Missed care in residential aged care in Australia: An exploratory study

Background The phenomena of missed nursing care is usually measured through quantitative surveys that detail the specific tasks that are rationed or delayed, and the reasons why this is so. These studies report high levels of agreement within and across countries between the two major measures employed; the Kalisch's MISSCARE tool and the RN4Cast Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Most of these studies have been conducted in acute care settings and demonstrate the impact of lack of human and other resources upon decisions to omit care. Less in known about missed care in residential aged care Aim To explore the frequency and causes of missed care in residential aged care in three Australian states: New South Wales, Victoria and South Australia. Methods Quantitative and qualitative data from 922 respondents working in residential aged care to the MISSCARE survey were bought together to identify the tasks missed in aged care and reasons for this. Findings Respondents report the omission of unplanned care (toileting and answering bells) and rehabilitative care. The primary reasons for missed care are staffing shortages and difficulties in meeting residents’ complex health care needs due to demands arising from increased resident acuity and fewer skilled nurses to meet this demand. Conclusion Resident care is missed in residential aged care with staffing numbers identified as a key cause

The Importance of VET teacher professionalism : an Australian case study

The effectiveness of vocational education and training (VET) systems depends upon their teachers. The teachers are regarded as “dual professionals,” requiring expertise in both their background industry areas and in VET pedagogy itself. This chapter uses Australia as a case study of what happens when the accepted regime of qualifications for VET teachers alters. In Australia full-time VET teachers were, until recently, required to undertake degree level qualifications in VET pedagogy, taught at universities, either before or, more usually, after entering the occupation. The required level has now reduced to the regulatory minimum of a Certificate IV level qualification, taught by training providers not universities, and often provided to their own teachers. The qualification contains only 300 nominal hours of training. It has been recognized as a particularly poorly taught qualification, requiring the introduction of a high degree of regulation and most recently a special compliance framework for training providers wishing to deliver it. In this chapter, the historical path of the decline in VET teacher professionalism in Australia is charted, including research evidence from a national project managed by the author, about the effects of higher-level qualifications on VET teacher practices and quality and teachers’ propensity to engage in professional development. A conceptual model of the attributes of professional VET teachers with regard to qualifications and professional development is presented. The chapter concludes with some recommendations for change and implications for other countries