Research

Driving change and improving community health through research

The Bolton Clarke Research Institute is our own research and innovation hub, and has forged a reputation both nationally and internationally for high impact community health and aged care research. By translating our research into policy and practice, we help improve services for our clients and the community, and enable more people to gain greater independence, quality of life and choice with regard to their healthcare. Ultimately, our research aims to support our clients’ ability to lead fuller and more satisfying lives.

Our team

The Bolton Clarke Research Institute comprises a multi-disciplinary team of research fellows and officers, and is underpinned by a strong governance framework including an ethics committee.

Our Work

Our approach to research is to identify pressing health needs, and co-design studies with our clients and families, nurses and carers to understand these needs and find ways to resolve them. We do this by listening to our clients and expert clinicians, and by leading research collaborations with national and international researchers, universities and centres in the areas of ageing, chronic illness, mental health and disability.
Our diverse areas of expertise include healthy ageing, chronic illness management, dementia, mental health, falls prevention and medications management.

 

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Conducting research with Bolton Clarke

All research conducted at Bolton Clarke or by Bolton Clarke staff requires review of the merit and rigour of the research proposal and protocol. In addition, research that has any perceived or actual impact on clients, staff or resources in the clinical area requires support and sponsorship from Bolton Clarke At Home Support Services, Residential Aged Care and Retirement Living.

The Bolton Clarke Human Research Ethics Committee (HREC) protects the welfare and rights of individuals, groups or communities who participate in research projects conducted within Bolton Clarke. If a project involves Bolton Clarke clients or staff, it is preferred that ethical review be undertaken by the Bolton Clarke HREC before submission to other ethic committees.

We welcome approaches from researchers and research organisations or groups to collaborate with Bolton Clarke in conducting research. External applications will be assigned to a Bolton Clarke Research Institute researcher to assist with facilitation of the application process and to actively participate in the research project. Please allow a couple of weeks for the application process when considering your submission date. Within your application, please include a statement outlining the benefit/s to Bolton Clarke from the proposed study.

To submit an enquiry please contact us

Older women living alone

Despite increasing longevity, older women are socially and financially disadvantaged compared to their male counterparts. This negatively impacts on their physical, mental and social wellbeing, and is particularly pertinent for older women living alone at home. Currently there is a significant gap in our knowledge relating to older women living alone and an absence in proven strategies that have been shown to maximize their wellbeing and independence while living in the community. To fill this gap, the Bolton Clarke Research along with Monash University will conduct a mixed-method study to understand the barriers and enablers to accessing services, and what strategies older women may need to maximise their health, wellbeing and independence.

Find out more about this project

Optimises: Diabetes and older Australians

Type 2 diabetes is a chronic disease, with increasing numbers of people developing it with advancing age. Managing diabetes is complex and particularly challenging in older people as they often have other health conditions. Treatment should be individualised, taking into account each older person’s broader health and functional capacity.

While we have information regarding the medicines use of Australians with type 2 diabetes, we do not have any information about the current diabetes management patterns in older people, and whether it aligns with best practice. In addition, there is a lack of information about individualised care and whether it is feasible or safe.

This project is investigating the safety and feasibility of a new model of diabetes care.  It aims to identify current management practices, and then propose best practice diabetes management in the home to improve quality of life for older people, using a specialised community-based diabetes team.

Find out more about this project

Veterans and mental health

Over half of individuals in the Australian Defence Force (ADF) experience a mental health diagnosis in their lifetime. In addition to being at a slightly higher rate than reported for the general community, the profile of diagnosis differs. Access to appropriate mental health services for veterans and their families is often hindered by confusion around entitlements, availability and best practice. There is evidence that ADF family members may experience distress in response to mental health issues, and that good family function is an integral part of maintaining or improving an ADF member’s mental health.

Bolton Clarke Institute is investigating effective mental health services for Australian veterans and their families. By co-creating an evidence-based mental health family toolkit and developing a mental health training program for community nurses, this project aims to progress evidence and support in the area of veteran’s mental health.

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Digital health solutions

The burden of chronic disease, particularly in our older population, threatens to overwhelm many aspects of the health system in Australia. As a major health service provider across the country, Bolton Clarke’s reform agenda is addressing health system sustainability pressures by embracing new models of care and enabling technologies.

Telehealth solutions provide effective delivery of complex care in a lower cost model, while reorienting the system for supported self-management. The program empowers and enables clients, promotes greater workforce utilisation and ultimately allows more services to be delivered to more people by using technology, clinical expertise and interdisciplinary teams.

The overall aim of this study is to reduce the economic and individual burdens of complex chronic diseases through the implementation of telehealth remote specialist nurse consultancy (teleconsults) compared with usual care (face to face visits).

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Promoting inclusive health care: implementing a framework to support diversity in aged care

 

Understanding and supporting the diverse needs of older Australians, and being able to tailor service provision to meet these needs, is an important component of enhancing the care experience for older Australians. This project aims to increase the knowledge, skills and uptake of knowledge into practice of aged care workers regarding awareness and actions related to diversity.

Twenty-four one-day workshops were delivered nationally to approximately 600 aged care workers. The workshops were evaluated through surveys and interviews, using an evidence-based evaluation framework, to assess knowledge, skills and uptake into practice of diversity principles. This was done from the perspective of aged care workers (including registered and enrolled nurses, home care workers, allied health professionals and service and policy managers) and older Australians receiving care.

A release of a series of publicly available resources based on the findings of the project is planned.

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Keeping feet healthy in people with diabetes

This project involves people with diabetes, clinicians and biomedical engineers in the co-creation of an education app. Once developed, the app will provide easy to access and understand information about foot self-care practices to improve foot health and reduce amputations in people with diabetes.

The app will be piloted for 12 weeks and then evaluated to determine the usage of the app and the change in knowledge, selfcare practices and foot health outcomes in people with diabetes. A second app can be used by clinicians to learn how to assess and manage foot care for people with diabetes, leading to improved service delivery by clinicians. Knowledge and practices of clinicians will also be assessed.

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Early detection of eye disease in vulnerable groups

Diabetic retinopathy and glaucoma are the biggest cause of vision impairment, leading to blindness. Currently there is no cure, although early stage detection of the disease can lead to appropriate treatment to prevent blindness. Diabetes and ageing are the known risk factors for the development of these diseases, and early detection is possible using current technology during a regular visit to the optometrist. However, many older people have difficulty regularly visiting optometrists, and this can lead to eye disease progressing undetected until the vision impairment symptoms are obvious and any possible treatment is ineffective.

In this project, we aim to refine existing software developed by RMIT University, working with the Centre for Eye Research Australia (CERA), to guide Bolton Clarke nurses to record diagnostic quality images using a smart-phone. Images are analysed on the smart-phone and the at-risk cases are transmitted to ophthalmologists of Royal Victorian Eye and Ear Hospital for their expert opinion. The community members with images suspected of requiring intervention are informed and advised to visit the eye-specialist clinic as soon as possible.

Pharmacist Workforce Model Trial

Medication errors, adverse medication events (AMEs), multi-morbidity and polypharmacy are common in older people. Previously, we piloted a model that integrated a formal role for clinical pharmacists working within the community nursing service. The model aimed to provide services to improve medicine safety, reduce risk of AMEs and facilitate interdisciplinary medicines management between community nurses, GPs, community pharmacists and specialists. The model was successfully developed, implemented and evaluated by Bolton Clarke.  This project replicates and implements the model in the eastern region of Melbourne within the Eastern Melbourne Primary Health Network catchment areas. The project is using a mixed methods study design to evaluate the implementation

Falls prevention for people with diabetes

Across the aged care sector, healthcare professionals, including nurses, are responsible for assessing risk factors related to older people. Understanding associated risks in a community care setting is essential to the delivery of quality care.

This project will identify clients living in the community who are at risk of diabetes related falls, and develop a needs-led, strategy-based training workshop to enable our community based nurses to be more effective in assessing risk and implementing fall prevention procedures.

The training programs will address any identified gaps in knowledge by better understanding the profile of community-based people with diabetes who fall and modifying training standards for nurses.

Consumer directed care and workforce retention

Workforce retention and turnover research has generated much interest over the years, particularly in the aged care setting.  The aim of this collaborative study with Griffiths University is to review employee retention, career outcomes and organisational commitment following the shift to consumer directed services in community care.  This will be done through interviews of staff pre and post consumer directed care implementation.

Findings from this project will provide organisations with a better understanding of the factors that influence employees’ intentions to stay or leave the aged care sector. This information can then be used by organisations to enhance workforce attraction and retention strategies.

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Pathways to Care

In Australia, care for the ageing, including community based aged care and health care, is a specialist area sitting between health and social services. Community based health services play an increasingly important role in the lives of older people, supporting them to maintain independence, promote healthy ageing and support health care service provision. The number of people requiring aged care services has been rising exponentially over the last ten years with higher proportion of older people (and particularly the ‘older old’ aged 85+) about to enter the aged care market. Increased demand will require innovative strategies to adapt health and aged care services to respond to these pressures. The relationship between health and ageing is essential to an enjoyable and productive experience of ageing and impacts the ability to age in environments of choice.

Research challenges in this area include the distribution of duty of care between health and aged care systems, impact of funding systems on access to care, aged care workforce clinical capacity, information management between providers, continuity of care, quality of life, advanced care planning and equity in health care access.

This project is taking a grounded theory approach to the systematic exploration and evaluation of pathways to care in the community nursing setting.

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