Better Practice Award 2014

Better Practice Award Winner 2014

   San Carlo Homes for the Aged

Health and personal care
We’re talking about your medication 


                                                                 Catherine Rosenbrock State Manager Vic/Tas AACQA presents the award to 
                                                                            Ann Dewey
(Nurse Practitioner/Clinical Care Coordinator) 
                                                      & some of the working group which included Clinical staff, Doctor, Pharmacist and Families

Although recognising a need for antipsychotic agents, San Carlo Homes for the Aged has through this project become an advocate for exploration of the need for use of antipsychotic agents in the management of dementia.

The project has resulted in all residents using antipsychotic agents having the rationale for use explored and documented.

A multi-disciplinary working party was established to survey families and explore current literature to ascertain concerns about the use of anti-psychotic medications, what information was needed and establishing family expectations in regards to their level of involvement in care and how the home might create a process that meets these needs.The project resulted in the creation of a facility policy encompassing a formalised evaluation and documentation system for the use of antipsychotic agents. This policy requires input from prescribing physicians, care staff and family. Education is provided for families and staff.

Results have included:

• reduced incidents of documented dissatisfaction with medication usage

• reduction in frequency of anti-psychotic use and dosage thus reducing risk of adverse effects

• more familial conversations regarding dementia management with numerous positive testimonials

• all users now having regular evaluation of effects and rationale for use by doctors and care staff

• staff saying they are able to identify non-pharmaceutical interventions for behaviour management and possible adverse medication events.An education needs analysis also indicated a need for further information relating to dementia management. Substantial attendance at education sessions held supported willingness for staff to develop their skills. The major objective was to, initiate a policy that ensured families were involved in the care process and made aware of medication interventions. This policy also had to involve staff in evaluating the need for use, review effect and formally relay these findings to families and treating professionals. The most extensive partnership has been between staff, RNs, ENs, PCAs, Physiotherapists, GPs, Pharmacists and families, fostered to create open, honest and frequent communication relating to product use, effect and necessity. Visiting general practitioners have been supportive, offering input into documentation development and use.

The Medication Advisory committee has offered guidance and direction into the project, reviewing documents created for both staff and family education and holding frequent education sessions for staff. Visiting pharmacists, in addition to attending meetings, continue to make recommendations relating to dosages and offer input into staff education sessions on a regular basis.

Input and suggestions have also been received from members of the Aged Care Nurse practitioner collaborative.

All commencement of antipsychotic agents is supported by documentation circulated to families and accompanying interview with staff explaining the rationales offered.

Use is commenced when alternative strategies have been documented as ineffective. A number of residents currently using the agents are overseen by Gerontologists.

All current staff have been supplied with a brief document explaining the role of antipsychotic agents and how our facility approaches their use.

Education materials illustrating adverse effects are posted in clinical areas. The project is also currently discussed at staff orientation sessions.

Residents (or their representatives) when admitted to the facility using these agents, have literature supplied in the admission package, relating to facility evaluation policy and an interview is completed to assist families in obtaining information they require.

Panel member’s comments: The site has adopted a policy of communication openly, honestly and transparently. This is often a very difficult thing to do in Aged Care let alone any industry. It is a focussed project that appears to have got great results so far and has been operating for a number of years. The ability for staff to now identify non-pharmaceutical interventions is a fantastic result.

An outstanding Project Management Plan was adopted as can be seen above. There is significant evidence of the sound project management and rigorous approach adopted here. All steps have been identified.

A small project with clearly articulated project goals. A strong methodology. Good results in bringing all parties together in an open and transparent manner.


San Carlo has also had success with iCare's electronic medication program and have recently implemented the new version for iPads.

Please click on the link to read more.