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Importance: Autistic adults face decreased community participation for employment, education, and social activities plus barriers to driving and transportation. However, little is known about their experiences of moving around community environments.Objective: To explore contextual issues and experiences of independent community mobility and driving for autistic adults and to determine the modes of community mobility, regions studied, and methodologies used.Data Sources: Seven databases were searched from 2000 to 2019. All empirical research relating to autism, community mobility, and driving for people older than age 5 yr was mapped. Studies examining experiences of community mobility and driving were selected for scoping review.Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews methodology was used. Thirteen studies reporting specifically on autistic adults' experiences with public transportation, driving, and pedestrian navigation of community environments were included. These studies were analyzed using concepts from the Person-Environment-Occupation-Performance Model.Findings: Nine studies examined experiences of autistic adults. Seven studies explored proxy perspectives. Those studies examining driving primarily focused on learner driver experiences. Although most studies reported on personal and environmental factors, some studies reported on broader social communication and personal narrative factors. None used inclusive methodology involving autistic adults. Conclusions and Relevance:A broader focus on the contextual experiences of community mobility and driving is needed to support participation of autistic adults in their communities. Linking community mobility experiences with participation outcomes and expanding research to include experienced drivers and nonurban populations is an important component of this work.What This Article Adds: Occupational therapy interventions should address community mobility and driving skills before school transition. Autistic adults' skill development may be affected by person factors such as motivation, anxiety, social skills, communication, and occupational performance desires. Environmental factors such as parental concerns, community safety, pedestrian environments, traffic volume, and public transportation design are important. Further research partnering with autistic adults could better inform future occupational therapy interventions for community mobility and driving.A utistic adults have lower rates of community participation (Myers et al., 2015), particularly in work or training (Shattuck et al., 2012), and poorer psychosocial outcomes (Zimmerman et al., 2018), than the general population. Independent community mobility can be a barrier to participation in education, work, health, and social activities, especially for young autistic adults (Deka et al., 2016;Zalewska et al., 2016). Community mobility bridges physical distance between home and the community spaces where partic...

Aims and Objectives To compare the self‐perceived preparedness, knowledge, comfort and confidence of Australian Registered Nurses when caring for people with ID and/or ASD across contexts of practice: primary care and community, intensive care, acute hospital, emergency department, paediatrics and ID/ASD. Background There is limited research comparing nursing preparedness and competency when caring for people with intellectual disability (ID) and/or autism (ASD) across nursing contexts of practice. A greater understanding of the differed educational preparedness, confidence and comfort across contexts of practice can aid the development of tailored educational programmes to improve nursing capacity to care for this cohort. Design Cross‐sectional descriptive study. Methods A descriptive survey tool of registered nurses (n = 69.3). Comparative inferential analysis was undertaken between the independent categorical variable of six nursing contexts of practice across several dependent variables including age, years since registration, educational content and exposure, knowledge, comfort and confidence. This cross‐sectional study was undertaken according to the STROBE Statement checklist of items. Results Occupying an ID/ASD nursing role was significantly associated with higher reported levels of educational preparedness, professional development and postgraduate education relevant to caring for people with ID and/or ASD. Levels of self‐reported knowledge of care issues, confidence and comfort when undertaking healthcare tasks was significantly associated with the context of practice, with nurses working in ID/ASD settings reporting the highest levels across all variables. Conclusion The findings of the study highlight an association between greater educational exposure to content relevant to working with people with ID/ASD and subsequently working in that field. Relevance to clinical practice This study has highlighted that professional development programmes aiming to improve nursing capacity to care for people with ID and/or ASD, should be informed by and address differing gaps in confidence, comfort and educational preparedness across nursing contexts of practice.

Aim To describe Australian registered nurses' awareness, and implementation of reasonable adjustments within their practice when caring for people with intellectual disability and/or autism. Additionally, the association between key demographic, workforce, and respondent variables and familiarity of the term and regularity of use was explored. Design Cross‐sectional survey. Methods Survey data were collected between August and October 2020 using an online survey tool. Data were analysed using descriptive and inferential statistics. Results Familiarity of the concept of reasonable adjustments was relatively low, compared to respondents who report applying adjustments when caring for people with intellectual disability and/or autism. Higher levels of confidence, comfort, and knowledge when caring for this cohort were associated with greater awareness and application of reasonable adjustments. Conclusion A higher volume, and diversity in type of, nursing education related to care for people with intellectual disability and/or autism is indicated.

AimTo scope the international literature about registered nurses delegated models of care to unlicenced workers, identify gaps and reflect upon how the evidence relates to nursing in multiple contexts.DesignScoping review of the peer reviewed literature from the year 2000 onwards, using the PRISMA‐ScR checklist.MethodsThe study searched the following databases in February 2022: CINAHL, Medline, ProQuest, and SCOPUS, and included keywords, Boolean operators and subject headings relevant to registered nurses delegating the provision of care to unlicenced workers.ResultsA total of 49 articles met the eligibility criteria for this study, and relevant data were extractedThree models of delegation were highlighted within the literature: direct, indirect and a mixture of both. The data highlighted that direct delegation mainly occurred in acute contexts, with delegation decreasing with increasing patient acuity and/or complexity but the threshold of when this would occur was not clear. There was one intervention study that measured patient outcomes which could aid in the determination of what is effective delegation. For studies that did report on it (n = 6), there were few examples of better patient outcomes in cases where care was delegated from registered nurses to unlicenced workers.ConclusionsThe scoping review highlighted heterogeneity in practice areas and methods of delegation practice. A key gap in literature is the absence of studies focusing on patient outcomes, with a clear baseline to measure and identify effective delegation practices. Additionally, the legal and logistical implications presented in both direct and indirect delegation practices is not evident in the literature.Implications for the ProfessionDecisions related to delegation are often made at the service level and prescribed to those who work within the service, suggesting that models of indirect delegation are in fact not delegation at all, rather a re‐distribution of nurses' work.Relevance to clinical practiceDelegation is a vital component of the scope of practice of registered nurses. This review has highlighted unique differences in delegation by practice context, where the proliferation of unlicensed workers in certain contexts places a vastly different professional and legal burden on the registered nurse.