Clinical
Our clinical nursing articles aim to inform and educate nurse practitioners and students. This is achieved through the publication of peer-reviewed, evidence-based, relevant and topical articles.
Forensic risk assessment in people with learning disabilities: principles and process
Why you should read this article: • To refresh your knowledge of the principles of forensic risk assessment • To recognise the benefits of, and the different evidence-based approaches to, forensic risk assessment • To increase your understanding of risk formulation and the development of a tailored risk management plan While forensic healthcare is a highly specialised area of clinical practice, many learning disability nurses will, over the course of their careers, be required to provide care to people who have had contact with the criminal justice system. Robust risk assessment and risk management systems are central to ensuring the well-being and safety of people with learning disabilities who have forensic needs. Although the core assessment skills required to undertake forensic risk assessments are embedded in nurses’ skill set, learning disability nurses need to develop their knowledge and understanding of how to apply these skills in forensic practice. This article explores the principles of forensic risk assessments and the elements of the forensic risk assessment process as a foundation to risk formulation. The author uses a fictitious case study to illustrate forensic risk assessment, risk formulation and the development of a tailored risk management plan.
Promoting oral health for people with learning disabilities
Why you should read this article: • To refresh your knowledge of risk factors for suboptimal oral health in people with learning disabilities • To recognise the importance of education and training for healthcare professionals and carers to support oral health for people with learning disabilities • To read about interventions that can be used to support access to dental care for people with learning disabilities People with learning disabilities have poorer oral health compared with the general population. Risk factors for suboptimal oral health in this group include diet, reliance on others for oral care and barriers to accessing dental care. This article discusses these risk factors and considers the importance of education and training for carers and healthcare professionals, including dentists and dental students, to enhance oral health in people with learning disabilities. The author uses a fictional case study to illustrate some of the challenges experienced by people with learning disabilities in accessing oral care and how the use of interventions such as desensitisation programmes, as well as reasonable adjustments, can help address these challenges.
How to support adherence to medicines among people with learning disabilities
Why you should read this article: • To recognise the importance of education, reasonable adjustments and medication reviews in supporting optimal medicines adherence in people with learning disabilities • To enhance your awareness of factors that contribute to suboptimal medicines adherence in people with learning disabilities • To acknowledge the importance of involving family or carers in supporting medicines adherence Rationale and key points People with learning disabilities often have long-term conditions that require the regular use of medicines. Medicines adherence can be particularly challenging in this population and support with taking medicines is often not provided in a way that meets people’s needs. Suboptimal medicines adherence can negatively affect the health outcomes of people with learning disabilities, which are already poorer than those of the general population. • Achieving optimal medicines adherence among people with learning disabilities requires a multi-component strategy that includes education, reasonable adjustments and medication reviews. • Factors that cause and/or contribute to suboptimal medicines adherence among people with learning disabilities include burdensome medicine regimens, medicines prescribed in unsuitable forms, overmedication and overprescribing, lack of medication reviews, lack of reasonable adjustments, suboptimal communication from healthcare professionals and suboptimal care coordination. • Family and carers are often those who administer medicines, so it is crucial to involve, educate and support them about the person’s medicine regimen so that they can help ensure the medicines are taken as prescribed. Reflective activity ‘ How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting a person with a learning disability to take their medicines as prescribed. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take to support a person with a learning disability to take their medicines as prescribed.
Supporting people with learning disabilities and needle phobia to be vaccinated
How a desensitisation programme was used to prepare people for the COVID-19 vaccination
How to diagnose constipation in people with learning disabilities
Diagnosis can be complicated by behaviours of concern in this patient group
Exploring the experiences of fathers who have a child with a learning disability
A literature review showed the need for tailored services or interventions to support fathers
Using behaviour change theories to promote physical activity
Ways to support adults with learning disabilities to do more exercise
Increasing cervical screening uptake among people with learning disabilities
A pilot project used an assessment tool showing that people can be supported to make a decision
Improving annual health checks of people with learning disabilities
Understanding health and communication needs, working with carers and making adjustments are crucial
Evaluating an online screening tool to identify learning disability in autistic people
The accuracy of the CAIDS-Q questionnaire online version and its value to professionals are assessed
How to support an adult with a learning disability to undergo an electrocardiogram
ECGs are needed to identify and manage a range of health issues common in people with learning disabilities
Communication challenges for people with learning disabilities in the digital age
Factors affecting communication in healthcare and strategies and tools for nurses to address them