Evidence and Practice
A look at Batten disease, a collection of rare and fatal inherited disorders of the nervous system
Reflexivity can be used by researchers to manage their thoughts, feelings and preconceptions
Exploring the evidence base for mindfulness-based interventions for people with LDs
Supporting and mentoring learning disability nursing students can be rewarding for all parties, but the challenge is to ensure that the process is robust and effective. The Nursing and Midwifery Council (NMC) standards for entry to the register require that all nursing students are competent in the four domains of professional values; communication and interpersonal skills; nursing practice and decision-making; and leadership, management and team working. Providing nursing students with the opportunity to practise and become competent in these domains formed the basis of the Telford model’s development. This article describes the model and explains how it works in practice, using the experiences of nursing students and their mentors. The article also shows how implementing the model can improve students’ competence and confidence while increasing placement capacity, which easily matches the new NMC standards to support learning and assessment in practice.
The benefits of a communication forum specifically in support of community reintegration
An interactive and collaborative approach may be most effective
Asthma is a long-term condition that requires patient education, support and close monitoring. It is important that individuals are empowered and educated about their asthma and supported to self-manage as appropriate. Self-management is a goal that is recommended as an established and effective approach. However, it can be challenging for many individuals, including those with learning disabilities. Learning disability nurses can support individuals diagnosed with asthma to self-manage the condition and should have the knowledge, skills and competence to do so.
Care should be person-centred, holistic and underpinned by current evidence-based practice
The knowledge and skills required to manage patients with a PEG tube safely and effectively
Many adults with intellectual disabilities require nutritional support as feeding problems are prevalent in this population. While many types of nutritional support are available, enteral feeding tubes, such as nasogastric (NG) tubes, are considered safe and effective. NG tube feeding is a common clinical procedure carried out to maintain patients’ nutritional needs when they have swallowing difficulties or cannot tolerate oral feeding. Insertion of an NG tube provides adequate nutrition and improves positive health outcomes and quality of life, but being fed through an NG tube may alter patients’ perceptions of feeding and mealtimes. Healthcare professionals, including intellectual disability nurses, should not underestimate the social aspect of mealtimes or the physical and psychological effects of NG tube feeding in patients with intellectual disabilities. Demonstrating competence and compassion with regard to insertion and care of an NG tube and applying best practice to ensure patient safety and well-being are critical to supporting patients with intellectual disabilities.
Healthcare professionals who support people who require an inhaler or nebuliser need to know how to use the devices, monitor and assess patients’ inhaler techniques effectively. Often, people have inadequate inhaler techniques, which can lead to poor management of their respiratory condition, increased signs and symptoms, reduced quality of life and increased use of primary/secondary care services and treatment costs. This article explains how to use inhalers and nebulisers appropriately and considers some of the challenges for children and adults with a learning disability. It also describes some devices and assessment tools, and explores assessment/review methods to help ensure people use their inhalers/nebulisers successfully.
Keratoconus is a potentially sight-threatening condition in which the cornea distorts and becomes fragile, and without treatment can lead to severe visual impairment. The condition is much more common in people with Down’s syndrome and likely to be more common in people with other types of learning disability. Since the advent of a new treatment, corneal cross-linkage, which is only applicable in the early stages of the condition, early diagnosis has become imperative. However, people with learning disabilities are less likely to complain of poor vision and more likely to have poor vision and astigmatism which can mask early changes, so keratoconus can be missed. It is essential that those caring for and supporting people with a learning disability appreciate the risk of keratoconus and ensure that clients have regular and appropriate eye examinations from the age of ten years. When keratoconus is diagnosed it is important to discuss treatment options and for carers to understand the effects of the condition to minimise sight loss and maximise quality of life. Aims and intended learning outcomes This article describes the progressive eye condition keratoconus and its effect on sight and treatment. The aim of the article is to enable readers to better identify the risk to people with learning disabilities they are supporting, to recognise signs and symptoms of sight loss and to anticipate potentially beneficial treatment. After reading this article and completing the time outs you should be able to: • Describe keratoconus and its prevalence among the general population and people with learning disabilities. • Summarise the effects of the various stages of the condition on sight. • Outline the treatment options and the stages at which they are applicable. • Discuss the importance and challenges of early diagnosis. • Advise families and carers on the importance of regular and appropriate eye examinations. • Appreciate how to support young people undergoing examinations and treatment for keratoconus.