To co-design and pilot test a best practice model of continence care and knowledge translation resources for Australian residential aged care, a mixed methods study was undertaken. The study had four stages: (1) a scoping review of literature;(2) a survey, interviews and co-design workshops with residential aged care stakeholders; (3) the co-design of a draft model and knowledge translation resources; and (4) a pilot trial of an education program and qualitative interviews with residents. The pilot trial involved a convenience sample of 22 staff (registered and enrolled nurses and personal care assistants) from two Australian residential aged care homes. Staff completed one pre-and two post-education surveys, and 13 aged care residents were interviewed about their views about continence care. Pilot test data revealed post-education improvements in staff knowledge for eight of the ten questions, and 100% agreement on the feasibility, appropriateness and acceptability of the model and education program. Of the 22 participants, 63% rated the education as 'very helpful' in applying the model to practice and 37% rated it as 'somewhat helpful'. There was no statistically significant difference between the results of any of the three assessment surveys. A content analysis of resident interviews validated the importance of evidence-based, safe, clinically-informed, person-centred continence care that optimises a resident's functional abilities and responds to their individual needs, choices and dignity. The Continence Foundation of Australia has used these findings to design Continence SMART Care (CSC), which represents best practice continence care, meets the Aged Care Quality Standards, and aligns with current reform strategies for the aged care sector. Further research is required to determine the impact on practice and resident outcomes, and its relevance for use in other settings or countries.

There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the individual residents.

Background Physical activity is important to maintain health in older age, with physical activity in the outdoors providing mental and physical health benefits for all age groups. One way by which older people can engage in physical activity in the outdoors is through using suitable age-friendly outdoor exercise equipment, the Seniors Exercise Park. The ENJOY MAP for HEALTH aims to evaluate the effect of the Seniors Exercise Park installation and associated capacity building activities on park visitation, park-based physical activity by older people and delivery of community physical activity programs. Method This study is a quasi-experimental (natural experiment) with pre and post study design evaluating the effect of age-friendly outdoor spaces with specialised outdoor exercise equipment on older people’s physical activity and wellbeing in six Victorian municipalities (local governments/councils). Each council will undergo four stages (site construction and development, promotion and marketing, capacity building and training, evaluation and sustainability). Several activities and methods will be employed from stage one through stage four to evaluate the potential impact of the age-friendly outdoor spaces on physical activity and wellbeing and will comprise the following elements: site observation and equipment utilisation, face to face intercept surveys, development of an online access monitor and community building activities. Discussion The project is expected to result in a significant change in the physical outdoor environment for the participating councils and communities whereby older people and other community members will be able to engage in safe physical and social activity programs, socialise more and hence improve the overall wellbeing of older people. Trial registration This trial is retrospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808. Date registered 23/07/2021.

Objective: To investigate the dispensing, administration and omission of medications in residential aged care (RAC) homes in New Zealand (NZ). Methods: Secondary data from a medication management database were analysed, to identify the most frequently omitted regular medications and commonly reported reasons for omissions in a sample of 11 015 residents across 374 RAC homes. Results: Overall, 3.59 medication doses were omitted per 100 (±7.4) prescribed doses per resident (SD 7.43). Common regular medications omitted ranged from analgesics to psychotropic medications. Recording of justifications for medication omissions was inconsistent-only 48% of omissions had a recorded reason. Conclusions: A wide range of medications are regularly prescribed and administered to RAC home residents in NZ. Omitted doses are frequently recorded without a justification. Inconsistent recording of omissions can increase potential for error, particularly in relation to psychotropic medications. More consistent recording may help staff to maintain a high standard of quality care. K E Y W O R D S aged care, new zealand, geriatric medicine, psychotropic drugs, nursing homes | e491 GARRATT eT Al.