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Posted: November 15th, 2023
Evidence-Based Nursing Practices for Disabled Patients
Nursing is a profession that aims to provide high-quality, person-centred care to all patients, regardless of their abilities or disabilities. However, disabled patients often face barriers and challenges in accessing and receiving appropriate health care services. Therefore, nurses need to be aware of the specific needs and preferences of disabled patients and implement reasonable adjustments to ensure that they are not disadvantaged or discriminated against.
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What are reasonable adjustments?
According to the Equality Act 2010, reasonable adjustments are changes or modifications that service providers must make to avoid putting disabled people at a substantial disadvantage compared to non-disabled people. Reasonable adjustments can include:
- Providing information in accessible formats, such as large print, braille, audio or easy read.
- Offering alternative methods of communication, such as sign language interpreters, speech-to-text software or communication aids.
- Allowing extra time for appointments, assessments or procedures.
- Providing additional support or assistance, such as personal assistants, advocates or peer mentors.
- Making physical changes to the environment, such as ramps, handrails, lifts or adjustable beds.
Reasonable adjustments should be based on the individual needs and preferences of each disabled patient and should be agreed with them in advance. Nurses should also document the reasonable adjustments that have been made and communicate them to other health and social care professionals involved in the patient's care.
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What is evidence-based practice?
Evidence-based practice (EBP) is a process of making clinical decisions based on the best available evidence, clinical expertise and patient values and expectations. EBP involves five steps:
- Asking a focused and relevant clinical question.
- Searching for and appraising the quality of the evidence.
- Integrating the evidence with clinical expertise and patient values and expectations.
- Implementing the decision or intervention.
- Evaluating the outcomes and effectiveness of the decision or intervention.
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EBP can help nurses to provide high-quality, safe and effective care to disabled patients by ensuring that their decisions and interventions are based on the most current and reliable evidence. EBP can also help nurses to identify gaps in knowledge and practice and seek further education or training to improve their skills and competencies.
Examples of evidence-based nursing practices for disabled patients
There are many examples of evidence-based nursing practices that can benefit disabled patients. Here are some of them:
- Nurses’ experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach. This review synthesised qualitative studies on nurses' experiences of caring for patients with intellectual developmental disorders (IDD) and found that nurses often lacked awareness and knowledge about this group of patients and faced challenges in communication, collaboration and coordination of care. The review suggested that nurses need more education and training on IDD, as well as nursing models that focus on patient-centred care and respect for diversity.
- Implementing reasonable adjustments for disabled people in healthcare services. This article described examples of how three healthcare services made reasonable adjustments for disabled patients, such as identifying them in advance, considering and recording their specific needs and preferences, communicating effectively with other health and social care providers, working together as a team and treating disabled people as individuals. The article highlighted the importance of involving disabled people in the planning and delivery of their care and ensuring that their views and experiences are valued and respected.
- What is evidence-based practice in nursing?. This webpage explained the concept and process of EBP in nursing and provided resources and tools to help nurses apply EBP in their practice. The webpage emphasised that EBP is not only about using research evidence, but also about incorporating clinical expertise and patient values and expectations into clinical decision making. The webpage also encouraged nurses to seek feedback from patients and colleagues and reflect on their practice to improve their outcomes and quality of care.
- Aging and Disability Evidence-Based Programs and Practices. This webpage provided information about evidence-based programs and practices in the areas of aging
and disability that have been reviewed by experts from the Administration for Community Living (ACL). The webpage listed various programs and practices that address different topics, such as chronic disease management, falls prevention, mental health promotion, caregiver support and dementia care. The webpage also provided links to additional resources and guidance on how to implement these programs and practices in different settings.
- Nursing Best Practices: Caring for Disabled Patients. This blog post summarised some best practices for nurses to consider when caring for disabled patients, such as ensuring accessibility, promoting autonomy, respecting dignity, providing holistic care, fostering inclusion, facilitating communication, building rapport, educating patients and families, advocating for rights and resources, collaborating with other professionals and evaluating outcomes. The blog post also suggested some online courses and webinars that nurses can take to enhance their knowledge
and skills on disability issues.
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Conclusion
Nursing is a profession that strives to provide high-quality, person-centred care to all patients, regardless of their abilities or disabilities. However, disabled patients often face barriers and challenges in accessing and receiving appropriate health care services. Therefore, nurses need to be aware of the specific needs and preferences of disabled patients and implement reasonable adjustments to ensure that they are not disadvantaged or discriminated against. Nurses can also use evidence-based practice to guide their clinical decisions and interventions and improve their outcomes and quality of care. By doing so, nurses can contribute to reducing the health and care inequalities that disabled people still face and promote their health and well-being.
References
: Appelgren M, Bahtsevani C, Persson K, Borglin G (2018) Nurses’ experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach. BMC Nursing 17:51. https://doi.org/10.1186/s12912-018-0316-9
: Heslop P, Turner S, Read S et al (2019) Implementing reasonable adjustments for disabled people in healthcare services. Nursing Standard. https://doi.org/10.7748/ns.2019.e11172
: American Nurses Association (2021) What is evidence-based practice in nursing? https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/
: Administration for Community Living (2021) Aging and Disability Evidence-Based Programs and Practices. https://acl.gov/programs/strengthening-aging-and-disability-networks/aging-and-disability-evidence-based-programs
: DiversityNursing.com (2023) Nursing Best Practices: Caring for Disabled Patients. https://blog.diversitynursing.com/blog/nursing-best-practices-caring-for-disabled-patients
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