The experiences of orthopaedic and trauma nurses who have cared for adults with a learning disability

Abstract

Background There is no published empirical research about the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability, however adults with a learning disability sustain more injuries, falls and accidents than the general population and because of their increased health needs there has been a corresponding increase in their numbers attending general/acute hospitals. The 6 C's is a contemporary framework and has been used to gauge how orthopaedic and trauma nurses rate the Care, Communication, Competence, Commitment, Courage and Compassion for patients with a learning disability in orthopaedic and trauma hospital settings compared to patients without a learning disability. Aim The aim of the study was to explore the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability. Design The study is based on a descriptive survey design and used a questionnaire to elicit data from participants. Methods Thirteen Registered Nurses completed a questionnaire. The study was explained to delegates attending a concurrent session on the topic of acute hospital care for people with a learning disability at a conference and the questionnaire was left on a table for participants to take if they wished. Potential participants were asked to return the questionnaire in a pre-prepared enveloped to the reception area of the hotel where the conference was held by the end of the 2 day conference. It was a convenience sample. Findings All participants that completed the questionnaire 100% (n=13) had cared for a patient with a learning disability. Using the 6 C's as a framework suggested that care, communication and competence of nurses were worse for people with a learning disability than for people without a learning disability. 3 main themes emerged regarding areas of good practices, 1. Promoting a positive partnership with patients and carers; 2. Modifying care and interventions; 3. Supporting the healthcare team. Conclusion There was evidence of good practices within orthopaedic and trauma settings such as the active involvement of family or a paid carer who is known to the patient and the modification of care and interventions along with specialist advice and support from the Acute Liaison Learning Disability Nurse. There were areas of concern such as the lack of use of Hospital Passports and the inconsistent implementation of reasonable and achievable adjustments. Alongside this it is unknown if the care for patients with a learning disability is adequate. However, the themes that have emerged accord with the key domains in ‘A competency framework for orthopaedic and trauma practitioners’ (RCN 2012) and therefore could be considered for inclusion in future orthopaedic and trauma competencies to enable sharing of best practices.