The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, however, there is very little literature on supporting residents to use PMDs safely. Prior to developing such supports, it is important to understand the frequency and nature of any incidents experienced by residents whilst using a PMD. The aim of this study was to determine the number and characteristics of PMD use related incidents occurring in a group of residential aged care facilities in a single year in one state in Australia including incident type, severity, assessment, or training received and outcomes on follow-up for PMD users living in residential aged care. Methods: Analysis of secondary data, including documentation of PMD incidents and injuries for one aged care provider group over 12 months retrospectively. Follow-up data were gathered 9–12 months post incident to review and record the outcome for each PMD user. Results: No fatalities were recorded as a direct result of PMD use and 55 incidents, including collisions, tips, and falls, were attributed to 30 residents. Examination of demographics and incident characteristics found that 67% of residents who had incurred incidents were male, 67% were over 80 years of age, 97% had multiple diagnoses and 53% had not received training to use a PMD. Results from this study were extrapolated to project that 4,453 PMD use related incidents occur every year within Australian residential aged care facilities, with the potential for outcomes such as extended recovery, fatality, litigation, or loss of income. Conclusion: This is the first time that detailed incident data on PMD use in residential aged care has been reviewed in an Australian context. Illuminating both the benefits and the potential risks of PMD use emphasizes the need to develop and improve support structures to promote safe PMD use in residential aged care. © 2023, Crown.
- Unsworth, Carolyn, Baker, Anne, Brito, Sara, Das Neves, B., Dickson, Natalie, Gohil, Apeksha, Kahandawa, Gayan, Naweed, Anjum, Timmer, Amanda
- Authors: Unsworth, Carolyn , Baker, Anne , Brito, Sara , Das Neves, B. , Dickson, Natalie , Gohil, Apeksha , Kahandawa, Gayan , Naweed, Anjum , Timmer, Amanda
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Transport and Health Vol. 25, no. (2022), p.
- Full Text: false
- Reviewed:
- Description: Introduction: With an ageing population, increasing numbers of people are using mobility devices, such as wheelchairs or scooters, whilst travelling on public route buses. The regulations and availability of active (wheelchair tie down and occupant restraint systems or WTORS) and passive (rearward facing) mobility device restraint systems on buses varies between countries. To date few studies have investigated passenger feedback on the use of restraint systems. This study aimed to gather feedback about WTORS on buses from passengers where these are in use (United States) and not in routine use (Australia) to guide decisions on their introduction. Methods: A prospective study using a purpose-designed electronic survey. Participants, predominantly recruited by Qualtrics, comprised two groups; mobility device and ambulant bus users in two countries; Australia and the United States (US). Results: The 448 participants rated the top two most important factors when deciding if buses should have WTORS as safety and comfort. Ninety-two percent of respondents believed people using mobility devices should use a WTORS which was rated 7.66/10 (SD1.97) as effective to prevent injuries to self or others. Only a minority of participants (13.2%) had ever slid or fallen from their mobility device, or seen a person slide or fall (13.6%) while on a bus with no differences between countries despite WTORS not being in use in Australia. Respondents reported it was OK to delay a journey an average of 5.52 (SD 2.89) minutes to secure/release a restraint system, which compares favourably to literature-reported real time of one to 4 min. Conclusions: Although WTORS were widely perceived by participants as important for safety, questions concerning their effectiveness to prevent slide or tip remain. Prior to the introduction of any securement system in Australia, the effectiveness of passive occupant containment systems to prevent slide or tip also warrants investigation. © 2022
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