Development of nursing quality care process metrics and indicators for intellectual disability services: a literature review and modified Delphi consensus study

Doody, Owen; Murphy, Fiona; Lyons, Rosemary; Gallen, Anne; Ryan, Judy; Downey, Johanna; Sezgin, Duygu

doi:10.1186/s12913-019-4749-y

Cited by 17 publications

(14 citation statements)

References 43 publications

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“…These issues are pertinent given the changing landscape of intellectual disability services in recent years with a shift from institutional care to a community care model. 73 74 Thereby, people with intellectual disability now access care through mainstream health services, and this has impacted on issues such as health disparities, 38 health inequalities 75 and health outcomes. 76 Within this changing landscape of service provision, 77 78 it is essential that healthcare professionals can anticipate and support the holistic needs of people with intellectual disability.…”

Section: Discussionmentioning

confidence: 99%

Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

2021

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ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

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Section: Discussionmentioning

confidence: 99%

Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

2021

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“…Thus, this has resulted in a cautious approach by disability providers to include nursing, fearing that intellectual disability nurses would medicalize the everyday lives of people with intellectual disability [ 80 ]. As a profession intellectual disability nurses need to make their contribution visible [ 7 , 81 ] as they have been described as a shy discipline lacking a strong voice in articulating and explaining their role [ 82 ]. To progress and address this matter, both undergraduate and postgraduate educational programmes and the profession of intellectual disability nurses internationally need to address professional identify, the landscape of service provision models of care and professional advocacy.…”

Section: Discussionmentioning

confidence: 99%

“…Registered nurses in intellectual/learning disability provide health, wellbeing and social care supports to individuals with an intellectual disability [ 6 ]. Ireland and the United Kingdom (UK) are the only two country’s specifically providing direct entry training programmes for intellectual/learning disability nurses [ 7 ], and therefore it may be anticipated that there would not be a retention or workforce issue. However, other factors such as staff stress and burnout, organisation culture, training and supervision [ 8 ] affect the retention of this specific discipline of nurses.…”

Section: Introductionmentioning

confidence: 99%

Fourth year intellectual disability student nurses’ journey and future work intention: a qualitative study

et al. 2022

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Background The aim of this qualitative study is to explore the views and experiences of final year BSc intellectual disability nursing students’ journey, future work plans and examine factors influencing their migration intentions following graduation. Methods A qualitative component of a mixed methods study where a focus group interview was conducted with final year BSc intellectual disability nursing students (n = 10) from one University in Ireland in June 2019. A topic guide was utilised, and participant’s were interviewed about their programme, future work plans and migration intentions. An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and thematic development. Duffy’s conceptual model of identity transformation provided a structure to analyse the data and map themes onto the conceptual framework. Results The findings were mapped onto the five stages of Duffy’s (2013) conceptual model of identity transformation: Pre-Entry; Reaffirming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to promote intellectual disability nursing and address professional esteem issues, support for education and professional development, such as providing career guidance opportunities prior to course completion, development of clinical skills within their education programme and support for the professional development of new graduates. Participant’s identified uncertainty about career opportunities and saw scope for future professional development opportunities particularly in community-based work. Conclusion This study has identified that final year intellectual disability nursing students are uncertain about career options and opportunities for intellectual disability nurses in other country’s. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of people with intellectual disability. This study identified a clear need for direction and information regarding intellectual disability nursing roles and career opportunities.

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“…A Delphi survey is a validated and robust framework that has been used extensively in the development of training programme content in various medical and nursing fields, including robotic surgery training (Collins et al, 2019), disaster preparedness for hospital nurses (Noh et al, 2018) and the development of nursing quality care process metrics and indicators for intellectual disability services (Doody et al, 2019). To the best of our knowledge, this is the first time that the Delphi survey framework has been used to determine the curricular‐based and systems‐related impact indicators of an intellectual disability awareness programme for acute hospital staff.…”

Section: Discussionmentioning

confidence: 99%

Developing curricular‐content and systems‐related impact indicators for intellectual disability awareness training for acute hospital settings: A modified International Delphi Survey

Taggart¹,

Marriott²,

Cooper³

et al. 2021

Journal of Advanced Nursing

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Aim To identify, and reach consensus on, curricular‐content and delivery methods, as well as ways to maximize the impact of intellectual disability awareness training programmes in acute hospital settings. Background With the continuing evidence of avoidable deaths and unwarranted variations in the quality of care to people with an intellectual disability in acute hospitals, it could be purported that current training provided to hospital staff appears to be making a minimal difference in the care provided to this population. Design A two‐round modified Delphi survey was conducted between June 2020–January 2021. Methods International experts from primary healthcare and hospital settings, and intellectual disability health fields participated in the survey. Initial curricular‐content items were developed from the literature, and based on the combined clinical and academic experience base of the authors. Items were evaluated in terms of agreement/consensus, importance and stability of responses. There were 57 expert responses in Round 1 and 45 in Round 2. Results The consensus was reached with regard to 55 of 65 curricular‐content indicators relating to Aims, Design, Content and Delivery. Ten curricular‐content indicators failed to be agreed on relating to the mode of training delivery. With regard to systems‐related impact indicators, 28 out of 31 reached consensus. The expert panel identified and agreed on seven system barriers that could obstruct the successful implementation of the awareness training programmes in acute hospital settings. Conclusions This is the first international Delphi survey to agree on curricular‐content and identify systems‐related facilitators for intellectual disability awareness training. Potential system barriers have been highlighted which could be addressed by systemic improvement. Implications for developing, and robustly testing the efficacy of, intellectual disability awareness training programmes are discussed, as are the implications for other cognitively impaired populations. Impact In order to maximize the impact, investment in acute hospital staff education will need to be accompanied by wider changes to systems and structures concerning the governance of service provision for people with an intellectual disability.

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Development of nursing quality care process metrics and indicators for intellectual disability services: a literature review and modified Delphi consensus study

Cited by 17 publications

References 43 publications

Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

Fourth year intellectual disability student nurses’ journey and future work intention: a qualitative study

Developing curricular‐content and systems‐related impact indicators for intellectual disability awareness training for acute hospital settings: A modified International Delphi Survey

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