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non-peer-reviewed, The wide range of health conditions and complex needs experienced by people with intellectual disability (ID) means that they are more likely to utilise acute care services in comparison with the general population. ID accounts for 1% to 3% of the world’s population and has an onset before the age of 18 years (22 years from an American perspective according to the American Association on Intellectual and Developmental Disabilities (AAIDD) 2021). ID is characterised by lifelong limitations in cognitive and adaptive functioning and experiences of social and environmental restrictions which create barriers to effective participation in daily life. With increased childhood survival rates and improved diagnostic, screening and identification, this percentage has the potential to increase in the coming decades., PUBLISHED, non-peer-reviewed

peer-reviewed, BACKGROUND: Nursing process quality care metrics and indicators are quantifiable measures of the nursing care delivered to clients. They can be used to identify and support nurses' contribution to high quality, safe, client care and are lacking in specialist intellectual disability nursing. In a national Nursing Quality Care-Metrics project for Irish intellectual disability services, a set of nursing quality care process metrics and associated indicators were established for intellectual disability services. METHODS: A two-stage design approach was undertaken; a broad scoping review of the literature and a modified Delphi consensus process. The Delphi included a four round e-Delphi survey and a consensus meeting. Four hundred one intellectual disability nurses working in Ireland were recruited for the surveys and 20 stakeholders attended the consensus meeting. RESULTS: From the review, 20 existing and 16 potential intellectual disability nursing metrics were identified for nurses to prioritise in the e-surveys. After the four survey rounds, 12 intellectual disability nursing metrics and 84 associated indicators were identified. Following the consensus meeting, these were reduced to 12 metrics and 79 indicators. CONCLUSIONS: This first set of intellectual disability nursing process metrics and associated indicators has been identified for implementation in practice. These metrics while developed in Ireland have international relevance and their application and appropriateness in practice needs to be evaluated., PUBLISHED, peer-reviewed

peer-reviewed, The full text of this article will not be available in ULIR until the embargo expires on the 25/06/2020, AIM: To develop a suite of nursing quality care process metrics and indicators for older persons care settings in Ireland. BACKGROUND: Regulatory investigations of health system failures highlight non-adherence to clinical guidelines and standards resulting in deficiencies in nursing care delivery. Limited attention has been paid to measuring nursing care processes particularly in the care of older people. Quality care process metrics can facilitate measurement of nurse-sensitive measures of care. DESIGN: A scoping literature review and modified Delphi-Consensus Technique. METHODS: A scoping review of literature published between January 2007 - January 2017 was conducted to identify nursing process metrics and indicators. The Delphi Consensus phase incorporated a four-round electronic survey of 404 nurses and a consensus meeting with 13 stakeholders working in Older Persons Care Settings in Ireland. FINDINGS: From the review, 33 potential metrics were identified. After all Delphi survey rounds, 20 metrics and 90 associated indicators were selected by the nurses. Following the consensus meeting, 19 metrics and 80 indicators were included in the final suite of nursing quality care process metrics and indicators. CONCLUSION: Developing this suite of nursing quality care process metrics and indicators for use in older persons care settings provided consensus on what nursing processes should be measured to improve the quality and safety of care delivery. IMPACT: The nursing processes identified, provide a framework for future research and educational programmes in the care of older persons. Although conducted in the Irish healthcare system, there is potential for adoption or adaption in other healthcare settings, ACCEPTED, peer-reviewed

peer-reviewed, 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., ACCEPTED, peer-reviewed

peer-reviewed, Purpose – Despite the high incidence of aggressive behaviours among some individuals with intellectual disability, Ireland has paid little attention to the prevalence of aggressive behaviours experienced by Registered Intellectual Disability Nurses (RNID). Within services the focus is mainly on intervention and management of such behaviours. Therefore a disparity occurs in that these interventions and management strategies have become the exclusive concern. Resulting in aggressive behaviour being seen as a sole entity, where similar interventions and management strategies are used for ambiguously contrasting aggressive behaviours. Consequently the ability to document and assess-specific behaviour typologies and their prevalence is fundamental not only to understand these behaviour types but also to orient and educate RNIDs in specific behaviour programme development. The paper aims to discuss these issues. Design/methodology/approach – This study reports on a survey of the prevalence of verbal aggression, aggression against property and aggression against others experienced by RNIDs’ within four residential settings across two health service executive regions in Ireland. A purposeful non-random convenience sampling method was employed. In total, 119 RNIDs responded to the survey which was an adaptation of Crocker et al. (2006) survey instrument Modified Overt Aggression Scale. Findings – The findings of this study showed the experienced prevalence rate of verbal aggression, aggression against property and aggression against others were 64, 48.9 and 50.7 per cent, respectively. Cross-tabulation of specific correlates identifies those with a mild and intellectual disability as displaying a greater prevalence of verbal aggression and aggression against property. While those with a moderate intellectual disability displayed a higher prevalence of aggression against others. Males were reported as more aggressive across all three typologies studied and those aged between, ACCEPTED, peer-reviewed

peer-reviewed

peer-reviewed, Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.

peer-reviewed, Background: People with intellectual disability experience poorer health and health-care access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person-centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. Methods: A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/ units/care homes were reviewed and reported as per PRISMA-ScR checklist and PRISMA flow diagram.

peer-reviewed, Aim: To describe the development of a guidance framework to assist nurses and midwives in selecting nursing and midwifery care process metrics and indicators for use in practice. Background: Process metrics are measures of care provision activities by nurses and midwives. Methods: Phase 1 was a rapid review assessment of the literature conducted to identify an initial framework. Six electronic databases were searched with Google Scholar and reference tracking performed. Phase 2 was expert review of the developing framework by nursing and midwifery experts in practice, academia and an international expert in quality care metrics. Results: The literature assessment yielded 28 papers with 59 metric attributes identified. From this, a six‐domain framework was developed. Following expert review, the framework was reduced to four domains: “Process Focused,” “Important,” “Operational” and “Feasible.” Conclusions: This is the first framework specifically to guide nurses and midwives in selecting nursing and midwifery process metrics and indicators.

peer-reviewed, Stress is an important issue within nursing and it is difficult to find agreement among those who are expert in the area regarding a concise definition of stress. Nevertheless stress is seen as a negative feeling affecting people’s health either physically and/or psychologically. However, stress is a normal part of life and considered necessary to increase functional capacity, whereas stress over a prolonged period or when extreme can cause distress which may have debilitating effects that reduce work output, increase absenteeism and reduce one’s ability to cope with situations. The most important resource in any organisation is the employee; therefore maintaining and supporting their health is vital to ensure their ability to work, maintain standards and continuously improve standards of care. Leadership styles within organisations must facilitate staff to be involved in decision making; thereby staff feel more valued and work in an autonomous way. This article identifies and discusses the effect of stress on health and its relationship to nursing

non-peer-reviewed, 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.