Faculty Presentations Faculty Presentations: Melissa L. Desroches

Identifying Nursing’s Contribution to Hospital Care Disparities Experienced by Adults with Intellectual Disabilities: A Qualitative Descriptive Study

Full list of poster authors

• Melissa L. Desroches, PhD, RN, CNE
• Kathleen Fisher
• Denise Daudelin

Conference where poster was previously displayed

ENRS 2024

Poster abstract

Identifying Nursing's Contribution to Hospital Care Disparities Experienced by Adults With Intellectual Disabilities: A Qualitative Descriptive Study

Melissa Desroches, University of Massachusetts Dartmouth Kathleen Fisher, Drexel University Denise Daudelin, Tufts Clinical and Translational Science Institute

Background

Adults with intellectual disabilities experience a cascade of health disparities, which include higher rates of hospitalizations and poorer outcomes from hospital care than people without disabilities. Evidence suggests that differential treatment contributes to these disparities, yet little research has explored the contribution of nurses as the primary providers of hospital care to health disparities of hospitalized adults with intellectual disabilities. 

Purpose

To identify differences in medical surgical nursing care processes and outcomes of hospitalized adults with intellectual disabilities as compared to hospitalized adults without disabilities 

Methods

Using a qualitative descriptive design, we conducted video conferencing interviews with 13 purposively selected medical surgical nurses from across the United States. We used manifest content analysis to organize and group relevant data into categories. We identified seven categories of differences in nursing care: comprehensive nursing assessment, communication, per-son-centeredness, task-focused care, time, safety, and advocacy. 

Conclusions

Key findings to address via nursing quality and safety health equity initiatives include the higher self-reported rates of delayed or missed care and lack of interpersonal engagement with hospitalized adults with intellectual disabilities. A task-focused approach in which multiple nurses or care staff quickly provide care was linked to greater resistance to care and increased use of restraints. Policy targets include adequate staffing to address increased time needed for care and improvement in the education of nurses to care for adults with intellectual disabilities. Future research should involve adults with intellectual disabilities to elicit their perspectives of medical surgical nursing care and areas of strength and need for improvement.