Medicolegal pitfalls when assessing decision-making capacity in people with cognitive impairment.

Background: The global population of older adults will double over the next three decades, and one in 10 will have dementia.

Objective: This article examines medicolegal pitfalls when assessing the decision-making capacity of cognitively impaired patients.

Discussion: Be aware of the pitfalls while completing the five steps of the assessment.

Deaths due to thermal injury from cigarette smoking in a 13-year national cohort of nursing home residents.

Objectives: To examine the nature and frequency of deaths due to thermal injuries from cigarette smoking reported to Australian coroners and to examine the decisions which surround these deaths.

Design: Retrospective cohort study.

Setting And Participants: Residents dwelling in accredited nursing homes whose deaths were reported to coroners between 1 July 2000 and 30 June 2013 and attributed to thermal injuries from cigarette smoking.

Managing risk for aging patients in long-term care: a narrative review of practices to support communication, documentation, and safe patient care practices.

Resident safety and welfare in long-term care (LTC) is being redefined as the focus shifts to promoting an optimal quality of life especially in LTC. Achieving this requires contemporary practice to improve the organization and staff's ability in identifying, communicating, documenting, and managing the risks that arise from the choices a person makes in pursuit of a better quality of life. This article is a narrative realist style review examining the issues of how to manage risks for older residents living in LTC.

Variations in death notification of nursing home residents to Australian Coroners.

Objectives: To examine the impact of changes to the reporting requirements in coronial legislation on the nature and frequency of nursing home resident deaths reported to Coroners.

Design: National retrospective study of a population cohort of nursing home resident deaths.

Setting: Accredited Australian nursing homes between July 2000 and June 2013.

A greater risk of premature death in residential respite care: a national cohort study.

Background: the demand for residential respite care for older persons is high yet little is known about the occurrence of harm, including death in this care setting.

Objective: to compare the prevalence and nature of deaths among residential respite to permanent nursing home residents.

Design: retrospective cohort study.

Optimising residential respite care in nursing homes: Current problems and solutions for a better future.

Aim: To examine whether residential respite care increases the risk of harm to older people and suggest directions for future research and policy.

Background: Respite care is a vital part of the aged care system that supports dependent older people and their caregivers to continue residing in the community. There is little research determining whether an older person experiences harm from residential respite.

Death Following Recent Admission Into Nursing Home From Community Living: A Systematic Review Into the Transition Process.

Objective: This study examines the impact of the transition process on the mortality of elderly individuals following their first admission to nursing home from the community at 1, 3, and 6 months postadmission, and causes and risk factors for death.

Method: A systematic review of relevant studies published between 2000 and 2015 was conducted using key search terms: first admission, death, and nursing homes.

Results: Eleven cohort studies met the inclusion criteria.

Mortality in Nursing Homes Following Emergency Evacuation: A Systematic Review.

Objectives: To determine the risk associated with mortality among nursing home residents within 6 months following an evacuation because of man-made or natural disasters.

Design: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement.

Setting: All peer-reviewed studies published in English, French, German, or Spanish between January 1, 2000 and December 31, 2015, examining mortality within 6 months of disaster evacuation from a nursing home.

Missed Opportunities to Prevent Workplace Injuries and Fatalities.

Prevention efforts, especially in high-income countries, have reduced work-related death and injury. Despite this, the global incidence of workplace fatalities remains unacceptably high with approximately 317 million incidents occurring on the job annually. Of particular concern is the occurrence and re-occurrence of incidents with a similar cause and circumstance, such as fatalities occurring in agriculture and transport industries.

Chronic disease self-management support for persons with dementia, in a clinical setting.

The burden of chronic disease is greater in individuals with dementia, a patient group that is growing as the population is aging. The cornerstone of optimal management of chronic disease requires effective patient self-management. However, this is particularly challenging in older persons with a comorbid diagnosis of dementia.

Frequency of forensic toxicological analysis in external cause deaths among nursing home residents: an analysis of trends.

There is a paucity of research examining the utility of forensic toxicology in the investigation of premature external cause deaths of residents in nursing homes. The aim of this study is to describe the frequency and characteristics of toxicological analysis conducted in external cause (injury-related) deaths amongst nursing home residents in Victoria, Australia. This study was a retrospective cohort study examining external cause deaths among nursing home residents during the period July 1, 2000 to December 31, 2012 in Victoria, Australia, using the National Coronial Information System (NCIS).

Physical restraint deaths in a 13-year national cohort of nursing home residents.

Objective: this paper aims to investigate the nature and extent of physical restraint deaths reported to Coroners in Australia over a 13-year period.

Methods: the study comprised a retrospective cohort study of residents dwelling in accredited nursing homes in Australia whose deaths were reported to the Coroners between 1 July 2000 and 30 June 2013 and was attributed to physical restraint.

Results: five deaths in nursing home residents due to physical restraint were reported in Australia over a 13-year period.

Workplace-based clinical leadership training increases willingness to lead.

Purpose: The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline.

Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved.

Recognizing junior doctors' potential contribution to patient safety and health care quality improvement.

Purpose: The purpose of this paper is to re-frame perceptions surrounding junior doctors' capacity to contribute to patient safety and quality improvement.

Design/methodology/approach: A targeted literature review was conducted followed by individual telephone interviews and a half-day forum involving junior doctor representatives and selected leaders in the sector.

Findings: Junior doctors' entry into health care is an ideal time to cultivate practitioners' interest and expertise in improving the health system for better patient care.

Interpretation of postmortem forensic toxicology results for injury prevention research.

Forensic toxicological data provides valuable insight into the potential contribution of alcohol and drugs to external-cause deaths. There is a paucity of material that guides injury researchers on the principles that need to be considered when examining the presence and contribution of alcohol and drugs to these deaths. This paper aims to describe and discuss strengths and limitations of postmortem forensic toxicology sample selection, variations in analytical capabilities and data interpretation for injury prevention research.

Application of a public health framework to examine the characteristics of coroners' recommendations for injury prevention.

Objectives: Exploring the characteristics of recommendations generated from medicolegal death investigations is an important step towards improving their contribution to injury prevention. This study aimed to: (1) quantify coroners' recommendations; and (2) examine the nature of these recommendations according to public health principles of injury causation and prevention.

Methods: Deaths where coroners' recommendations were and were not made in the State of Victoria, Australia during the period 1 July 2000 to 30 June 2005 were compared by sex, age group and underlying cause of death.

The prevalence of work-related deaths associated with alcohol and drugs in Victoria, Australia, 2001-6.

To describe the presence of alcohol, cannabis and amphetamines in work-related injury deaths in Victoria, 2001-6, an observational study of work-related deaths reported to the State Coroner's Office, Victoria, Australia was conducted. Case and postmortem forensic toxicology data were obtained from the National Coroner's Information System for work-related injury deaths with positive toxicology screens. Over 6 years there were 43 worker deaths in a total of 355 unintentional work-related injury deaths.

Fatal injury in tree felling and related activities, Victoria, Australia 1992-2007.

This study aims to examine fatalities resulting from tree felling and related activities in Victoria, Australia, involving work and do-it-yourself (DIY) activities, 1992-2007. Case identification was undertaken using coronial databases. A manual review of coroners' findings of closed cases was performed.