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Haematomas of the lower limb are traumatic wounds that can have serious and often debilitating consequences; especially in the aged. Wound healing may be protracted due to multiple factors including disruptive consumer behaviours from poor cognition from dementia. This case study describes the management of an elderly consumer with dementia in a nursing home who sustained an extensive haematoma that resulted in a complex wound. Wound management was provided under local restrictions imposed by COVID-19. The importance of using holistic wound assessment frameworks and evidence-based approaches to wound management to achieve positive wound healing outcomes are emphasised. [ABSTRACT FROM AUTHOR]

Background: Peripheral artery disease (PAD) is implicated in up to 50% of diabetes-related foot ulcers (DFU) and significantly contributes to morbidity and mortality in this population. An evidence-based guideline that is relevant to the national context including consideration of the unique geographical and health care system differences between Australia and other countries, and delivery of culturally safe care to First Nations people, is urgently required to improve outcomes for patients with PAD and DFU in Australia. We aimed to identify and adapt current international guidelines for diagnosis and management of patients with PAD and DFU to develop an updated Australian guideline. Methods: Using a panel of national content experts and the National Health and Medical Research Council procedures, the 2019 International Working Group on the Diabetic Foot (IWGDF) guidelines were adapted to the Australian context. The guideline adaptation frameworks ADAPTE and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were applied to the IWGDF guideline for PAD by the expert panel. Recommendations were then adopted, adapted or excluded, and specific considerations for implementation, population subgroups, monitoring and future research in Australia were developed with accompanying clinical pathways provided to support guideline implementation. Results: Of the 17 recommendations from the IWGDF Guideline on diagnosis, prognosis and management of PAD in patients with diabetes with and without foot ulcers, 16 were adopted for the Australian guideline and one recommendation was adapted due to the original recommendation lacking feasibility in the Australian context. In Australia we recommend all people with diabetes and DFU undergo clinical assessment for PAD with accompanying bedside testing. Further vascular imaging and possible need for revascularisation should be considered for all patients with non-healing DFU irrespective of bedside results. All centres treating DFU should have expertise in, and/or rapid access to facilities necessary to diagnose and treat PAD, and should provide multidisciplinary care post-operatively, including implementation of intensive cardiovascular risk management. Conclusions: A guideline containing 17 recommendations for the diagnosis and management of PAD for Australian patients with DFU was developed with accompanying clinical pathways. As part of the adaptation of the IWGDF guideline to the Australian context, recommendations are supported by considerations for implementation, monitoring, and future research priorities, and in relation to specific subgroups including Aboriginal and Torres Strait Islander people, and geographically remote people. This manuscript has been published online in full with the authorisation of Diabetes Feet Australia and can be found on the Diabetes Feet Australia website: https://www.diabetesfeetaustralia.org/new-guidelines/. [ABSTRACT FROM AUTHOR]

Objective: To use participatory action research (PAR) to understand workplace engagement of caregivers in aged residential care (ARC) in New Zealand. Methods: A PAR study was conducted in a 40‐bed ARC facility providing rest home‐ and hospital‐level care in rural New Zealand. The four‐step study included an advisory group of caregivers (N = 6) who co‐designed the process. Data were collected via verbatim transcripts of four advisory group meetings, five interviews with staff and field notes over a period of six months. The data were analysed using thematic analysis. Results: A model was developed to describe factors that encouraged caregivers' engagement in their work. Caregivers were more engaged in their workplace when the influencers of 'Communication', 'Contributing to the workplace' and 'Caring for oneself' were present and when they experienced 'feeling valued', 'being heard' and 'being listened to'. Conclusion: Factors influencing positive changes in workplace engagement were identified that could be considered when implementing organisational change or service development in other ARC facilities. These factors could potentially increase productivity and quality of care at little cost, as well as improve workplace satisfaction. [ABSTRACT FROM AUTHOR]