Exploring decision making in intellectual disability nursing practice: a qualitative study

Abstract

Due to the dearth of relevant research, intellectual disability nurses may have difficulty identifying sources of evidence on which they can base their clinical decisions. The aim of the present research was to explore how intellectual disability nurses make decisions and how their decisions are influenced by evidence. The method was guided by interpretative phenomenology and the analysis adopted an idiographic approach. Twelve National Health Service intellectual disability nurses in Wales participated in semi-structured interviews. Four key themes were identified: getting to know the person; working as a team; evidence to support decision making; and understanding of evidence-based practice. In the context of the myriad of other professionals involved in caregiving, the nurses conveyed a commitment towards ensuring that the person with intellectual disability is at the centre of decision making. Although using empirical evidence to support practice was acknowledged, these nurses considered person centred decision making to be paramount.

‘To move or not to move’: a national survey among professionals on beliefs and considerations about the place of end‐of‐life care for people with intellectual disabilities

“…This is in line with the findings of Williams et al . (), who found that listening to the person with ID is central to the decision‐making of ID nurses. Nonetheless, only 8% of the care staff and ID physicians explicitly mentioned that the wishes or preferences of the client were taken into account in actual decisions, while the wishes and preferences of family members were mentioned twice as often (15%).…”

Understanding the contemporary role of the intellectual disability nurse: A review of the literature

“…It can also mean providing physical care such as oral and personal hygiene, attending to matters of sexual health, and conducting mobility assessment (McKeon, ; Nelson & Carey, ; Taggart, Truesdale‐Kennedy, & McIlfatrick, ). Finally, it can mean delivering relational or psychological care such as client advocacy, assistance with decision making, behavioural management and counselling (Llewellyn & Northway, ; Sheerin & McConkey, ; Williams, Roberts, Irvine, & Hastings, ).…”

“…Some nurses have expressed a need for training and education in advocacy to support the health and well‐being of their clients (Llewellyn & Northway, ). Others have suggested that education founded on appropriate research would greatly enhance the decision‐making processes of nurses working with people with ID through influencing person‐centred thinking and better using evidence from the person with ID (Williams et al., ). Additionally, client education and health promotion has been described as a key role for nurses working with people with ID (O'Connor & Carey, ; Taggart et al., ).…”

Working with people with learning disabilities in varying degrees of security: nurses' perceptions of competencies

“…Knowledge of the patient and team working constituted key factors in making decisions, concurring with Williams et al . (), although there was sparse reference to recognized sources of evidence, an acknowledged problem in learning disability nursing (Girot ) because of the limited research base (Griffiths et al . ).…”