Excellence - New Zealand Aged Care Association

THIS
ISSUE
P2 CEO:
NEW ONLINE FORMAT
P3 JUDITH JOHNSON:
WHAT MAKES ME CRINGE?
P6 RESEARCH ROUNDUP
PRACTICE AND CARE
P12 ACC UPDATE
VITAMIN D IN AGED CARE
CONFERENCE 2013
Moving with the Times
MARK YOUR DIARY NOW
SkyCity Convention Centre
Auckland 28 – 30 August 2013
Excellence
APRIL 2013
in CARE
One voice for the aged residential care sector www.nzaca.org.nz

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One voice for the aged residential care sector www.nzaca.org.nz

Excellence in CARE April 2013 www.nzaca.org.nz
Advertising
For enquiries regarding
advertising or to place
an advertisement in
Excellence in CARE
please contact:
Robyn Gray
National Office
New Zealand Aged
Care Association
PO Box 12481
Wellington 6144.
Phone: 04 473 3159
Fax: 04 473 3554
NZACA National
Office Staff
Martin Taylor
CEO
martin@nzaca.org.nz
Robyn Gray
Conference Manager
robyn@nzaca.org.nz
Alyson Kana
Policy Advisor
alyson@nzaca.org.nz
Jennifer Taylor
Administration
jennifer@nzaca.org.nz
Asti Laloli
asti@nzaca.org.nz
Accounts
accounts@nzaca.org.nz
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UPfront
2. CEO’s Report
Martin Taylor on the new online format
Features
3. Words from the Wise
What Makes Me Cringe? By Judith Johnson,
Consultant to the Aged Care Sector
5. Conference 2013
Moving with the Times. MARK YOUR DIARY NOW.
6. Research Roundup
A summary of the latest in evidence-based
practice and care.
8. Infection Protection is in Your Hands
By Judy Forrest Infection Control Consultant
Bug Control New Zealand Ltd
10. Paying Too Much for your Bread
and Dairy Products
Goodman Fielder: Our Homegrown Food Company
11. Five Ways to Motivate your Staff to
Complete Education Programmes
By Julie Sparks, General Manager, Health Ed Trust
12. Update: Vitamin D Used in
Aged Care Facilities
By Judith Johnson, Consultant to the Aged Care Sector
13. NZACA Prefered Suppliers
Disclaimer:
The information in this publication is given in good faith and has been derived from
sources believed to be reliable and accurate. However, neither New Zealand Aged
Care Association nor the publishers accept any form of liability whatsoever for its
contents, including advertisements, editorials, opinions, advice or information, or
any consequence of its use.

UPfront
THE CEO’S MESSAGE
CEO MARTIN TAYLOR
CEO’s Message
NZACA’s New Online Magazine
The New Zealand Aged Care Association’s magazine Excellence in Care has
undergone a transformation with the New Year and moved into the future.
Moving to an online format we hope to make it more accessible to members
and their staff.
Our goal is to provide the best possible content to support you and your business.
Our goal is to
provide the
best possible
content to
support you
and your
business
The content of this magazine and future issues has also undergone a face lift.
We are looking to provide up-to-date information, support and articles that are
topical and relevant to our sector. New regular sections of this magazine include
elder law information from Barrister Wendy Aldred, “Words from the Wise” sees
aged care consultant Judith Johnson share her knowledge and experience from
decades of working, owning and consulting to the sector, and “Bugs and More”
has information from infection control consultant Judy Forrest.
We are very proud to include the “Research Round Up” section offering some
of the latest clinical articles specifically on aged care. We hope this section will
be of great benefit to your nursing staff.
Excellence in Care will be published three times a year and sent directly to
your inbox.
We would also like to hear from members with suggestions on topics you would
like us to cover or articles you may wish to have published.
We hope you enjoy the new magazine.
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2. Excellence in CARE APRIL 2013

Feature
WORDS FROM THE WISE
WORDS FROM THE WISE
What makes me cringe?
By Judith Johnson, Consultant to the Aged Care Sector
When asked to write an item on the above
topic, the first thing that came to mind
was ‘attitude’ – how the attitude of various
people throughout the aged care sector
(and beyond) impacts on the actual care
delivered, and it is usually their attitude
that makes me cringe. For example, the
resident backing away whilst being fed
from the spoon of food as it was too hot
– the carer didn’t consider that, or possibly
didn’t want to, as she was more interested
in getting the task done. (A spoonful on the
carer’s forearm will hopefully keep food
temperature to the fore of her mind when
feeding residents, and the consequences
ought to influence her attitude, should the
incident occur again.)
There are millions of hours of excellent care delivered to
residents every year, but how often, as management, do
we turn a ‘blind eye’ (consciously or not) to the attitude of
some we deal with?
Should we accept an assessment of a resident which we
believe to be inaccurate, or routinely go through appeals
to the assessment agency, so causing delays to being
adequately paid? Delays may save government money,
but is the attitude that this is acceptable appropriate?
In the interim it is very difficult to deliver the higher level
of care on the lower income and if it is being delivered
to the client in question, how much is it eroding the care
delivered to others in the facility?
Should we accept the staff attitude when they become
focused on the ‘task’ and how quickly tasks can be done,
rather than on the individual resident they are caring for?
Why does the resident get persuaded to go to bed at
7.30pm, instead of attending the evening’s entertainment
– which she wanted to do? I believe it was so the staff
could ‘finish their tasks earlier’.
The attitude that the residents are
just another chore to be attended
to makes me cringe.
If you can’t happily wait tables don’t be a waiter.
If you can’t happily deliver care then don’t be a carer.
It sounds simple but the reality is, as managers, we
often have staff whose attitudes do not promote good
care delivery or happy teams. The reason residents are
not always treated as individuals usually comes down
to attitude. Although it may be plastered over the walls
that residents are to be treated with respect and as
individuals (another tick in the audit box), does it
influence the behaviour of the carer?
Many studies have been undertaken on the relationship
between attitudes and behaviour, and in the 1970s there
was doubt about whether attitudes could predict behaviour.
However, it is now considered that attitudes do contribute
to behaviour and those attitudes can be influenced.
The theory of reasoned action assumes that people
deliberate about the wisdom of a given course of action
(Ajzen & Fishbein, 1980). Research shows that when
people are motivated and opportunity is high, they engage
in the effort necessary to retrieve specific details from
memory. However, when people are less motivated or
under time pressure, they resort to their overall attitude to
the situation.
For example, I am in a hurry and need to transfer
Resident G. My attitude is that I am strong enough to
do it on my own without a hoist, so I do that.
As management, you would want me to stop and
consider what harm I could be doing to the resident
and/or myself (whatever motivates), and that I have the
opportunity to access equipment (hoist) to undertake the
transfer. If I have received education and have become
competent at using the hoist, I will not consider it to be
3. Excellence in CARE APRIL 2013

Feature
WORDS OF WISDOM
excessively time-consuming. Also, you might have
detailed the disciplinary action you may take should I
not transfer as per the residents care plan. My attitude
has been influenced. Management should also be
mindful that some kinds of people typically display greater
attitude-behaviour consistency than do others (Rhodes &
Bailey, 1983). Some are guided by their internal feelings
and others tend to rely heavily on cues in the situation to
decide how to behave. People often behave as they
believe others expect them to behave.
The above should factor in when we consider what
influences are being exerted on staff. Are all our team
members providing positive influence? As management,
does our attitude towards residents/families provide a
positive influence? For example, if we aren’t placing
importance on the input from families into the care
delivered, will staff?
Attitude is Everything
It sure is, but we cannot always determine a person’s
attitude at interview – or even be responsible for
employing all the staff we have in our team – so we
need to focus on how we can influence attitude.
A positive ‘service delivery attitude’ goes a long way to
having happy residents, families and staff and making a
long-term viable business.
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Aged Care ACA (92x140mm).indd 1
4. Excellence in CARE APRIL 2013

CONFERENCE 2013
MOVING WITH THE TIMES
The New Zealand Aged Care Association’s
Annual Conference for 2013 will be held at
SkyCity Convention Centre, Auckland,
from Wednesday 28th August to Friday 30th August.
NZACA promotes excellence in care, choice and
security for all within the aged care industry and
for older New Zealanders who require our support
and care. The Association strives to improve the
political, economic and social environment in which
the industry operates.
MARK YOUR DIARY NOW
NZ Aged Care Conference
SkyCity Convention Centre Auckland
28 – 30 August 2013
Our Conference Sponsors
2013 Conference: Moving with the Times
Throughout the economy, many sectors are
facing changing consumer expectations, changing
regulations and changing technology. All of these
changes have an impact on existing businesses
and only those operators who adapt and plan for
the future will have successful business models.
The aged care sector is no different, which is why
the theme of this year’s conference is ‘Moving with
the Times’. This year we hope to focus delegates’
minds on what they need to do in the short and
medium term to maintain and grow as aged care
operators in the face of rapid and inevitable change.
Registration and further details will
be out at the end of April.
5. Excellence in CARE APRIL 2013

Feature
RESEARCH ROUNDUP
Research Roundup
A summary of the latest in evidence-based practice and care.
The following is a selection of recently published
research reports, relevant to those working in the aged
residential care sector, which may help improve the
safety, wellbeing or quality of life of residents. The
reports have been summarised and translated into
everyday language. The literature search and summary
was prepared by Equinox Health Ltd.
1. Identifying New Residents at Risk of Falling
Leland, N. E., P. Gozalo, et al. (2012). Falls in newly admitted
nursing home residents: a national study. Journal of the
American Geriatrics Society 60(5): 939-945.
The objective of this study, conducted in the United States,
was to examine the relationship between nursing home
organisational characteristics and falls in newly admitted
residents. All residents admitted to nursing homes in the US
undergo a full assessment at 30 days post admission. The
research involved examining the information gathered at these
assessments to discover the characteristics of residents who
had suffered a fall in this period and those of the facilities in
which they resided.
The most significant finding was that 21% of residents had
suffered a fall in the first 30 days post admission. The most
prevalent risk factors for falling were:
• previous history of falls
• habitual wandering
• cognitive impairment
• Parkinson’s Disease
• use of antipsychotic medication.
The authors also looked at organisational characteristics of
the nursing homes, specifically staff makeup. They found
that higher numbers of certified nursing assistants, a similar
position to caregiver, were associated with fewer falls than
higher numbers of registered nurses. They conclude that
this was most likely because caregivers are present during
activities that are associated with the greatest risk of falling,
e.g. toileting and transfers. The findings were reported in
general terms rather than specific percentages and ratios per
resident and the authors acknowledged that this is an area for
further research.
To view this research report please visit:
- www.nzaca.org.nz/publication/research-documents.htm
2. Learning from Medication Incidents to
Improve Resident Safety
Tariq, A., A. Georgiou, et al. (2012). Medication incident
reporting in residential aged care facilities: limitations and
risks to residents’ safety. BMC Geriatrics 12: 67.
This qualitative study explored the challenges that aged
care facilities face regarding the accurate, timely reporting
of medication incidents. The research took place in three
aged care facilities in Australia and involved semi-structured
interviews with staff, reviewing completed medication incident
6. Excellence in CARE APRIL 2013
reports and observing staff in the workplace. The aim was
to attain a complete picture of the factors that influence
medication incident reporting. The key findings of the
research were:
• The medication incident report forms contained
information of variable quality and were usually
handwritten in free text, which was sometimes difficult
to read and interpret.
• The information gathered was limited to the actual incident
and did not explore any causal or contributory factors that
may have led to the incident.
• There was little or no information about the impact of the
incident on the resident and the actions taken to minimise
any harm related to the incident
• Time constraints meant that reports were often completed
at the end of shifts, or even later, and the paper-based
system meant information was sometimes lost.
• The authors acknowledge that, due to the complexity of
the medication management processes in residential
aged care, a completely error-free environment is
unlikely. However, they make several recommendations to
increase the accuracy and meaningfulness of information
gathered. These include:
- a medication incident reporting process that enables
the identification of the root cause of incidents so
that systems and processes around medication
management can be examined and adjusted if
necessary
- a process that facilitates the seamless flow of
accurate, timely information between key
stakeholders to encourage a multi-disciplinary
approach to medication incident management.
The authors suggest that the most effective way to achieve
the above is with an electronic reporting system that is
integrated with the facility’s resident management ICT system.
To view this research report please visit:
- www.nzaca.org.nz/publication/research-documents.htm
3. Staff Education Improves Resident Nutrition
Beattie, E., M. O’Reilly, et al. (2013). How much do residential
aged care staff members know about the nutritional needs of
residents? International Journal of Older People Nursing, 13
Feb 11. doi: 10.1111/opn.12016 (in press).
The aim of this research was to identify the knowledge,
practices and attitudes of staff regarding resident nutrition.
The study took place within one residential care facility in
Brisbane, Australia, and was part of a larger project focusing
on improving the nutritional intake of people with dementia.
A questionnaire was completed by all staff involved with
resident meals, including nurses, caregivers and catering staff.
The authors found significant gaps in some areas of nutritional
knowledge. These included:
• specific daily fluid requirements for frail older people
• understanding of specific nutrients, for example the
relationship between vitamin C and iron uptake
• the importance of protein for wound healing.

Other factors identified by staff as impacting negatively on the
nutritional status of residents included limited time to fully assist
those who need it at meal times, and limited understanding
of how to perform a comprehensive nutritional assessment.
Interestingly, the authors noted that the study participants
exhibited considerable interest in nutrition issues throughout
the study.
Factors that improve resident nutritional status identified by the
authors include:
• education in the workplace to raise the profile of nutrition
and hydration and enhance staff knowledge
• the use of simple screening tools to identify residents as
risk of malnutrition
• Support and mentoring to improve staff confidence in
managing the behavioural factors that impact on nutrition.
To view this research report please visit:
- www.nzaca.org.nz/publication/research-documents.htm
4. Do PPIs Increase Mortality in Frail
Older Residents?
Teramura-Gronblad, M., J. S. Bell, et al. (2012). Risk of death
associated with use of PPIs in three cohorts of institutionalized
older people in Finland. Journal of the American Medical
Directors Association 13(5): 488 e489-413.
• Proton-pump inhibitors (PPIs) include drugs such as
omeprazole, pantoprazole and lansoprazole, which
are commonly prescribed for upper GI tract disorders
and protection against GI toxicity associated with
nonsteroidal anti-inflammatory drugs (NSAIDs). This
research compared the risk of death associated with PPIs
in three cohorts of institutionalised older people in Finland.
The three cohorts were:
1. those living in assisted living facilities – mainly
independent who may require assistance with
some ADLs.
2. long-term care hospitals – very frail, often bed-bound,
needing 24-hour nursing care
3. acute geriatric wards or nursing homes – older people
with disabilities and often with dementia but with some
functioning, e.g. they may be independently mobile.
The research involved gathering initial information about the
participants, approximately 1,300 older people, then following
them for one year.
The information gathered included:
• demographic details
• number and severity of co-morbidities
• level of dependency and nutritional status
• the presence of delirium.
The research showed the use of PPIs was not associated
with increased mortality in cohort 1 (those in assisted living
facilities). These people generally had better nutritional status
and less disability that those in cohorts 2 and 3. However, the
use of PPIs was associated with increased mortality in cohorts
2 and 3. These cohorts represent older people more vulnerable
to infections, hip fractures and strokes. The overuse of PPIs has
received recent international attention and the authors suggest
that further research specifically targeting frail older people
would provide greater insight into this controversial subject.
To view this research report please visit:
- www.nzaca.org.nz/publication/research-documents.htm
5. Person-Centred Care in Aged Care Facilities
Brownie, S. and S. Nancarrow (2013). Effects of personcentered
care on residents and staff in aged-care facilities:
a systematic review. Clinical Interventions in Aging 8: 1-10.
The reason for this systematic review was to evaluate the
evidence for replacing the traditional institutional model of care
with a person-centred approach. The authors conducted a
literature search of six major databases to find relevant articles
and reports regarding person-centred care in aged residential
care facilities. They were looking specifically for experimental
studies that included measurable interventions.
The interventions included:
• environmental enhancement
• opportunities for social interaction
• continuity of care
• staff empowerment
• individualised care.
There were three main models of person-centred care
identified: The Eden Alternative, Green House model; and
Wellspring (the Wellspring Innovative Solutions Inc). As well
as these established models, the authors found several
reports about facility-specific person-centred care projects.
The authors found significant evidence that person-centred
interventions were associated with improvements in the
psychological status of residents and reduced levels of
agitation in residents with dementia. They also found
improvements in staff satisfaction, particularly with regard
to being able to provide individualised care. However, the
authors caution that the introduction of person-centred care was
also associated with increased resident falls, and they recommend
the adoption of this model be accompanied by
an environmental safety audit.
To view this research report please visit:
- www.nzaca.org.nz/publication/research-documents.htm
The researchers were able to compare the time to death
between those who were taking PPIs and those who weren’t,
within the three cohorts.
7. Excellence in CARE APRIL 2013

Feature
INFECTION PREVENTION
INFECTION PREVENTION
IS IN YOUR HANDS
By Judy Forrest Infection Control Consultant
Bug Control New Zealand Ltd
Effective Hand Hygiene is the single
most important strategy in preventing
the transmission of infection.
In 1846 Ignas Semmelweiss, known as the Father of
Infection Control, demonstrated that hand washing could
prevent infections, yet more than 150 years later we are
still trying to convince and remind staff of the importance
of this protocol in preventing infection transmission.
Staff often don’t realise they have germs on their hands
because they can’t see them. Nurses, caregivers and
other healthcare workers can pick up hundreds or even
thousands of bacteria on their hands when carrying out
simple tasks in the workplace. These bacteria can then
be passed on the residents they care for, surfaces they
touch and equipment they use. It’s important to wash
your hands frequently. Did you know that microbes can
live on surfaces anywhere from a few minutes to several
months? Imagine these disease-causing microorganisms
living on your computer keyboard, a light switch, or even
on the lift button!
Studies have identified that poor compliance with hand
hygiene routines has been attributed to a number of
factors including:
• heavy workloads
• takes too much time
• hands don’t appear dirty
• problems with skin irritation
• sinks poorly located.
The Centers for Disease Control and Prevention (CDC)
recommends washing thoroughly and vigorously with
soap and water for at least 20 seconds, followed by
hand-drying with a paper towel. In the absence of running
water, an alcohol-based hand rub can be used in place of
soap and water. A good hand wash takes about as long
as it does to sing “Happy Birthday,” so some recommend
washing your hands for the duration of this simple tune.
Surprisingly, most people don’t know when or how to
effectively wash their hands!
The 5 Moments of Hand Hygiene
The World Health Organisation identifies 5 key moments
when hand hygiene should be performed, using soap and
water or an alcohol-based hand rub.
Moment 1
To protect against acquiring harmful germs from
the hands of others, hands should be cleaned after
shaking hands, assisting a resident to move, touching
an invasive device such as a catheter connected to a
resident, bathing, dressing, brushing hair, putting on
personal protective equipment, taking a pulse, BP,
temperature, preparation and administration of oral
medications and when performing oral care and feeding.
Moment 2
To protect the resident from harmful germs (including
their own) entering their body, hand hygiene should be
performed before a procedure such as insertion of a
needle into a resident’s skin or any assessment,
treatment and resident care where contact is made
with non-intact skin or mucous membrane (i.e. wound
dressings).
Moment 3
To protect yourself, and the healthcare surroundings,
from harmful resident germs, hands should be cleaned:
• after contact with a used urinary bottle/ bedpan or
used specimen jars/ pathology samples;
• after cleaning dentures, spills of urine, faeces,
or vomit; or
• after contact with any blood, saliva, mucous,
semen, tears, urine, faeces, vomitus.
Moment 4
Hand hygiene should be performed after touching a
resident, to protect yourself, and the healthcare
surroundings you are working in, from harmful
resident germs and to reduce the opportunity of
transfer of these germs to others.
Moment 5
To protect yourself, and the healthcare surroundings,
from harmful resident germs by performing hand hygiene
after touching the resident’s immediate surroundings,
even when the resident has not been touched.
8. Excellence in CARE APRIL 2013

Use of alcohol-based hand rubs
Alcohol-based hand rub is the gold standard of care for
hand hygiene practice in healthcare settings, whereas
hand washing is reserved for situations when hands are
visibly soiled, or in the care of a patient with C. difficile.
Using alcohol-based hand rubs may be more beneficial
than using traditional soap and water in some instances
because they:
• require less time to use
• result in a significantly greater reduction
in bacterial numbers than soap and water,
in many clinical situations
• cause less irritation to the skin
• can be made readily accessible to workers
• are more cost effective.
Hand care is also important
It is important to ensure the skin on your hands remains
intact, with no cuts, sores, scratches or burns – all areas
where bacteria can enter through the skin. However, if
you come to work with a cut, abrasions or other skin
lesions, these MUST be covered with a waterproof
dressing prior to commencing work.
The frequent use of hand creams and emollients can
prevent dehydration, damage to the skin, skin shedding
and loss of lipids and can restore the water-holding
capacity of the skin. A good emollient can create a
chemical barrier, which may prevent cross-contamination.
It should be remembered that some hand creams and
emollients can neutralize the effects of chlorhexidine,
so compatible hand hygiene products are essential.
Long fingernails can harbour bacteria, so nails should
be kept short and scrupulously clean. False fingernails
and chipped or scratched nail polish can harbour
bacteria and should not be worn for clinical care.
Jewellery, other than a plain wedding band, should not be
worn – again, because bacteria can live and thrive under
jewellery.
Remember: Effective Hand Hygiene is the single most
important thing you can do to prevent the transmission
of infection to yourself, your residents and your family.
Infection Prevention is in your hands!
The specialist Health & Aged Care team at Jones Lang
LaSalle provides valuations and property consultancy advice to
individual operators, major institutions, public companies, private
investors, lenders and developers.
We help clients future proof their assets by anticipating the
expectations of the next generation.
Our in-depth understanding of retirement and aged care market
drivers and trends creates a clear competitive advantage for our
clients to:
• Maximise their investment return
• Minimise property risk
• Avoid building obsolescence
• Continue to align product offerings with latest consumer trends
Michael Nimot
Director, Health & Aged Care
+64 9 914 9723
michael.nimot@ap.jll.com
Matt Straka
Registered Valuer
+64 9 363 0208
matt.straka@ap.jll.com
Aged Care Specialists
Nigel Fenwick
Associate Director
+64 4 971 1319
nigel.fenwick@ap.jll.com
Lance Collings
Director
+64 3 341 8215
lance.collings@ap.jll.com
www.joneslanglasalle.co.nz
9. Excellence in CARE APRIL 2013

Feature
GOODMAN FIELDER
Paying too much
for your bread and
dairy products?
Check out the Vogel range available to NZACA members
Free phone: 0800242424
For enquiries contact: dncallcentre@goodmanfielder.co.nz
Orders: orders@goodmanfielder.co.nz
Join the NZACA Preferred supplies scheme with Goodman
Fielder
For new accounts, contact the Outbound Sales Team on
newaccounts@goodmanfielder.co.nz
Remember to mention you are a current member of NZACA.
Q&A’s – Vogel’s Gluten Free Bread
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Where is Vogel’s Gluten Free bread made?
Vogel’s Gluten Free bread is made at our dedicated gluten
free bakery in Huntly - and it is distributed throughout New
Zealand from this site.
Is the Vogel’s Gluten Free bread made in the same
bakery as ‘wheat and gluten’ containing products?
No –definitely not. Vogel’s Gluten Free bread is baked
IN A DEDICATED GLUTEN FREE BAKERY. Absolutely
NO wheat or gluten enters this bakery –it is completely
separate from any ‘standard bread or baked goods’.
Why is the bread packaged differently to
ordinary bread?
Vogel’s Gluten Free bread uses vacuum packing
technology which helps retain freshness. This packaging
technology gives Vogel’s Gluten Free bread two weeks
shelf life.
How long will my gluten free bread keep once I have
opened the pack?
Once opened, we suggest you place the bread in its
packaging into a plastic bag and seal to retain freshness,
then store in a cool, dry place and use within 3 days.
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Is the Vogel’s Gluten Free bread packaging
‘resealable’.
Unfortunately no. This is the case for Burgen and Venerdi
as well. Many people tuck the open top down and pop the
pack into the freezer –alternatively, people can put into a
plastic bag & seal up.
What ingredients do you use in the gluten free
products instead of wheat?
Maize, rice, soy and tapioca starches and flours
Are there any Preservatives in the Vogel’s Gluten
Free bread?
The Vogel’s Gluten Free bread does contain ‘’vinegar’
which helps is ‘natural’ and helps retain freshness –
however, there are no artificial preservatives in the recipe.
Does the Vogel’s Gluten Free bread contain milk
and soy?
Yes, Vogel’s Gluten Free bread does include milk and soy
in the recipe. This helps the bread stay fresher for longer
and gives it a better texture.
Is the Vogel’s Gluten Free low GI like the other
Vogel’s breads?
Unfortunately no. The grains in Vogel’s (which contain
gluten) are a key ingredient in making the ‘standard’ Vogel’s
bread low GI. Because we have to omit wheat containing
grains from our gluten free recipes, it prohibits it from being
low GI.
Is the Vogel’s Gluten Free bread high fibre?
Unfortunately no. Typically the ingredients used in gluten
free products contain some fibre but not nearly as much as
gluten containing grains.
Is the Vogel’s Gluten Free bread low in fat?
Unfortunately no. There is a higher level of canola oil
in the gluten free bread recipes to help with freshness
& moistness.
Q
A
Q
A
Q
A
Q
A
What is the shelf life of the Vogel’s Gluten Free bread?
14 days from day of manufacture
Can I freeze the Vogel’s Gluten Free bread?
Yes, it can be stored frozen for up to 3 months.
Do I need to store my gluten free bread in the fridge?
No. Once opened, we suggest you place the bread in its
packaging into a plastic bag and seal to retain freshness,
then store in a cool, dry place and use within 3 days.
Is the Vogel’s Gluten Free bread packaging ‘easy peel?
Unfortunately no. The seals need to be permanent seal
at this stage on the bread (like Burgen and Venerdi) –
however, we are running trials on the ‘easy peel’ type of
packaging and would like to move to this as soon as
possible.
10. Excellence in CARE APRIL 2013

Feature
HEALTH ED TRUST
Five Ways to Motivate
your Staff to Complete
Education Programmes
How important is education to your organisation?
Health Ed Trust recently conducted Assessor Workshops
in ten locations from Auckland to Invercargill. The first
session each day was ‘How to Motivate Students’.
The following is the combined wisdom from about
300 attendees.
Number One
Fostering a great education culture in any organisation starts at
the top. If Management and Assessors expect achievement and
qualifications then this expectation flows through to all staff. A
combination of enthusiasm, recognition and rewards backed up by
company policy appear to set the culture that is the main contributor
to high achievements.
Allowing paid time for the Assessor to run classes and mark
papers sends a message to the whole facility. A survey of
attendees showed that paid time allocated for training activities
varied from a challenging one hour a week to a generous one day
a week. Of course, the size of the facility has a huge
bearing on the time required.
Number Two
Recognition can be a powerful motivator; some students craved
this more than rewards. Suggestions include the following.
• Ceremonies where badges, certificates or flowers are
presented are always appreciated. Morning/afternoon teas
in front of other staff and residents, or BBQs with all the family
invited give the caregivers a real sense of achievement.
• One Assessor told of students being handed certificates
as they arrive, without any presentation – this is a huge
recognition opportunity wasted. This also devalues the
achievement.
• The Health Ed Trust Honours Board is used with great effect in
many places. One facility puts the student’s name on the
Board, without any of the coloured achievement squares,
as soon as they start the programme. This motivates the
caregivers to finish so their names can have the tags added as
soon as possible. If your facility does not have an Honours
Board, then frame the certificate and hang it in the foyer.
• Only allowing caregivers to work in sought-after areas if they
have completed education to a certain level.
• Talking about how good the qualification will look on their CV
and how the qualification is recognised throughout NZ.
• Replacing the caregiver’s uniform with a different coloured
uniform, to show that they are a trained staff member, is a
recognition technique that works well at another facility.
• Status symbols. One facility gives out an expensive-looking key
ring to staff that have completed the programme. These are
valued and carried with pride. Others give graduation bears.
• Some Assessors reported how some caregivers like to set an
example for their children.
Number Three
Rewards each time a programme is completed – suggestions
include the following.
• Pay increments. Varied from 10c to $1 per hour.
• A paid day off.
• $50 bonus.
• One facility pays the caregiver 30 minutes for every hour they
attend an education session.
Number Four
Peer Pressure. Taking small groups through the education
programmes at one time can be used as a motivating factor.
(Small groups were considered to be the best way to run an
education programme onsite.)
• Students love to receive their results quickly and see how they
are progressing with each module. One Assessor refuses to mark
any of the students’ modules until the whole group’s modules are
handed in. If one student dares not to have papers in on time, the
rest of the group applies pressure to the miscreant student.
• Create a waiting list. Only take a few students through at a time.
Take special interest in this group – everyone wants what they
can’t have.
Number Five
Although only to be used as a last resort when nothing else
works, a possibility is to include achieving the education
programme as a requirement in the caregiver’s employment
contract. When continued requests and encouragement do
not produce any results, the issue can be managed as a
performance issue.
Why don’t caregivers want to complete programmes?
It is always handy to know these reasons so objections can be
overcome from the beginning.
• Fear: This was first on the list at almost all locations. Mainly
this was fear of failure, as caregivers had not done well at
school, had English as a second language or thought the work
would be too difficult. Suggestion: start with an easier Module.
Encourage, encourage and encourage. Thousands of caregivers
have completed ACE Courses.
• Too busy: Well, can’t we all say that?! Break the assessment
down and ask the caregiver to complete one or two questions
each night.
• Know it all: Caregivers who have been employed for a long time
say they don’t need to do this course. The best answer to this:
“You will fly through it, then… You can help teach the others in
the group.”
• Too expensive: convince Management to at least go halves
in the cost. Many more facilities are now paying all the
processing fees for students.
• Too close to retirement: Health Ed Trust has had several
caregivers who are over 70 complete this course. It has been
proven that it is very good for the brain cells to learn new things!
Any other suggestions would be gratefully received.
By Julie Sparks
General Manager
Health Ed Trust
Ph 03 3798519
Email Julie@healthedtrust.org.nz
11. Excellence in CARE APRIL 2013

Feature
ACC UPDATE
Update:
Vitamin D Used in Aged Care Facilities
Judith Johnson - Consultant to the Aged Care Sector
Current national supplementation
rate for New Zealand
• Data provided by the Ministry of Health indicates that around 75% of the 65+ population who reside in residential care are
receiving Vitamin D supplementation.
• There cannot be a direct causal link made between the use of Vitamin D in residential settings and a reduction in claims,
due to the number of variables involved.
However as seen in the chart below, claims have reduced as supplementation levels have increased.
Results
ACC claims for falls in ARC vs Vitamin D prescribing
16000
80%
14000
70%
Number of 65+ fall claims by those in
residential care
12000
10000
8000
6000
4000
60%
50%
40%
30%
20%
Percentage of Vitamin D Prescribing
2000
10%
0
2006/07 2007/08 2008/09 2009/10 2011/12
ACC Financial Year (July to June)
65+ residential falls Vitamin D prescribing
0%
There is local variation on supplementation figures, with the highest rates occurring in areas that have embedded
Vitamin D supplementation into ‘business as usual’ activities. These processes include:
• discharging ‘Standing Orders’ from hospital
• ensuring Vitamin D is included in admission procedures to residential units.
Going forward
• Future plans to start working with DHBs and PHOs around community prescribing for Vitamin D for individuals who would
benefit, as per ACC’s ‘Community Dwelling Prescribing Advice’.
• ACC are currently trialling Community Pharmacists to take the lead in identifying people who would benefit in the Nelson
region and hope to also fund trials using the interRAI system in the near future.
To find out more about ACC injury prevention in general or information visit: www.acc.co.nz/preventing-injuries.
11. Excellence in CARE APRIL 2013

NZACA
PREFERRED SUPPLIERS
Paying too much for your bread, milk, yogurt, telecom,
or your mobility vans?
Contact our preferred supplier companies to see what
they can offer you.
13. Excellence in CARE APRIL 2013

One voice for the aged residential care sector www.nzaca.org.nz