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Population ageing is a success story of our time. Unfortunately healthcare, especially in hospitals has been slow to adapt to the changing needs of the community.

Background and/or rationale: "Specialling" is a common nursing practice in hospitals which entails the allocation of extra staff to be with an older person who is confused to maintain safety. Despite ongoing use, this practice has little evidence of effectiveness. To facilitate further investigation, a concept analysis of "specialling" was undertaken. Aims: The aim of this paper was to report on a concept analysis on the practice of "specialling" pertaining to older people who have cognitive impairment when in hospital. Methods: This study used Rodgers evolutionary approach to concept analysis to clarify the attributes, antecedents and consequences of the concept to determine a definition of "specialling." Web of Science (Core Collection and Web of Science Medline), CINAHL and SCOPUS databases were searched to identify relevant literature. Due to the scarcity of papers, the search was broadened to include all sources that could add understanding. Findings: A total of (n = 43) sources were identified. The attributes were themed to 5 categories: Labels and descriptions; the "Special" role; Patient safety; Patient care; and Communication. The antecedents to 2 themes: Patient characteristics; and Organisational risk. The consequences of "specialling" were diverse with 6 themes: the "Special" role; the Older persons experience; Costly; "Special" use and nursing beliefs; Safety outcomes; and Opportunities. Discussion: The process of concept analysis provided a means to identify knowledge gaps and practice challenges. The definition determined from this analysis has provided a reflective opportunity for clinicians and researchers to consider when implementing care initiatives to support older people in hospital. Important is the lack of person-centred approaches and the opportunities in developing nurse leadership through empowerment. The findings from this analysis will inform a PhD study. Implications for practice: Nurses have an opportunity to lead care improvements by

presented at the 11th International Association of Gerontology and Geriatrics Asia/Oceania Regional Congress, 23-27 October 2019, Taipei, Taiwan

Background: The global acceptance and use of technology in health care has resulted in an abundance of mobile health (mHealth) applications (apps) available for use in the delivery and improvement of care. With so many apps available to patients and clinicians, it is important to understand how data from apps are being used to inform quality improvement in practice. Aim: The aim of this integrative review is to establish current knowledge of how mHealth apps are used to produce data to inform quality improvement in health care. Methods: Scopus, Web of Science, CINAHL, and Medline Plus Full Text databases were searched for peer-reviewed papers written in English. The inclusion criteria comprised of full-text, empirical research studies relating to mobile health application use (not development) in clinical care. Results: Nineteen studies met inclusion criteria. The functions of the apps outlined in the studies can be summarized into four different categories: communication, illness management, clinical management, and education/information. The types of data collected by the apps included numerical, textual, photographic, and graphical with several apps able to collect a variety of data types. Analysis of the studies showed that although data collection is rarely outlined as the explicit purpose of mHealth apps, data collected through such technology are and can be used to inform practice change both in real time and retrospectively. Linking Evidence to Action: This review highlights while this is an emerging area, data obtained from mHealth apps can and are being used to inform quality improvement in health care. Further research is required in this area to adequately understand how data from mHealth apps can be used to produce quality improvement, specifically in relation to nursing. This review also highlights a need for the development of apps that aim to capture data to inform quality improvement, particularly from the patient perspective.

Poster presentation from the 8th Biennial Australia and New Zealand Falls Prevention Conference, 18-20 November 2018, Hobart, Australia.

There is recognition that working in the aged care setting can be physically and psychologically demanding, stressful and can lead to staff burnout. These types of demands can result in reduced job satisfaction, disengaged staff and can be detrimental to care delivery. In order to address these issues in a 52 bed sub - acute geriatric hospital within Australia, a self-care program was initiated to support staff wellbeing. The staff (nursing, allied health, managers, security staff) themselves were engaged in co-designing the self-care program alongside the project team. The Wellness Wednesday program runs for 45-60mins every Wednesday for eight weeks and includes a variety of self-care strategies e.g. yoga, reflexology, mindfulness and gratitude. There is wide recognition that strategies such as mindfulness can enable healthcare staff to work with compassion in stressful and demanding work environments, improving listening to others, being more present, less judgmental and more considerate of others perspectives. All staff within the hospital were invited to participate in the eight sessions. Each eight week program caters for 10-12 multidisciplinary team members. Throughout the study participants were supported to 'IMAGINE' how the care environment could be enhanced to support the well-being of all staff, suggestions for improvement were captured and submitted to the Imagine committee for consideration. In addition staff were encouraged to use the techniques they were learning with their colleagues and where appropriate with patients (e.g. providing simple hand massage). In this presentation we will share the results of this mixed-methods intervention study including what worked well, how the strategies impacted on improved participant well-being and promoting a healthy workplace culture. Highlighting improvements in staff engagement, job satisfaction, workplace wellbeing and reduced intention to leave. We will also offer insights into how you could use the Imagini

This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

The concept of person-centred practice provides nurses with a framework for undertsanding the complexity of the health-care setting. It is applicable across differing care contexts (from acute care to rehabilitation to care within the home), and flexible enough to take into account the needs of patients of all ages. At its heart is the need for those who work in such contexts to focus on delivery of care that achieves outcomes that benefit the patient, their family and themselves. Providing such care not only nurtures the patient and supports the family, but also ensures staff invest in creating care cultures that result in improved well-being for all. The creation of effective person-centred cultures is neither easy or straightforward; it requires a common vision and goals, strategic planning, systematic approaches, supportive leadership, tenacity and dedication. In this chapter we will be sharing with you how one organsiation has developed Person-Centred Paediatric Practice as the foundation for nursing.

There has been significant work in better managing health-care services as costs in service delivery escalate due to advances in science and technology, an ageing population, and new and emerging diseases requiring increased access to health care. This has occurred without the expected reciprocal increase in quality and safety of care. In addition it has been recognised that the traditional approaches to health-care planning and delivery do not necessarily meet the needs of consumers, are often fragmented, result in waste within the health-care system and do not reflect best practice.