To describe how specialised models of registered nurse-led care and support can play a vital role in the health and quality of life of someone with intellectual disability and multiple chronic and complex health problems.
Single instrumental case study.
Data collection occurred between March and August 2023, and included interviews with parents, historical case files, descriptions of the nurse-led model of care and a list of the daily registered nurse-led interventions.
The evidence presented strongly support the positive impact a nurse-led model of care can have for persons with profound disability and complex health conditions, and their families. The improved quality of life observed in this project underscores the significant role nurses play in enhancing the well-being of this vulnerable population.
Further research on a larger scale should be completed to create a robust foundation of a specialised, nurse-led model of care for individuals with profound disability and complex health conditions.
There is room for funded intermediate models of care as the health system cannot be expected, and nor is it appropriate, to provide ongoing care for all people with intellectual disability.
This study adhered to the COREQ guidelines for qualitative research.
No patient or public contribution.
To survey registered nurses' familiarity with delegation standards and confidence to delegate to unlicenced workers within their practice.
Cross-sectional exploratory survey design.
The survey focused on Australian registered nurses (n = 420). Initial descriptive analysis was undertaken. Additionally, inferential analysis was undertaken between two independent variables focused on familiarity of delegation policy, and confidence to delegate, and several demographic and workplace variables. Stepwise linear regression was undertaken to determine predictors of the two delegation variables. The cross-sectional study was undertaken according to the STROBE reporting checklist.
The majority of respondents were somewhat familiar, or not familiar at all with delegation standards. This pattern was followed for results relevant to confidence delegating to unlicenced workers. Nurses working in adult acute, intensive care and emergency department reported the lowest levels of familiarity with delegation. Additionally, intensive care nurses were significantly less likely to feel very confident delegating to unlicenced support workers. Stepwise regression revealed identifying as male, and working in the public sector were less likely to be confident delegating. Nurses working in the acute setting and public sector were less familiar with delegation standards.
The findings of this study highlight the nuanced nature of delegation to unlicenced workers in Australian nursing settings, with nurses from certain contexts being far less likely to be familiar with or confident undertaking the practice.
The findings of this study have significant implications to increase understanding of nurses diverse contexts of practice and how delegation standards might not be implemented in practice in a confident manner.