Mikaela Jorgensen

Macquarie University

Objectives Inclusion of consumer perspectives is a key component to person‐centred health‐care approaches. While current residential aged care systems focus on recording adverse events to meet the requirements of regulatory reporting, little is known about the views of residents. The aim of this research was to explore residents' responses on the t...

In the residential aged care sector medication management has been identified as a major area of concern contributing to poor outcomes and quality of life for residents. Monitoring medication management in residential aged care in Australia has been highly reliant on small, internal audits. The introduction of electronic medication administration s...

Background People with intellectual disabilities are at much higher risk of preventable deaths compared to the general community. However, studies identifying the cause of death in people with intellectual disability are generally based on one primary cause which is frequently attributed to the person's disability. Therefore, the aim of this study...

Objectives Restrictive practices (RP) include any practice or intervention that infringes on the rights and freedom of movement of people with disability, including those with neurodevelopmental disorders (NDD). The use of RP is inconsistent with the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The objective of this...

Background: Pharmacological interventions are frequently used for people with autism spectrum disorder (ASD) to manage behaviours of concern, including irritability, aggression, and self-injury. Some pharmacological interventions might help treat some behaviours of concern, but can also have adverse effects (AEs). Objectives: To assess the effec...

Background: There is evidence that psychotropic medications are overprescribed and overused to manage behaviours of concern for people with intellectual disabilities. Disability support workers and support staff lack education and training on the administration and safety of psychotropic medication use. This study aimed to test the applicability a...

While disability is recognised by the United Nations Convention on the Rights of Persons with Disabilities (CRPD) as an evolving concept, the language of positive behaviour support has not kept pace with the current human rights-based approach. The widely-used terms ‘challenging behaviour’ and ‘behaviours that challenge’ imply that the behaviour is...

Background: Adults with intellectual disability are at higher risk of being administered psychotropic medications. The UK-developed SPECTROM (Short-term PsychoEducation for Carers To Reduce Over Medication of people with intellectual disabilities) training programme educates disability support workers on psychotropic medications and alternatives t...

Background: Adverse incidents are well studied within acute care settings, less so within aged care homes. The aim of this scoping review was to define the types of adverse incidents studied in aged care homes and highlight strengths, gaps, and challenges of this research. Methods: An expanded definition of adverse incidents including physical, soc...

There is a growing awareness of the need to create residential care systems for older people that encompass strong safe environments and effective clinical care processes alongside attention to dignity and quality of life. Drawing on three studies: i) a scoping review of 46 published articles; ii) examination of 67,000 residential aged care inciden...

In 2020, Dr Jeffrey Chan from the Australian National Disability Insurance Scheme Quality and Safeguards Commission (The NDIS Commission), Mandy Donley from Life Without Barriers, and Associate Professor Nathan Wilson from Western Sydney University met to explore a shared interest in reducing the unnecessary use of psychotropic medication in pe...

What adversely impacts older people in residential aged care? Drawing from three studies (a scoping review, analysis of incident report data, and interviews with residents), this presentation brings together differing perspectives on adverse incidents in aged care. Emerging themes are presented which challenges the traditional definition of advers...

Objectives: Australia is lagging behind other countries in implementing quality indicators (QIs) in home- and community-based aged care. This research aimed to identify and appraise home care QI sets used internationally for older adults, to inform the future development and utilisation of QIs in the Australian context. Methods: A systematic sea...

Background Falls in older adults remain a pressing health concern. With advancements in data analytics and increasing uptake of electronic health records, developing comprehensive predictive models for fall risk is now possible. We aimed to systematically identify studies involving the development and implementation of predictive falls models which...

Adverse events research in residential aged care predominately focuses on physical impacts experienced by older persons living in aged care. Yet the WHO definition of health describes health as not only as the absence of disease, but the intersection of physical, mental, and social wellbeing. This paper draws on evidence from (i) a scoping review o...

The Australian residential aged care sector has been under scrutiny throughout the Royal Commission. The release of the final report and its recommendations have shown new thinking is required to facilitate a system combining medical care with social care, one that takes a person-centred approach to understanding events which impact its users and t...

Objective Adverse incident research within residential aged care facilities (RACFs) is increasing and there is growing awareness of safety and quality issues. However, large-scale evidence identifying specific areas of need and at-risk residents is lacking. This study used routinely collected incident management system data to quantify the types an...

Social participation is critical to the health and well‐being of older adults, however, participation often declines with age. Research has identified that personal and environmental factors such as high socioeconomic status and accessible transportation are associated with higher levels of social participation. However, the barriers and facilitato...

Objectives: The size and type of older adults’ social networks is associated with health, mental and social outcomes. Investigators within many disciplines are now measuring social networks, but it is not always clear what they are assessing, or which measures may best meet their objectives. To undertake a systematic review to identify (i) social n...

Electronic information systems are becoming increasingly common in residential aged care in Australia. These systems contain valuable data generated during day‐to‐day care delivery for older adults. These data (termed ‘routinely collected residential aged care provider data’) are currently underutilised, however have potential significant benefits...

Introduction There is a clear need for improved care quality and quality monitoring in aged care. Aged care providers collect an abundance of data, yet rarely are these data integrated and transformed in real-time into actionable information to support evidence-based care, nor are they shared with older people and informal caregivers. This protocol...

Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets. Methods A retrospective sample of 1...

Background Social isolation is an increasing concern for older adults who live in the community. Despite some availability of social support programs to address social isolation, their effectiveness is not routinely measured. This study aimed to evaluate an innovative excursion-based program offering unique social experiences to older adults receiv...

Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets. Methods A retrospective sample of 11...

Objective The aim of this study was to quantify the work activities of community aged care case managers and assess changes following consumer-directed policy reforms. MethodsA longitudinal, time and motion study was performed, with direct observation (n=339h) of case managers undertaking work in the office or in the community. We compared the dist...

Across Residential Aged Care Facilities (RACF), electronic management systems collecting clinical and care management information including Adverse Events (AE), have become common place. AE research has focused on individual types of events and evaluation of mitigation strategies. However, the sector still lacks a clear overview of the burden of AE...

Background: The number of older Australians using aged care services is increasing, yet there is an absence of reliable data on their health. Multimorbidity in this population has not been well described. A clear picture of the health status of people using aged care is essential for informing health practice and policy to support evidence-based,...

Background Transdermal medication patches have caused serious adverse events in residential aged care facilities (RACFs). Preliminary research suggests that facilities are using a workaround consisting of manually entered reminders in their electronic medication administration records (eMARs) to prompt staff to check and remove patches, because the...

Falls are the leading cause of injury and hospitalisation for older adults (aged 65 years or older) worldwide. Data collected by community aged care providers are an underutilised source of information about precipitating risk factors and consequences of falls for older adults living in the community. The objective of this longitudinal, observation...

Aged care services have the potential to support social participation for the growing number of adults aging at home, but little is known about the types of social activities older adults in community care are engaged in. We used cluster analysis to examine the current profiles of social participation across seven domains in 1,114 older Australians...

This study developed a model for using Google Analytics (GA) data to evaluate utilisation trends of the Sydney North HealthPathways portal. HealthPathways GA data merged with dates of page localisations and promotional events from March 2017 through June 2018 were analysed to evaluate engagement and use of HealthPathways, integration into clinical...

Background : The number of older Australians using aged care services is increasing, yet there is an absence of reliable data on their health. Multimorbidity in this population has not been well described. A clear picture of the health status of people using aged care is essential for informing health practice and policy to support evidence-based,...

Background: The number of older Australians using aged care services is increasing, yet there is an absence of reliable data on their health. Multimorbidity in this population has not been well described. A clear picture of the health status of people using aged care is essential for informing health practice and policy to support evidence-based, e...

Objective: To utilise routinely collected data to examine changes in the client profile of a large aged care provider before and after commencement of the 2017 policy reforms, whereby home care packages were allocated to individuals rather than providers. Methods: Interrupted time series analysis was used to measure changes in service uptake and...

Objectives (1) To describe the processes used to plan and conduct a stakeholder forum in aged care as a means of informing future uptake of consumer participatory research. (2) To discuss how capturing and drawing on stakeholders’ experiences of aged care can generate new research ideas and inform the delivery of more person-centred aged care servi...

Background Physiotherapy can improve functional ability, prevent falls and reduce pain for older adults in nursing homes. However, there are no legislations or guidelines that specify the parameters of physiotherapy required in nursing homes. With the increasing healthcare demands of ageing populations worldwide, it is important to understand the c...

Osteoporotic fractures impose substantial morbidity and mortality among older adults. Undertreatment is an ongoing concern; treatment rates declined following reports of adverse effects of guideline-recommended bisphosphonates, but new antiresorptives have since become available. Our goal was to identify contemporary trends in osteoporosis treatmen...

Background Several outcome measures can be utilised to measure social participation and Quality of Life (QoL) in research and clinical practice. However there have been few large-scale trials of these tools in community care to identify their value to clients and providers. This study aims to evaluate the implementation of the Australian Community...

Rich social relationships contribute to improved well-being and health outcomes, yet aged care client assessments tend to focus almost exclusively on physical issues. We aim to explore the experiences of aged care staff following their use of social engagement and well-being instruments as part of routine assessments for home-care clients. The soci...

Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines. Design: A cross-sectional analysis of eMAR data. Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia. Participants...

Objective: To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Design: Longitudinal incidence study using routinely-collected electronic care management data. Setting: A large aged care service provider in New South Wales and...

Objective: To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care. Design: Longitudinal cohort study using routinely collected client management data. Setting: A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. Partici...

Objectives A key target to reduce the gap in early childhood outcomes between Australian Aboriginal and non-Aboriginal children has been to increase preschool enrolment rates, particularly in remote communities. However, there is little population-based information on preschool attendance and its impact on child development for Aboriginal children...

Objectives Almost one-fifth of Australian Aboriginal mothers give birth before 20 years of age compared with 3% of non-Aboriginal mothers. We aim to quantify the effect of maternal age at birth on child development outcomes in Aboriginal compared with non-Aboriginal children. Approach The ‘Seeding Success’ study cohort comprises an almost complete...

The challenge of providing services that meet the growing needs of an ageing population is one confronted by communities across Australia and internationally. The aim of this study was to: a) undertake semi-structured interviews and focus groups across a sample of service and technical staff to identify the interconnection between communication, in...

Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. With population aging and increases in survival, the number of CRC survivors is projected to rise dramatically. The time following initial treatment is often described as a period of transition from intensive hospital-based care back into “regular life.” This review prov...

Clinicians are less likely to recommend adjuvant chemotherapy for older adults based on their age alone. This study aimed to develop a mortality risk model to assist treatment decision making by identifying patients who are unlikely to live to benefit from chemotherapy. All lymph node-positive colon cancer patients ≥65 years who received surgery in...

Objectives To investigate the effect of patient age on receipt of stage-appropriate adjuvant therapy for colorectal cancer in New South Wales, Australia. Materials and Methods A linked population-based dataset was used to examine the records of 580 people with lymph node-positive colon cancer and 498 people with high-risk rectal cancer who underwe...

Context: The Eastern Cooperative Oncology Group/World Health Organization Performance Status (ECOG/WHO PS) is a prognostic factor. It should be used in analyzing health outcomes such as risk-adjusted hospital performance models in cancer populations. Performance status is rarely recorded in surgery, often the place where cancer is first diagnosed....

To identify predictors of variation in colorectal cancer care and outcomes in New South Wales. Multilevel logistic regression analysis using a linked population-based dataset based on the records of patients with cancer of the colon, rectosigmoid junction or rectum who were registered in 2007 and 2008 by the NSW Central Cancer Registry and treated...

Rates of abdominoperineal resection (APR) have been suggested as a solitary surrogate marker for comparing overall hospital quality in rectal cancer surgery. This study investigated the value of this marker by examining the associations between hospital APR rates and other quality indicators. Hospital-level correlations between risk-adjusted APR ra...

Older colorectal cancer patients are significantly less likely than younger patients to receive guideline-recommended adjuvant chemotherapy. Previous research has indicated that patient refusal of treatment is a contributing factor. This study aimed to identify potential barriers to adjuvant chemotherapy use in older patients by examining the assoc...

Cancer is primarily a disease of ageing, yet the unmet supportive care needs of older cancer patients are not well understood. This study aims to explore how unmet needs differ by age over the 3 months following colorectal cancer surgery. Control groups from pilot phases of an ongoing randomised trial completed the Supportive Care Needs Survey-Shor...

Increasing patient age independently predicts nonreferral and nonreceipt of adjuvant therapy among patients with colorectal cancer. This study aimed to identify factors affecting surgeons' decisions to refer older patients for adjuvant therapy. DESIGN/SETTINGS/PARTICIPANTS: A self-administered survey was sent to all Australian and New Zealand color...

To investigate the effects of a familiar communication partner on the production of narrative after traumatic brain injury (TBI). Ten participants with TBI were matched with 10 control participants for sex, age, and education. Participants independently retold a story from a picture sequence and also retold a video segment with a friend to a resear...