Standards of Professional Nursing Practice for Intellectual and Developmental Disabilities (IDD) Nurses



Standards of Professional Nursing Practice for Intellectual and Developmental Disabilities (IDD) Nurses





Significance of Standards for IDD Nurses

The Standards of Professional Nursing Practice are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The standards published herein may be utilized as evidence of the standard of care, with the understanding that application of the standards is context dependent. The standards are subject to change with the dynamics of the nursing profession, as new patterns of professional practice are developed and accepted by the nursing profession and the public. In addition, specific conditions and clinical circumstances may also affect the application of the standards at a given time (e.g., during a natural disaster). The standards are subject to formal, periodic review and revision.

The competencies that accompany each standard may be evidence of compliance with the corresponding standard. The list of competencies is not exhaustive. Whether a particular standard or competency applies depends upon the circumstances.


These standards apply to both the registered nurse and APRN in IDD. They apply to the nursing care of persons with IDD of all ages, cultures, socioeconomic backgrounds, and medical diagnoses. Furthermore, these standards apply to any health care, education, residential, or community setting where healthcare consumers with IDD might be. The competencies have been developed by the authors to represent quality practice and performance in the nursing care of healthcare consumers with IDD.



Standards of Practice for IDD Nurses


Standard 1. Assessment

The registered nurse who specializes in IDD collects comprehensive data pertinent to the healthcare consumer’s health and/or the situation.


COMPETENCIES

The registered nurse:



  • Collects comprehensive data including but not limited to physical, functional, psychosocial, emotional, cognitive, sexual, cultural, age-related, environmental, spiritual/transpersonal, and economic assessments in a systematic and ongoing process while honoring the uniqueness of the person. This may involve observation, interviewing, and the use of screening and assessment tools. Diagnostic tests may be used as part of the assessment process if the nurse has specific training in that area (e.g., developmental diagnostic testing).


  • Uses analytical models and problem-solving tools that are appropriate for healthcare consumers with IDD.


  • Elicits the values, preferences, expressed needs, and knowledge of the healthcare situation of the consumer with IDD and family/legal guardians.


  • Involves the healthcare consumer with IDD, family/legal guardians, other healthcare and interdisciplinary professionals and paraprofessionals, and the work and home environment, as appropriate, in holistic data collection.


  • Identifies barriers (e.g., cognitive, physical, psychosocial, literacy, financial, cultural) to effective communication and makes appropriate adaptations.


  • Recognizes the impact of personal attitudes, values, and beliefs.



  • Assesses family dynamics and impact on health and wellness of the consumer with IDD.


  • Prioritizes data collection based on the immediate condition or the anticipated needs of the healthcare consumer with IDD or situation.


  • Uses appropriate evidence-based assessment techniques, instruments, and tools in collecting pertinent data, including, but not limited to, genetic studies, special serum screening (e.g., cystic fibrosis, Tay-Sachs, sickle-cell disease), nutritional needs and metabolic functioning, and any other condition-specific data measures.


  • Synthesizes all data, information, and knowledge from the consumer with IDD, family members/legal guardians, the interdisciplinary team, and the individual’s environment that is relevant to the situation to identify patterns and variances. This may involve data and information from the school, work site, and/or residential setting.


  • Applies ethical, legal, and privacy guidelines and policies to the collection, maintenance, use, and dissemination of data and information.


  • Recognizes that healthcare consumers with IDD have authority over their own health by honoring their care preferences. As legally appropriate, a guardian may be involved in identifying and expressing those preferences.


  • Documents relevant data in a retrievable format.


ADDITIONAL COMPETENCIES FOR THE APRN WHO SPECIALIZES IN IDD

The advanced practice registered nurse:



  • Initiates and interprets diagnostic tests and procedures relevant to the current status of the healthcare consumer with IDD.


  • Assesses the effect of interactions among individuals, family/legal guardians, community, and social systems on health and illness.





Standard 3. Outcomes Identification

The registered nurse who specializes in IDD identifies expected outcomes for a plan individualized to the healthcare consumer with IDD or the situation.


COMPETENCIES

The registered nurse:



  • Partners with the healthcare consumer with IDD, family/legal guardians, members of the interprofessional team, and others in formulating expected outcomes when possible and appropriate.


  • Derives culturally appropriate expected outcomes from the diagnoses.


  • Considers associated risks, benefits, costs, current scientific evidence, expected trajectory of the condition, and clinical expertise when formulating expected outcomes.


  • Defines expected outcomes in terms of the values of the healthcare consumer with IDD; the values of family members/legal guardians when appropriate; ethical and legal considerations; environment, culture, or situation with such consideration as associated risks; benefits and costs; and current scientific, ethical, and/or legal evidence.


  • Develops expected outcomes that facilitate continuity of care and person-centered care as appropriate.


  • Modifies expected outcomes according to changes in the status (i.e., health, social, living, economic, and/or legal) of the healthcare consumer with IDD or evaluation of the situation.


  • Documents expected outcomes as measurable goals that include an estimated time to attain expected outcomes.


ADDITIONAL COMPETENCIES FOR THE APRN WHO SPECIALIZES IN IDD

The advanced practice registered nurse:



  • Identifies expected outcomes that incorporate scientific evidence and are achievable through implementation of evidence-based practices.



  • Identifies expected outcomes that incorporate cost and clinical effectiveness, legal and ethical boundaries, satisfaction and understanding, and consistency and continuity among the individual with IDD, family/legal guardians, healthcare providers, and members of the interprofessional team.


  • Supports the use of clinical guidelines linked to positive patient outcomes.


  • Differentiates outcomes that require care process interventions from those that require system-level interventions.



Standard 4. Planning

The registered nurse who specializes in IDD develops a plan that prescribes strategies and alternatives to attain expected outcomes.


COMPETENCIES

The registered nurse:



  • Develops an individualized plan that is person-centered when appropriate, in partnership with the person, family/legal guardians, and others considering the person’s characteristics or situation, including but not limited to values, beliefs, spiritual and health practices, preferences, choices, chronological age and developmental level, coping style, culture, available technology, and the least restrictive environment.


  • Establishes the plan priorities in collaboration with the healthcare consumer with IDD, family/legal guardians, others, and the interprofessional team as appropriate.


  • Includes strategies in the plan that address each of the identified diagnoses or issues. These strategies may include but are not limited to strategies for:



    • Promotion and restoration of health;


    • Prevention of illness, injury, and disease;


    • Alleviation of suffering; and


    • Supportive care for those who are dying.


  • Includes strategies for health and wholeness across the lifespan.


  • Provides for continuity in the plan.


  • Incorporates an implementation pathway or timeline in the plan.


  • Considers the economic impact of the plan on the healthcare consumer with IDD, family/legal guardians, caregivers, or other affected parties.



  • Integrates current scientific evidence, trends, and research affecting comprehensive care of healthcare consumers of all ages with IDD into the planning process.


  • Uses the plan to provide direction to family members/legal guardians and other members of the healthcare and interprofessional team.


  • Investigates practice settings and safe space and time for the nurse and the healthcare consumer with IDD to explore suggested, potential, and alternative options.


  • Defines the plan to reflect current statutes, rules and regulations, and standards.


  • Modifies the plan according to the ongoing assessment of the healthcare consumer’s response and other outcome indicators.


  • Documents the plan in a manner that uses standardized, person-first language and recognized terminology.


ADDITIONAL COMPETENCIES FOR THE APRN WHO SPECIALIZES IN IDD

The advanced practice registered nurse:



  • Identifies assessment strategies, screening and diagnostic strategies, and therapeutic interventions that reflect current evidence, including data, research, literature, and expert clinical knowledge.


  • Selects or designs strategies to meet the multifaceted and complex needs of healthcare consumers with IDD.


  • Includes in the plan a synthesis of the values and beliefs of the healthcare consumer with IDD regarding nursing, medical, social, and educational therapies.


  • Leads the design and development of interprofessional processes to address the identified diagnosis, situation, or issue.


  • Actively participates in the development and continuous improvement of organizational systems that support the planning process.



  • Supports the integration of clinical, human, and financial resources to enhance and complete the decision-making and evaluation processes.


  • Serves as a consultant to the registered nurse in plan development, priority setting, cost-benefit analysis, and identification of resources, as needed.


  • In collaboration with the registered nurse and other members of the interprofessional team, and in partnership with the community, derives community-focused plans that are based on identified problems, conditions, or needs and that build on the strengths of the community.


  • Develops plans that ensure continuity of care and minimize or eliminate gaps and duplication of services.


Jul 8, 2016 | Posted by in NURSING | Comments Off on Standards of Professional Nursing Practice for Intellectual and Developmental Disabilities (IDD) Nurses

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