Aim
To determin if the clients or an organization would gain any benifit from monitoring managed behaviours in the ACQA indicators.
To make the behaviour of concern indicator relevent to ACQA members
Background
The behaviour of concern indicator is not being used consistantly across the group of ACQA users, it is a need of ACQA to understand why this is not being used and how it will provide value to the users of ACQA. The Behaviour of concern indicator was launched in 2009 after extensive consulation and research.
The rational for the behaviour of concern indicator is
The aim of this indicator is to identify resident and organisation trends that will encourage members to identify improvements to reduce the risk of ongoing incidents of behaviour of concern (ACQA Guidelines)
Then we need to define what is a Behaviour of Concern?
Definition:A behaviour of concern is any behaviour that is causing distress, risk or actual harm to either the resident, or others.(ACQA Guidelines)
Behavioural management is an ongoing monitoring and maintenance process which is captured in care planning and in the exceptional reporting. The residential care manual states that
Behavioural management—The needs of residents with challenging behaviours are managed effectively. (Residential Care Manual Commonwealth of Australia 2009 pg 55).
It was agreed at an ACQA forum meeting that behaviour was more than a single incident and its management but a complex aray of statergies that were employed daily to ensure that the incidents did not happen. This management plan my be born out of incident management but it becomes an intrinsic and elemental aspect of the work that is done with the clients by nursing staff and carers.
With every aspect of care that is provided in residential care the Aged care standards are the final word in what out comes we should achive and Outcome 2.13 Behavioural management - Results - Management demonstrates its approach to behavioural management is effective in meeting residents needs, then in the processes, How does the home evaluate and review behavioural management practices in meeting needs of the residents.
Using the behaviour of concenr indicator as a measuring stick of problem behaviours that are managed satifys this outcome and would take the monitoring of exisiting behaviours to a new level of consistent review and monitoring.
Method
Use of the behaviour of concern indicator to capture known behaviours of clients and use this as a monitoring tool of behaviours that are managed in a facility.
Plan
The monitoring of managed behaviours in secure dementia sites to see if this benifited the clients with care outcomes and also the organization in planning for care.
These sites capturing all behaviours documented in care plans on the indicator and using this as a way of checking off known behaviours vs incidents to see if through this monitoring the everyday management of clients behaviours are acknoledged, interventions more frequently reviewed
Implementation
At Eudunda the Care plan recorded behaviours were placed on to the indicator tool. This showed that number of behaviours that were managed and highlighted how much work went into the maintenance of residents with significant behaviours as compaired to the rates of incidents. It also showed that there is a period of trial and error that exists on the arival of a new resident. In this period there are more incidnets registered that lead to care plan changes and initatives. Alternativly several incident based care plan issues were able to be reviewed and the interventions that were orriginaly applied reviewed with the goal of minimal intervention.
Issues that evolved were that the descriptions of the behaviours were not broard enough
