A new $1.2 million national project is aiming to build the capacity of nurses in Australia to provide quality accessible care to people with intellectual disability and/or autism in mainstream health services.
Co-led by Southern Cross University Professor Andrew Cashin, and Associate Professor Nathan Wilson, from Western Sydney University, the three-year project will develop free online learning resources, co-designed with people with disability, to equip more than 400,000 nurses with the skills to provide more inclusive experiences for the cohort and better meet their health needs across settings such as hospitals and primary care.
The project received funding earlier this year from the first round of the National Disability Insurance Scheme’s (NDIS) Mainstream Capacity Building Program grants, with more than $35 million awarded to 28 organisations to carry out projects that lead to practice change in the delivery of mainstream services and more inclusive approaches for people with disability.
“We’re very excited because it will enable us to do some really timely work to understand what’s happening in the space of disability nursing in Australia and hopefully do some work with nurses so we can all make a big impact in people’s lives who need it,” says Andrew Cashin, Professor of Autism and Intellectual Disability at SCU.
The project’s tagline is caring for people with intellectual disability and/or autism is every nurse’s business.
A broad range of consortia members representing universities and peak professional bodies are involved, including the Australian Nursing and Midwifery Federation (ANMF), the Australian College of Critical Care Nurses (ACCN), the Professional Association of Nurses in Developmental Disability Australia (PANDDA), the College of Emergency Nursing Australasia (CENA) and the Australian Primary Health Care Nurses Association (APNA).
They will help tap into their more than 280,000 nurse members nationally and promote and distribute learning material to them via varied platforms.
Professor Cashin reveals the plan for the project evolved from research into the lack of consistent content within current education on the topic in undergraduate nursing curriculums.
“The other thing is there’s been really well publicised disparities in health outcomes of people with intellectual disability and autism and that offered another insight into the fact we could do better in terms of helping people,” he explains.
“People with an intellectual disability and autism often don’t fit well within systems that are designed based on typical thinkers and it has been practice in some places to receive less than inclusive care.”
“We’re nurses working with nurses on a shared goal of building mainstream access to healthcare for people with intellectual and developmental disability.”
The evidence-based online learning resources targeting the scope of nurses’ practice in Australia will consist of three training levels.
The first will involve an hour of interactive learning content, including short videos and a quiz, on topics such as definitions and causes, common physical and mental health problems and disparities, and reasonable adjustments to nursing practice.
The intermediate level, consisting of four hours of training, will delve deeper into the same areas and add an interactive documentary video on how to conduct a health setting audit with people with intellectual disability and/or autism and offer tools to modify that setting to increase inclusivity.
The final and advanced training will cover content from previous levels and expects nurses undertaking the level to be on track to become ‘champions’ and liaise with workers within their practice area.
The enhanced content will include how to modify nursing assessments, how to reduce diagnostic overshadowing, and how to develop social stories to reduce anxiety related to health procedures.
Crucially, at this stage participants will also be able to access online group discussion sessions with intellectual disability and/or autism nursing experts to discuss clinical issues.
“It’s moving from just raising awareness that it is every nurse’s responsibility and that reasonable adjustments need to be made to allow people to access services which are vital to changing these health disparities, to actually starting to get an idea what the reasonable accommodations would be – what sort of small changes can make the world of difference to allow someone to participate in healthcare.”
The foundational level content will be made freely available to consortia member organisations to promote, distribute and manage, while the intermediate and advanced levels will be housed on a secure learning site embedded in the Professional Association of Nurses in Developmental Disability Australia (PANDDA) website.
Ultimately, Professor Cashin says the capacity building project is aiming to fill the void of current training and provide a valuable resource for nurses in Australia, who are at the forefront of the mainstream health system, to become more confident and competent when caring for people with intellectual disability and/or autism.
Importantly, he says the learning resources will be co-designed with people with intellectual disability and/or autism and their carers, allowing insights to the barriers facilitators faced when accessing the mainstream health system to be garnered.
“On the whole, the health disparities experienced by people with intellectual disability and autism mean they’re dying earlier and have a higher burden of chronic illness. It tells us that these outcomes are less than optimum so we need to actually build capacity to improve outcomes.”
Professor Cashin says the project will also include two national surveys, one at the beginning of the project and one at completion, to gauge the confidence levels of nurses, their strengths, and perceived challenges, when it comes to caring for people with an intellectual disability and/or autism, in a bid to shape targeted educational interventions.
His vision is that the project shows that caring for people with an intellectual disability and/or autism is every nurse’s business and that they must help facilitate both preventative and remedial quality access to healthcare.
“The main thing is we hope nurses become conscious of the fact that the health disparities are so great and that there’s so much difference they can make in people’s lives through small accommodations to practice.”