The role and development of consultancy in nursing practice

The term consultancy is used in many contexts. It has been applied to advanced nursing practice roles such as clinical nurse specialist, advanced nurse practitioner, nurse practitioner and other occupations. This causes confusion in the healthcare setting as the word is often used interchangeably between roles and has traditionally been used in a medical context. In addition, the development of nurse consultant posts has further compounded the uncertainty around consultancy. However, regardless of the role holder, consultancy in nursing is normally used in the context of a person in possession of expertise. This article describes consultancy in nursing; identifying its development, approaches, application and possibilities for the future

Loss and grief within intellectual disability

One of the most significant trends seen in recent years has been the increasing longevity of people with intellectual disability (Doody et al., 2013). Advances in medical and neonatal care along with deinstitutionalisation have increased life expectancy for most individuals with intellectual disability. In today’s society individuals with intellectual disability live with family members, in special assisted living facilities, community group-homes or on their own. Just like anyone else people with intellectual disability have created and developed attachments to various persons be it family members, fellow residents, staff members, co-workers, members of their communities, and other friends. With such attachments comes the experience of loss, where staff members leave, other residents relocate or die and the death of a parent, caregiver or family member may occur. Thereby loss and grief are a natural part life however; individuals with intellectual disability may experience significant secondary losses such as the loss of a parent or caregiver may necessitate a change in residence leading to a cascade of losses that may include friends, neighbors and employment. In addition some higher functioning individuals may experience a sense of grief and loss over their disability where they experience a persistent sense of loss over the fact that they are perceived as different from others

Moving from a long-stay institution to a community-based residential programme for persons with intellectual disability: The views of families.

Moving from a long-stay institution to a community-based residential programme for persons with intellectual disability: The views of families

An evaluative audit of the introduction of a new nursing document within a specialist palliative care inpatient unit in Ireland

Aim and objectives: To audit the introduction of a new nursing document within a specialist palliative care inpatient unit in Ireland. Background: Nursing documentation contributes to effective patient care and communication between healthcare professionals and patients through providing a clear picture of; a patient’s status, nurse’s actions and care outcomes. However, documentation is often seen as a low priority and often lacks explicit information on patients’; preferences, needs and quality of life. Design: An evaluative audit. Results: Higher rates of documentation were evident in the unit using the new structured nursing documentation and significant differences were evident. Greater evidence of assessment, intervention and evaluation were evident in the new document and enables nursing care to be evident and identifiable. Conclusion: This project evaluated a new palliative nursing documentation system and identified that utilizing a structured document promotes accurate recording of clinical information and limits inconsistent documentation. Relevance to clinical practice: An effective system for documentation improves the identification of quality care provided and facilitates individualized care

Families’ views on their relatives with intellectual disability moving from a long-stay psychiatric institution to a community-based intellectual disability service: an Irish context.

The pattern of residential services for people with intellectual disability in Ireland has seen many positive developments in recent years, with more places made available in residential homes within both community- and campus-based accommodation. This paper reports on the findings of a study which explored families’ views regarding the movement of people with intellectual disability from a long-stay psychiatric institution to campus-based accommodation within a local intellectual disability service. A Husserlian phenomenology was chosen, ethical approval was granted, eleven participants were interviewed and data transcribed. Through Colaizzi’s (1978) procedural framework for data analysis two key themes were identified. The positive transition resulting from the move and the enlightened thinking that has developed as a consequence of the move. Overall, the study indicates the importance of; care and care delivery from the family’s perspective, the interaction of staff with families and families knowing the staff

Conducting a pilot study: case study of a novice researcher.

Pilot studies play a vital role in health research, but are often misused, mistreated and misrepresented. A well-conducted pilot study with clear aims and objectives within a formal framework ensures methodological rigour, can lead to higher-quality research and scientifically valid work that is publishable and can benefit patients and health service delivery. A pilot study contributes valuable information to assist researchers in the conduct of their study. Conducting a pilot study provides the researcher with the opportunity to develop and enhance the skills necessary before commencing the larger study. By conducting a pilot the researcher obtains preliminary data, can evaluate their data-analysis method and clarify the financial and human resources required. This article presents an overview of pilot studies, why they are conducted, what to consider when reporting pilot studies and the authors’ experience of conducting a pilot study. To conduct a successful study, researchers need to develop their skills, choose the right methods and carefully plan for all aspects of the process

Introducing evidence into nursing practice: using the IOWA model.

Evidence-based practice has gained increasing popularity in all healthcare settings. Nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform decisions, actions and interactions with patients, to deliver the best possible care. Within the practice setting, there is an increasing challenge to provide clearly measurable care of the highest quality, which is evidence-based. In order for nurses to operate from an evidence-based perspective, they need to be aware of how to introduce, develop and evaluate evidence-based practice. This article presents how evidence may be introduced into practice using the Iowa model, offering practical advice and explanation of the issues concerning nurses in practice

Health promotion for people with intellectual disability and obesity

Obesity is a significant health problem for people with intellectual disability, as they report a 59% higher rate of obesity as compared with those in the general population (Centres for Disease Control and Prevention, 2006). Causes are multifactorial and obesity leads to a higher risk of developing chronic conditions, such as diabetes and heart disease. While the risks of these conditions generally increase with age, people with an intellectual disability are at risk of developing them earlier owing to their higher levels of obesity. Client groups with mild intellectual disability residing in a group home or family home are at a higher risk of obesity than those in institutional care, mainly owing to increased independence and available choices. Healthcare services have predominantly focused on the primary disability rather than on prevention or reduction of secondary health conditions. As health promotion enables people to gain control over their lives, it is essential to address the health concern of obesity for people with intellectual disability. This article highlights the issues in health care faced by people with an intellectual disability and aspects that health professionals need to consider when engaging in health promotion for those who are obese

Intellectual disability nursing and transcultural care.

In today’s healthcare environment nurses’ are urged to use up-to-date research evidence to ensure better patient outcomes and inform nursing decisions, actions and interactions with patients. Within the practice setting there is an increasing challenge to provide care to patients from minority ethnic groups. In order to deliver care to different cultural groups, nurses need to recognize and empathize with patients’ belief systems, being mindful of their diverse cultural needs. This article presents the concept of transcultural care and identifies issues within intellectual disability nursing through a focus on the components identified by Capina-Bacote (2002; 2003) and Cortis (2003): cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire. It highlights the issues relevant nursing practice, cultural care and service provision for persons with intellectual disability from ethnic minorities in Irelan

Transformational leadership in nursing practice

Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as ‘transformational’; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealized influence; inspirational motivation; intellectual stimulation; and individual consideration