Introduction
Quality care metrics offer a measuring system that provides real-time reports and a standardized system to track and benchmark the quality of care. These metrics can determine and support nurses’ contribution to high-quality client care and many more (Health Service Executive, 2018).
Person-centered communication and personal assessment are some of the intellectual disability quality care metrics. Registered Nurse in Intellectual Disability (RNID) ensures that all support is person-centered and involves careful planning and assessing healthcare services. RNID conducts communication assessments and develops a plan that meets the patient’s needs (Health Service Executive, 2018). In physical health assessment, RNID determines the health risk factors with the treatment plan for an individual with an intellectual disability. Therefore, the RNID promotes quality care by using quality care metrics, person-centered communication and physical assessment.
Person-Centred Communication
Person-centered communication is an integral part of person-centered care because it helps in promoting quality care. It is described as a system that invites and motivates patients together with their families to participate in activities and negotiate decisions based on their healthcare needs (Health Service Executive, 2018). Patient-centered communication is vital in the provision of patient-centered care since it requires patients and healthcare providers to take part in treatment. In addition, patient-centered care can be done by honoring the dignity of patients via patient-centered communication. It is important for healthcare providers to understand the rights of patients because it enhances the provision of quality care. As a result, it helps RNID to acknowledge an individual as a person and respond to an individual’s feelings, needs and preferences.
The first role of RNID in person-centered communication is to assess the communication of the patient and document a plan. The RNID examines an individual’s communication abilities to understand their strengths and weaknesses (Health Service Executive, 2018). They can conduct various exams and language comprehension exercises designed to assess an individual competency in both written and oral mediums. Since individuals who have an intellectual disability may have communication problems, having different layers of this evaluation aid in determining how effectively an individual understands language, how quickly they absorb it, and their ability to react appropriately in the same language. The RNID uses the information gathered from the assessment to create a program for treating the patient.
The second role of RNID is to identify communication strategies to use during the treatment period. The RNID can use several communication strategies to communicate with an individual with an intellectual disability (Health Service Executive, 2018). For example, patient teach-back is an important communication strategy that the RNID can adopt to ensure that the patient communicates important information effectively and understands. In this strategy, a patient is asked to repeat back what they have been told in their own words. However, due to the nature of their patients, RNID can also consider using simple language. Effective communication is important for the delivery of quality healthcare services. Therefore, the RNID is tasked with assessing the patient and choosing the most appropriate communication strategy.
The third role of RNID is to document non-verbal and atypical communication behavioral patterns. Non-verbal communication transfers information through body language, while atypical communication is where a part of communication is not developing as anticipated, especially during childhood. Individuals with intellectual disabilities are prone to communication impairment (Health Service Executive, 2018). Since RNID give continuing care and support to young people with ID and their families as they develop from child to young adult, it is their mandate to ensure that they record communication behavior patterns. Thus, RNID promotes person-centered communication by documenting non-vernal and atypical communication patterns.
The fourth role of RNID is to ensure that an individual’s choice is obtained, valued and documented. The patient is at the center of treatment and should be involved in making appropriate decisions, especially in communication. Like their peers without disabilities, the RNID presumes individuals with intellectual disabilities as competent (Nursing and Midwifery Board of Ireland, 2014). As a result, RNID ensures that patients are engaged in selecting communication tools to use in the process. For example, if the patients choose to support certain communication strategies, the RNID ensures that the decision is respected and documented in the treatment plan. The intention is to ensure that patients take an active role in their treatment. Therefore, the RNID plays an integral role in ensuring that the treatment is person-centered by engaging the patient and integrating their choices into the plan.
Moreover, when a patient appears to lack understanding and cannot convey a choice for a treatment or procedure to be used, such as communication, RNID provides them with the time and assistance they require to maximize their ability to make decisions for themselves. Suppose the provider is uncertain about a patient’s capacity to make healthcare decisions. In that case, the doctor and other healthcare team members assess the patient’s capacity (Nursing and Midwifery Board of Ireland, 2014). They usually consider the expressed views of the patient who seems to lack the ability to make treatment or care decisions. In adverse situation, the RNID involve the family members, carers, or guardians. The purpose of this involvement is to make appropriate care decisions that consider a patient’s interest. As a result, RNID assesses an individual’s condition in the course of treatment to validate decision-making.
Physical Health Assessment
Physical health assessment is an integral part of nursing assessment because it assists in collecting key information about a patient. It is also known as physical examination and health assessment. Physical health assessment is crucial in determining an individual’s physical health issues (McCarron et al., 2018). It is usually considered the first step that assists in determining an individual’s medical need. To complete this task, the RNID uses assessment methods such as inspection and conducting a general survey. Acute changes and trends are tracked over time, and unexpected changes and values that differ greatly from the patient’s typical values are brought to the patient’s primary healthcare provider’s attention. Therefore, a physical examination is done to collect important information to facilitate treatment.
The first role of RNID in physical health assessment is to understand the associated health risk factors in the care plan. An individual’s health and well-being are usually impacted by various factors (Keenan and Doody, 2017). Knowledge of the health risks that people with intellectual disability experience help the RNID to avoid health problems and create an effective plan for its management. Some of the risk factors for intellectual disability that the RNID may encounter are infection, environment, nutrition, trauma before and after birth, and sometimes unexplained factors (Keenan and Doody, 2017). For example, children with neurodevelopmental disorders like cerebral palsy, or inborn metabolic abnormalities, frequently have gastrointestinal issues. The problem may be caused by feeding difficulties, aspiration, and malnutrition. The RNID uses this information to develop an effective treatment plan.
The second role of RNID is to conduct physical health checks every year. The checks provide specialized screening for health concerns specific to people with intellectual disabilities. For example, feeding, behavior, continence, and sensory issues are critical to knowing how an individual lives daily (Health Service Executive, 2018). The checks provide an excellent opportunity for health promotion and can assist individuals in taking an active role in their health and well-being. Information regarding co-existing long-term health problems and screening programs can benefit both the individual and their caregiver. In addition, conducting health checks regularly enables the RNID to understand the positive or negative changes in an individual’s health. The RNID prepares a plan to counter the negative changes with this information.
The RNID also ensures that recognized assessment tools for an individual with an intellectual disability are adopted. There are various assessment tools at the disposal to diagnose an individual (Connell, Barnett and Waters, 2018). Some of the assessment tools that a healthcare provider can use are health risk appraisal and comprehensive health assessment programs. Based on this, it is the mandate of the RNID to make sure that the right assessment tool is used in the process. They must also ensure that relevant stakeholders recognize the tool. For instance, a patient must know and understand the assessment tool. Having a good understanding of the assessment tools enable the patients to make an informed decision, especially during diagnosis. Therefore, RNID plays an important role in ensuring that the assessment process is effective and meets the standards of care.
Conclusion
The RNID uses quality care metrics, person-centered communication and physical assessment to play an integral role in the provision of quality care. Quality care metrics, such as entering data electronically, provide RNID with individualized data, which helps to enhance person-centered communication. They have the ability to assess a person’s communication talents to determine their strengths and limitations. In addition, the RNID administers various assessments and language comprehension exercises to evaluate an individual’s proficiency in both written and oral mediums. In physical assessment, RNID uses reports generated by quality care metrics to conduct research to determine the health risk factors linked with the care plan. As a result, a variety of circumstances frequently influence an individual’s health and well-being.
Reference List
Connell, T., Barnett, B. and Waters, D. (2018). ‘Barriers to antenatal psychosocial assessment and depression screening in private hospital settings. Women and birth’, 31(4), pp.292-298. Web.
Health Service Executive. (2018). Nursing and Midwifery Quality Care-Metrics: Intellectual Disability Services Research Report. HSE Office of Nursing & Midwifery Services Director: Dublin.
Keenan, P.M. and Doody, O. (2017). Nursing in Intellectual Disabilities: Irish and International Perspectives. Dublin: Nursing Network in Intellectual Disability Ireland.
McCarron et al. (2018). ‘Shaping the future of intellectual disability nursing in Ireland. Health Services Executive, Ireland’, 5.
Nursing and Midwifery Board of Ireland. (2014). ‘Code of professional conduct and ethics for registered nurses and registered midwives’. Web.