Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

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Interventions to Reduce Benzodiazepine and Sedative-Hypnotic Drug Use in Acute Care Hospitals: A Scoping Review

10.21203/rs.3.rs-88543/v1 ◽

2020 ◽

Author(s):

Heather L Neville ◽

Courtney Granter ◽

Pegah Adibi ◽

Julia Belliveau ◽

Jennifer E Isenor ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Relaxation Training ◽

Care Setting ◽

Grey Literature ◽

Healthcare Providers ◽

Acute Care Setting ◽

Stakeholder Consultation ◽

Behavior Change Interventions ◽

Hospital Patients

Abstract Background Benzodiazepines and sedative-hypnotics (BZD/SHD) are commonly utilized in the acute care setting for insomnia and anxiety and are associated with cognitive impairment, falls, fractures, and increased mortality. Interventions to reduce use of BZD/SHD in hospitals are not well characterized. The objective of the scoping review was to identify and characterize interventions to reduce the use of BZD/SHD by adults for anxiety and sedation in hospitals.Methods We included studies and abstracts published in English that described an intervention to reduce BZD/SHD in adult hospital patients. Six databases (PubMed, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science) and the grey literature (Opengrey, Grey Matters, Google Advanced) were searched up to July 2018. Titles and abstracts were screened and full-text articles were reviewed for potential inclusion by three independent reviewers. Data on each eligible study was charted in a Microsoft Excel® database. Stakeholder consultation occurred before and after the scoping review was completed. Results There were 9480 records identified from all sources and 35 studies were included in the scoping review. Included studies were divided into two categories that emerged from stakeholder feedback: sedatives prescribed in hospital or home medications. The most common study designs were pre-/post-test (24, 68.6%) and randomized controlled trials (6, 17.1%). The majority of studies tested a single intervention (28, 80%) and these were most commonly education, relaxation training and sleep protocols. Patients were frequently the target of relaxation training and behavior change interventions, while sleep protocols, multifaceted interventions and education were usually directed at healthcare providers, either alone or in combination with patients. Most studies reported positive outcomes in decreasing BZD/SHD use (23, 65.7%), including some that were statistically significant (13, 37.1%). Conclusions This scoping review found a variety of interventions aimed at decreasing the utilization of BZD/SHD in the acute care setting, where previously little was known. Current literature addressed the initiation of BZD/SHD in hospital, rather than chronic medications that had been prescribed in the community. Stakeholder consultation supported these findings and pointed out important factors to consider when designing an intervention for hospital patients. Registration: Open Science Framework, https://osf.io/u7s4h/?view_only=15a9b9134be743b6a4177ba2eec9e91a

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A qualitative study of nurses’ perspectives of caring for children with intellectual disability and their families in a paediatric acute care setting

Journal of Child Health Care ◽

10.1177/1367493519867234 ◽

2019 ◽

Vol 23 (4) ◽

pp. 639-651 ◽

Cited By ~ 1

Author(s):

Peter Lewis ◽

Nathan J Wilson ◽

Hayden Jaques ◽

Kate O’Reilly ◽

Michele Wiese

Keyword(s):

Intellectual Disability ◽

Acute Care ◽

Care Setting ◽

Adaptive Functioning ◽

Care Delivery ◽

Hospital Setting ◽

Acute Care Setting ◽

Additional Time ◽

Paediatric Hospital ◽

Children With Intellectual Disability

Children with intellectual disability (ID) experience chronic and pervasive limitations across intellectual and adaptive functioning. They are also at risk of developing co-morbidities. They are likely to be hospitalised more frequently and for longer periods of time than other children. The purpose of this study was to understand the experiences of nurses when caring for children and teenagers with ID in an acute paediatric hospital setting. The aim of the research was to inform future directions for the delivery of equitable and effective care for this vulnerable population. This study used a qualitative thematic analysis of individual interviews conducted with eight registered and enrolled nurses who provided care to children and adolescents with ID in an Australian paediatric acute hospital setting. Themes which emerged from this analysis were (1) Recognising similarities and managing differences; (2) Nurse–parent relationships; and (3) Caring for children with ID requires additional time. This study highlights that navigating care delivery and relationships when working with young people with ID and their caregivers in an acute care setting is complex. Nursing children with ID in hospital requires sophisticated skills. To ensure quality healthcare for patients with ID, a range of strategies are proposed.

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What Evidence Informs the Nursing Care of People with Class III Obesity in an Acute Care Setting? A Scoping Review.

10.21203/rs.3.rs-31488/v1 ◽

2020 ◽

Author(s):

Beverley Ewens ◽

Vivien Kemp ◽

Amanda Towel-Barnard ◽

Lisa Whitehead

Keyword(s):

Patient Care ◽

Acute Care ◽

Nursing Care ◽

Scoping Review ◽

Improve Patient Care ◽

Well Being ◽

Class Iii ◽

Inclusion Criteria ◽

Class Iii Obesity ◽

Acute Care Settings

Abstract Background: Obesity is a complex psycho-social construct which is strongly linked with health and well-being. The health and socioeconomic impacts of obesity on individuals and health care systems can be significant. The nursing care of people with Class III obesity needs careful attention to ensure the provision of appropriate care. This scoping review aims to synthesise available evidence on the nursing care of Class III obese patients in acute care settings. Methods : A scoping review informed by the Joanna Briggs Institute approach was undertaken. We searched CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase databases for primary research articles relating to the nursing management of people classified as Class III obese in acute care settings. The methodological quality of all studies that met the inclusion criteria were assessed and data relating to methods and the findings extracted and synthesised into themes. Results : 3809 records were identified. Thirteen studies met the inclusion criteria and were included in the review. Three themes were generated from the synthesis of the findings: Access, knowledge and training related to equipment; Patient care; and Opportunities to improve care. Conclusions : The need for proactive planning to improve the nursing care provided to people classified as class III obese and admitted to acute care settings is vital. Access to appropriate equipment to support moving and handling and education on equipment use to prevent injury to both patients and staff is necessary. Education and support to promote engagement with patients, adapt nursing care practices and promote self-care have the potential to improve patient care and patient outcomes.

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What do we know about frailty in the acute care setting? A scoping review

BMC Geriatrics ◽

10.1186/s12877-018-0823-2 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 61

Author(s):

Olga Theou ◽

Emma Squires ◽

Kayla Mallery ◽

Jacques S. Lee ◽

Sherri Fay ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Care Setting ◽

Acute Care Setting

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Two Simple Glucose Tests Flag Diabetes in Acute Care Setting

Hospitalist News ◽

10.1016/s1875-9122(08)70193-7 ◽

2008 ◽

Vol 1 (8) ◽

pp. 8

Author(s):

LEANNE SULLIVAN

Keyword(s):

Acute Care ◽

Care Setting ◽

Acute Care Setting

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Accurate falls risk assessment and interventions for preventing falls in patients in the acute care setting within a private hospital in a large capital city: a best practice implementation project

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-201513090-00023 ◽

2015 ◽

Vol 13 (9) ◽

pp. 386-406 ◽

Cited By ~ 3

Author(s):

Samara Szymaniak

Keyword(s):

Risk Assessment ◽

Acute Care ◽

Best Practice ◽

Care Setting ◽

Private Hospital ◽

Capital City ◽

Acute Care Setting ◽

Falls Risk ◽

Implementation Project ◽

Practice Implementation

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Methods used to attribute costs avoided from pharmacist interventions in acute care: A scoping review

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxab214 ◽

2021 ◽

Author(s):

Sujita W Narayan ◽

Ivo Abraham ◽

Brian L Erstad ◽

Curtis E Haas ◽

Arthur Sanders ◽

...

Keyword(s):

Acute Care ◽

Scoping Review ◽

Pharmacy Practice ◽

Economic Implications ◽

Medline Search ◽

Cost Avoidance ◽

Harmful Consequence ◽

Pharmacist Interventions ◽

Acute Care Settings ◽

Human Participants

Abstract Purpose Cost-avoidance studies are common in pharmacy practice literature. This scoping review summarizes, critiques, and identifies current limitations of the methods that have been used to determine cost avoidance associated with pharmacists’ interventions in acute care settings. Methods An Embase and MEDLINE search was conducted to identify studies that estimated cost avoidance from pharmacist interventions in acute care settings. We included studies with human participants and articles published in English from July 2010 to January 2021, with the intent of summarizing the evidence most relevant to contemporary practice. Results The database search retrieved 129 articles, of which 39 were included. Among these publications, less than half (18 of 39) mentioned whether the researchers assigned a probability for the occurrence of a harmful consequence in the absence of an intervention; thus, a 100% probability of a harmful consequence was assumed. Eleven of the 39 articles identified the specific harm that would occur in the absence of intervention. No clear methods of estimating cost avoidance could be identified for 7 studies. Among all 39 included articles, only 1 attributed both a probability to the potential harm and identified the cost specific to that harm. Conclusion Cost-avoidance studies of pharmacists’ interventions in acute care settings over the last decade have common flaws and provide estimates that are likely to be inflated. There is a need for guidance on consistent methodology for such investigations for reporting of results and to confirm the validity of their economic implications.

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