1. Niamh Walsh RNID

2.  To educate all staff (nursing & non-nursing) on the ageing process in people with Intellectual Disability. It has been identified that a gap in knowledge existed within this area (IDS-TILDA, 2014).  To encourage Professional development through education to support and enhance best outcomes within clinical practice at ground level.  For Nurses to participate and instigate lead in service improvement and quality initiatives within clinical practice areas to progress and maintain high quality care provision supported by the most up to date best evidence based research, practice and standards (HIQA, 2013).

3.  The HSE Change Model (2008) has 4 phases, with a combination of 7 elements in total  Intiation: 1. Preparing to lead the change.  Planning: 2. Building commitment, 3. Determining the detail of change, 4. Developing the implementation plan.  Implementation: 5. Implementing change.  Mainstreaming: 6. Making it ‘the way we do our business’, 7. Evaluating and learning.

4. ◦ Development of a PROJECT PLAN: consultations held with stakeholders, i.e. CNME, CNM2, ACO, SN’s, HCA’s, GP, Physiotherapist & Dietician, resulting in a diversity of different perspectives and expertise (Srikanth et al., 2011). ◦ Communication: informal discussions were held initially. Failure in relation to change has been identified in the literature as being a direct result of insufficient communication (Ford & Ford, 2010). ◦ Staff Meetings: suggestions were put forward and agreed upon - education session on Ageing process in Intellectual Disability and Musculoskeletal Disorders.

5.  In-Depth Research: via literature review into the chosen topic, Intellectual Disability & ageing, and, musculoskeletal disorders. Contact made with MDT for input.  Time Frame: agreed with CNM2 that education session would be carried out as part of a staff meeting. Total time allocated 1 hour.  Delivery: via power point presentation, with hand outs and use of video links.  Evaluation: staff gave feed back via written evaluations following education session.

6.  Feedback from staff was largely positive.  Improvements for service users: o Increased awareness of ageing process in people with an Intellectual Disability. o Increased awareness regarding musculoskeletal disorders specific to service users, minimising the risk of harm. o Facilitating enhancement of person centred care. o Direct changes seen in practice as a result of the combination of newly informed awareness / knowledge and the Physiotherapists and Dieticians input. o Staff engaged fully with results being seen in day to day care such as manual handling and lifting & medication review.

7.  Education session facilitated individual case review improving quality of MDT input and this was evident in the care plan.  Education sessions result in continuous quality improvement for service users.  Nurses leading change for improved quality of life and better clinical outcomes.

8.  Education session was rolled out to other units / day centre. Can be mainstreamed.  This education session had a direct impact on the quality of life of the residents within the community group home / day centre as identified in the evaluations of the care plans.  Further education sessions planned – 1. Body systems, 2. Care planning, 3. Health screening.  Advantage of local delivery approach, less resources are required, the release of staff to attend training was not an issue as most staff attend staff meetings monthly and bi- monthly capturing a large mixed skill audience at once.  Nurses actively engaging in clinical research, bridging the theory-practice gap.

9.  Service improvement initiatives are necessary to improve the quality of care and safety to those entrusted with us. Staff’s personal and professional development is intrinsically linked to this improvement (Gill, 2007).

10. “The best outcomes for people with Intellectual Disabilities result when their needs are aligned with the needs of the rest of society” (Unknown)