The development of clinical nurse specialist roles in Ireland

While the term specialist in nursing can be traced to the turn of the 20th Century, it is only since 2001 that a framework was developed for a clinical career pathway in Ireland. This framework has promoted the development and expansion of the clinical nurse/midwife specialist (CNS/CMS) throughout Ireland over the past 10 years guided by the National Council for the Professional Development of Nursing and Midwifery (NCNM). To build upon the achievements of the NCNM and advance nursing practice, it is imperative that CNS/CMS’s adopt and fulfil the components of their role. Since CNS/CMS practice is relatively new to Ireland, there is the opportunity to learn from experiences of other countries. This article outlines the development and challenges of the CNS role in Ireland

Primary care for persons with intellectual disabilities: issues for practice

Primary care for persons with intellectual disabilities: issues for practic

An integrative review to identify how nurses practicing in inpatient specialist palliative care units uphold the values of nursing

Background: Caring for individuals and their families with a life-limiting, symptomatic illness and those who are dying has long been an integral role of palliative care nurses. Yet, over the last two decades, the specialty of palliative care has undergone significant changes in technology and medical treatments which have altered both the disease trajectory and the delivery of palliative care. To date, there is little evidence as to the impact of these medical and nursing advancements on the role of nurses working in palliative care and how in clinical practice these nurses continue to uphold their nursing values and the philosophy of palliative care. Methods: An integrative review was conducted searching seven academic databases from the time period of January 2010 – December 2019 for studies identifying research relating to the role of the palliative care nurse working in specialist palliative care units and hospices. Research articles identified were screened against the inclusion criteria. Data extraction was completed on all included studies and the Crowe Critical Appraisal Tool was utilized to appraise the methodological quality and thematic analysis was performed guided by Braun and Clarke’s framework. The review was conducted and reported in lines with PRISMA guidelines. Results: The search yielded 22,828 articles of which 7 were included for appraisal and review. Four themes were identified: (1) enhancing patient-centred care (2) being there (3) exposure to suffering and death (4) nursing values seen but not heard. The findings highlight that while palliative care nurses do not articulate their nurse values, their actions and behaviors evident within the literature demonstrate care, compassion, and commitment. Conclusion: These findings suggest that there is a need for nurses working in specialist palliative care units to articulate, document, and audit how they incorporate the values of nursing into their practice. This is pivotal not only for the future of palliative nursing within hospice and specialist palliative care units but also to the future of palliative care itself. To make visible the values of nursing further practice-based education and research is required

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

Objectives To capture the extent and nature of intellectual disability nursing publications in Ireland. Design Scoping review using Arksey and O’Malley approach. Data sources Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020. Eligibility criteria Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education. Data extraction and synthesis Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken. Results The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring. Conclusions This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health managemen

Surveying community nursing support for persons with an intellectual disability and palliative care needs

Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of palliative care services and integration of people with intellectual disability into their communities has resulted in an increased demand and greater diversity in the population groups accessing palliative care services. This study aims to describe the provision of community nursing support for persons with an intellectual disability and palliative/end-of-life care needs from the perspective of community nurses. A quantitative descriptive cross-sectional survey was employed. On receipt of ethical approval, data were collected through self-reporting questionnaires and descriptive analysis was conducted to describe frequencies and to identify patterns of the respondents using spss version 18. Only 85 people with an intellectual disability were referred to palliative/end-of-life care services over a 3-year period. Those delivering care expressed challenges including, understanding communication styles, late referrals, lack of time, knowledge and skills. Highlighted within the study were the benefits of liaison between family and professional and nonprofessional carers. Findings provide insight into the importance of teamwork, advance planning, knowing the person and best practice in providing palliative/end-of-life care for people with intellectual disability through collaboration

Nursing documentation in palliative care: an integrative review

Purpose: Nursing documentation is essential in ensuring communication between team members, continuity of care and evidence based practice. The purpose of this paper is to review and synthesiseresearch pertaining to nursing documentation in specialist palliative care. Method: An Integrative review (IR) utilising Whittemore and Knafi’s five stage process was employed. Electronic searches of: Scopus, Medline, Cinahl, Web of Science, Academic Search Complete databases (2010-2017) were conducted. 10,842 articles were retrieved which were reduced to five articles for review. Data extraction, quality assessment (Critical Appraisal Skills Programmes – CASP) and thematic analysis were conducted on the included articles. Results: Two overarching themes emerged in this review, symptom management and engagement. Symptom management focused on documentation of symptoms while engagement highlighted emotional care, information giving, providing support, coordinating care, supporting families and education. Conclusions: Clear, accurate, and complete documentation is crucial to the delivery of quality health care and pivotal to effective communication within the team. Although this is important in all aspects of care it is arguably even more so in end of life care. In order to audit the care provided, such care must be clearly identified and documented

The provision of community nursing support for persons with an intellectual disability and palliative care needs: a descriptive survey

Forward On behalf of the research team, I am pleased to introduce this report which presents the findings of a regional evaluation entitled: The provision of community nursing support for persons with an intellectual disability and palliative care needs. The broadening of the World Health Organisation (2002) position on palliative care, developed to include the provision of palliative care for all persons with a life threatening illness regardless of diagnosis, has resulted in increased numbers of patients and families accessing palliative/end of life care services. It is known that people with an intellectual disability have a disproportionate health burden when compared with the general population and accessing health service can be difficult. In today’s society people with an intellectual disability have largely moved away from a long term residential model of care, and are accessing wider health services. They are entitled to receive equitable care and support from a workforce that recognises all as equal citizens. However, internationally it is acknowledged that there is an inequity of experience for people with an intellectual disability within mainstream health services, and this is not satisfactory. This report provides a snapshot of community nursing practice in an Irish setting of palliative/end of life care for people with an intellectual disability in a health region. The report is a welcome addition to the existing international literature which includes a small number of Irish studies. I would like to take this opportunity to sincerely thank the respondents for giving of their time to complete the questionnaire and the Irish Hospice Foundation and the University of Limerick for their continued interest and support