Parents' perspectives on reasonable adjustments in acute healthcare for people with intellectual disability: A qualitative descriptive study

Aim: To describe parents' perspectives on reasonable adjustments in acute healthcare  for people with intellectual disability (ID). Background: People with ID are vulnerable in terms of their health needs and marginalized when accessing and utilizing acute healthcare services. Reasonable adjustments  are positive measures that can help alleviate health disparities. However, despite significant research advocating their use, evidence of implementation of reasonable adjustments in acute healthcare practice is limited. Design: A qualitative descriptive study. Methods: Qualitative semi-structured interviews were conducted with six parents  of children with ID, who had accessed and used acute healthcare services. The interviews were conducted between January and May 2022, audio-recordings were  transcribed and thematically analysed. Results: Parents described limited or no experiences of reasonable adjustments when  accessing or utilizing acute healthcare services for their children. The findings are captured in three themes; describing the reality, understanding the impact and signposting  the future. The findings highlight a lack of implementation of reasonable adjustments  in acute healthcare which negatively impacts the experience of all stakeholders. Conclusion: There is a pressing need for reasonable adjustments to be implemented  at a strategic level across acute healthcare services, so that people with ID and their  families can access person-centred acute healthcare when needed. Impact: The research findings will inform researchers interested in reasonable adjustments and implementation research, and those interested in advocating for the rights  of people with ID. Reporting Method: This study adhered to the Equator research reporting checklist:  Consolidated criteria for reporting qualitative research: a 32-item checklist for interviews and focus groups. Patient or Public Contribution: A parent of a child with an ID was part of the research  team informing the design, data collection, data analysis and write-up of this article </p

Time to re-envisage integrity among nurse leaders

Aim: This paper highlights integrity as a central tenet in the journey of ethical leader-ship among nurse leaders and dialogue as a way of working within integrity. Background: Nurse leaders play a critical role in ensuring ethically sound, safe patient care by supporting staff and fostering positive working environments. Although there is an abundance of literature on leadership, no universally accepted leadership theory exists. Hence, it can be difficult to apply leadership theory and principals to real-life clinical practice. Evaluation: From the literature, it is evident that integrity is a crucial aspect of leader-ship. This paper proposes suggestions for nurturing integrity and fostering open and honest dialogue. Key issues: Globally, public health care is complex and evolving and effective nursing leadership is paramount to meet public health needs and support health care systems. Conclusion: This paper explores integrity with leadership, re-envisaging personal and professional integrity as a portal to authentic leadership, which has human relation-ships and dialogue at its core. Implications for Nursing Management: Nurse leaders need support in guiding the nursing profession and promoting ethically sound patient care. The true nature of leadership is dialogue, and nurturing a culture of listening and openness at different levels within an organisation is crucial

The value and contribution of intellectual disability nurses/ nurses caring for people with intellectual disability in intellectual disability settings: A scoping review

Background: People with intellectual disability experience poorer health and health-care access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person-centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. Methods: A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/ units/care homes were reviewed and reported as per PRISMA-ScR checklist and PRISMA flow diagram

Presenting problem/conditions that result in people with an intellectual disability being admitted to acute hospitals in Ireland: An analysis of NQAIS data from 2016-2020

The wide range of health conditions and complex needs experienced by people with intellectual disability (ID) means that they are more likely to utilise acute care services in comparison with the general population. ID accounts for 1% to 3% of the world’s population and has an onset before the age of 18 years (22 years from an American perspective according to the American Association on Intellectual and Developmental Disabilities (AAIDD) 2021). ID is characterised by lifelong limitations in cognitive and adaptive functioning and experiences of social and environmental restrictions which create barriers to effective participation in daily life. With increased childhood survival rates and improved diagnostic, screening and identification, this percentage has the potential to increase in the coming decades

Final year undergraduate nursing and midwifery students’ perspectives on simulation-based education: a cross-sectional study

Background: Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support fnal year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods: This study aimed to evaluate a simulation-based education initiative from the perspectives of fnal year undergraduate nursing and midwifery students (N= 95). An online survey, using the validated Simulation Efectiveness Tool – Modifed (SET-M), was distributed to fnal year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results: The results of the study highlight fnal year nursing and midwifery students’ perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confdence and gain experience in preparation for real-life practice. Students reported feeling more confdent in their assessment skills, in providing care and interventions in responding to changes in a person’s health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefng and debriefng sessions were highlighted as important aspects of the simulation which helped to increase student confdence and cultivate meaningful learning. Conclusion: Simulation-based education is a valuable teaching and learning modality, particularly for fnal year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional.</p

Virtual reality use and patient outcomes in palliative care: A scoping review

Objective: Virtual reality is increasingly used in healthcare settings. Potentially, it’s use in palliative care could have a positive impact; however, there is limited evidence on the scope, purpose and patient outcomes relating to virtual reality use in this context. The objective of this scoping review is to chart the literature on virtual reality use in palliative care, identifying any evidence relating to biopsychosocial patient outcomes which could support its use in practice. Methods: A scoping review of the literature, involving . a systematic search across 10 electronic bibliographic databases in December 2021, . Eligibility criteria were primary research studies, of any research design within a 10-year timeframe, which reported on virtual reality use and patient outcomes in palliative care. A total of 993 papers were identified, and comprehensive screening resulted in 10 papers for inclusion. Results: This scoping review identified 10 papers addressing virtual reality in palliative care, published within a three-year timeframe 2019–2021. Research methodologies included mixed methods, quantitative and qualitative. The evidence high-lights virtual reality use with patients receiving palliative care in a variety of settings, and data around use ability, feasibility and acceptability is positive. However, the evidence regarding biopsychosocial patient outcomes linked to virtual reality use is limited. Conclusion: Virtual reality is gathering momentum in palliative care and is potentially a helpful intervention; however more research is needed to underpin the evidence base supporting its application, particularly in understanding the impact on biopsychosocial patient outcomes and ascertaining the best approach for measuring intervention effectiveness.</p