Residential care staff working knowledge of reporting restrictive practices within Intellectual Disability and Older Persons care settings: A scoping review

Veronica Mukwashi 

HSE, Waterford Residential Care Centre, Waterford, Ireland

https://orcid.org/0009-0006-6200-3495

Brian Sharvin 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland

Ruth Maher 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland

https://orcid.org/0000-0002-9556-3142

Michelle Davitt 

HSE, Wexford Residential Intellectual Disability Services, St. John’s Hospital, Munster Hill, Enniscorthy, Co. Wexford, Ireland

https://orcid.org/0009-0005-9383-2846

Louise Bennett 

Department of Nursing and Health Care, School of Health Sciences, Cork Road, South East Technological University (SETU), Ireland 

https://orcid.org/0000-0003-0311-2959

https://doi.org/10.33700/jhrs.4.1.143

Abstract

Introduction: This Restrictive practice is an intentional restriction of an individual’s voluntary movement or behaviour. Given the impingement of human rights associated with restrictive practice, many jurisdictions all over the world have advocated for a reduction in their use, highlighting the importance of reporting restrictive practice. However, a paucity of literature exists examining the knowledge of residential care staff regarding reporting restrictive practice.

Aim: To examine the knowledge of residential care staff regarding the reporting of restrictive practices in intellectual disability and older persons care settings.

Methods: A scoping review referenced to JBI and PRISMA guidelines was used. The studies were retrieved from a library multi-search function of various databases. Sixteen studies were included in the final analysis.

Findings: Findings demonstrate that residential staff lack knowledge of what defines a restrictive practice and find the reporting system as unnecessary, time consuming and burdensome. The identified barriers to reporting restrictive practice included: fear, lack of clear guidelines and awareness of the reporting system, lack of time, and staff shortages. While the facilitators included awareness campaigns, availability of appropriate reporting structures, and managerial support.

Conclusion: This review suggests that improvements in terms of residential staff understanding of and reporting of restrictive practice is required. Moreover, this review has the potential to assist policymakers to understand the individual, organisational and regulatory barriers and facilitators to reporting restrictive practice within intellectual disability and older persons care settings.

Keywords: residential care staff, residential care, reporting, incidents, restrictive practices, older persons, intellectual disability, knowledge

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Rehabilitation nurses’ knowledge, experiences, and perceptions of the provision of psychological care for patients post stroke in Ireland: A cross-sectional study

Gillian Merrigan Waterford Residential Care Centre Wateford

Louise Bennett South East Technological University https://orcid.org/0000-0003-0311-2959

https://doi.org/10.33700/jhrs.2.2.82

ABSTRACT

Introduction: Early assessment and management of depression and anxiety for patients after stroke is critical. However, suboptimal provision of psychological care is widely reported. Nurses are the largest professional group to care for patients post stroke and have an important role in addressing their emotional wellbeing.

Aim: The aim of this paper is to examine nurse’s knowledge, experiences, and perceptions of the provision of psychological care to patients post stroke in Ireland.

Methods: A cross-sectional descriptive survey design involving both quantitative and qualitative items was administered to a convenience sample of seventy-four (n=74) nurses working in six Irish community hospital rehabilitation units.

Results: Findings demonstrate suboptimal psychological care provision for patients post stroke with no formal pre-defined care pathways. Despite nurse’s knowledge of psychological problems and symptomology, participants revealed receiving limited training in psychological monitoring and no systemic allocation of psychological care duties. This research suggests that pre-defined/formal care pathways; access to psychology expertise; further training and support for members of the Multi-Disciplinary-Team has the potential to improve the provision of psychological care for patients post stroke.

Conclusions: This study has implications for the reform and development of rehabilitation services in relation to practice, education, and research. It identifies opportunities to support nurses to improve the delivery of psychological care for patients post stroke.

Keywords: stroke, rehabilitation nurses, knowledge, experiences, perceptions, psychological care, service improvement

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Rehabilitation nurses’ knowledge, experiences, and perceptions of the provision of psychological care to stroke patients: Systematic Review

Gillian Merrigan Our Lady’s Ward, Community Rehabilitation Unit, Waterford Residential Care Centre (WRCC), HSE, Waterford, Ireland. 00353-051- 848700
Louise Bennett 2. Department of Nursing and Health Care, School of Health Sciences, South East Technological University (SETU), Cork Road, Waterford City, Ireland, X91 N2FP. 00353-051- 845558 https://orcid.org/0000-0003-0311-2959

https://doi.org/10.33700/jhrs.2.1.70

ABSTRACT

Introduction: Depression and/or anxiety is associated with sub-optimal recovery and a reduction in quality of life for patients following a stroke. However, the literature suggests that the psychological needs for patients post stroke are insufficient with poor provision of psychological services.
Aim: To examine HCPs knowledge, experiences, and perceptions of the provision of psychological care to patients post stroke.
Methods: A systematic review referenced to PRISMA guidelines was used. The studies were retrieved from six databases (CINAHL, the Cochrane Library, PubMed, Science Direct, Wiley Online library and Ovid SP). Twelve studies were included in the final analysis.
Results: Findings demonstrate that HCPs have a basic understanding of the psychological/emotional problems associated with stroke. Psychological care was identified as been given a low priority within stroke rehabilitation services and described as inconsistent, uncoordinated, and ad hoc. Barriers to providing psychological care included: poor access to specialist expertise; lack of resources and poor managerial support. Furthermore, the need for specialist supports via case discussion and reflective practice was identified.
Conclusions: This review suggests that improvements in terms of psychological care and services offered to patients post stroke is needed as is the value of support from managers to provide sufficient resources. This review has the potential to assist policymakers to understand the barriers and potential facilitators to psychological care provision to patients post stroke.

Keywords: Stroke, HCPs, rehabilitation services, knowledge, perceptions, experiences, psychological care, service improvement

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