Whanganui District Health Board (WDHB) invested in their commitment to improving patient outcomes with the establishment of a dedicated Centre for Patient Safety and Service Quality. 

One of the early undertakings of the Centre was to review practice around internationally recognised issues that increased risk of injury and decreased the quality of life in vulnerable elderly patients.  Of particular interest to WDHB was the incidence of falls, malnutrition, incontinence, pressure areas and the use of restraint. 

The survey was a collaborative effort between WDHB, Dr Jan Weststrate from the Graduate School of Nursing Midwifery at Victoria University, the project group LPZ, Maastricht University, Netherlands and most importantly the aged care providers who opted to participate in the survey. 

The survey was originally focused on Wanganui Hospital Services however the decision was made to invite local aged care providers to participate, which they did willingly and during one week in April 2010, 15 of the 17 local aged care providers were surveyed and 336 residents were assessed for the presence of pressure ulcers, incontinence, malnutrition, use of restraint in the past week and falls.

The results indicate that on average, 14% of the participants had a fall within the previous two weeks, and 9% were restrained as a way to prevent falls.  Six percent of participants suffered from a pressure ulcer, some for longer than six months, 55% experienced either urinary/faecal or double incontinence and 23% were malnourished.

Conducting this study and making the results publicly available is a brave move by Whanganui DHB and is a reflection of our commitment, in partnership with our service providers, to improving patient outcomes.  Overall, the results are low compared to international benchmarks, including Queensland Australia where similar studies have been conducted.  

The survey results should not in any way be seen as a reflection of poor patient care by our service providers, in fact the survey team were impressed with the overall standards of care.  Many of the indicators surveyed, such as malnourishment, are more an indicator of overall population health.  Malnourishment amongst the elderly population at large is a complex issue, often a subset of other aged related illness and can apply to obesity as much as weight loss.

Having access to such data enables us to understand, benchmark and evaluate performance, and subsequently provides opportunity to make informed, systematic quality improvements to care provision.  This will allow the greater Whanganui care provider community access to information with which to improve patient outcomes.

It is anticipated that the Survey be repeated every one to two years to enable the participating rest homes to measure changes to care and interventions around the five modules.