Grisham Melinda Grisham_Melinda_NR660_Capstone Project
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Transcript of Grisham Melinda Grisham_Melinda_NR660_Capstone Project
Education and communication competencies for student nurses to
improve communication with special needs children with minimal to
non-existent verballanguage abilities: How to speak without
saying a wordMelinda M. Grisham RN, BS, BSNChamberlain College of Nursing
NR660 CapstoneFebruary 21, 2015
Nursing Concern Special Needs Children as Patients
Autism Spectrum Disorder (ASD)
Down’s Syndrome
Cerebral Palsy
Mental Retardation/Impaired Cognitive Abilities
Developmental Delays (Drake, Johnson, Stonek, Martinez, and Massey, 2012)
Language and Communication Skills
Minimal to Non-Existent
Age Appropriate
Cognitively Delayed (Brown and Elder, 2014)
Nursing Curriculum Lacking Components
Education
Co-morbidities
Congenital
Reasons for Developmental Delays
Communication
Student Uncertainty
Alternative Methods
Time Factor
Literature Review
Harris, Abbott and Jukes (2012) discussed UK health care professionals must adhere to the Equality Act of 2010.. "The hospital passports developed by the South West London Access to Acute Group (2010), for example, conveys information through a traffic-lights system, where red indicates things staff must know about the client, amber indicates things that are important to the client, and green indicates the client's likes and dislikes" (Harris, Abbott and Jukes, 2012, p. 29).
Davis-Evans (2013) shared education and interventions when caring for surgical patients. Surgery is a major stress source for patients that stimulate panic attacks and anxiety. Patients with non-verbal skills cannot express their anxiety verbally, but they can display physical behaviors that can cause injury to themselves or to staff.
Drake, Johnson, Stoneck, Martinez, and Massey (2012), conducted a study using a cross-sectional post-test survey to evaluate nurse's perceptions utilizing a coping kit intervention for hospitalized children with developmental disabilities. The coping kits consisted "of simple communication cards, a social script book about going to the hospital, distraction items (toys), a pad of paper and a pencil, a picture communication card set on a ring, and a piece of theta-tubing to play with or chew" (Drake, Johnson, Stoneck, Martinez, and Massey, 2012. p. 217).
Literature Review
Dreyfus (2012) is a systemic functional linguist from Australia, who conducted research on her 17-year-old intellectually disabled son who does not communicate with speech. During her 10-year research observations, Dreyfus found her son communicated using gestures, vocalizations, artifact actions, certain behaviors and eye gazes in varying combinations.
Phillips (2012) performed a literature search that reflected themes that special needs patients experienced in general hospitals. Identified themes were: effect on the patient in the hospital, staff attitude and knowledge, hospital environment, role of family, and improvement recommendations.
Singer (2012) discussed how school nurses in the UK feel that their jobs are challenging as more learning disabled students enter into the school system.. Singer’s intent was to explore challenges that nurses face that prevent provision of high-quality nursing and health care with these school aged students.
Collins, Golembeski, Selgas, Sparger, Burke and Vaugh (2007) discuss a model to guide practice change called the Clinical Excellence Through Evidence-Based Practice (CETEP). The model is a continuous cycle of inquiry where the process is an assessment of evidence-based factors, patient factors, and clinical setting factors. Once the assessment has been formulated then a planning, implementation, evaluation process begins. The cycle completes and if new information is derived after the evaluation, then the inquiry cycle begins again.
Literature Review Pinto and Gardner (2014) brought awareness with augmentative
and alternative communication (AAC) systems used by children with no oral communication skills. Tablets and smartphone technology are used as a form of AAC. Data from a female child with CCN and cerebral palsy using an iPad facilitated conversation between the child and the mother.
Temple and Mordoch (2012) looked at how Canadian nursing students perceived disability and their preparedness to care for disabled patients. The study reported majority of second and fourth year students did not receive education during nursing courses on how to interact and care the intellectually disabled.
Ely, Chen-Lim, Zarnowsky, Green, Shaffer and Holtzer (2012) discuss how children with cognitive impairment and physical limitations are not medicated adequately for post-surgical pain when there is communication gap.
Fan, Wang, Chao, Jane, and Hsu (2015) researched competency-based education reported increased academic performance in a medical-surgical course and practicum that those that were in a traditional course
How can nurses provide nursing care and communicate with a non-verbal or
cognitively impaired child?
Project Details: Expected Results
Resolution: Toys, distractors and communication boards
Reinforce positive behavior with age appropriate reward
Resolution:Nursing Outcomes
for Improved
CommunicationPrepared pre-licensure students
Competencies
Achieved and Met
Education
Communication
Simulation
Role Playing
Resolution: New Modalities of Scholarship
Implement Curriculum Changes
Simulated Scenarios
With Non-Verbal Child
Student Role Play with Sign Language
Clinical Rotation
Special Needs Classroom
Typical Classroom
Early Childhood Intervention Programs
Evaluation of Outcomes
EBP-research on communications competency
Better patient outcomes for Special Needs children
Prepared nurses to manage complexcommunications needs
Adept to simple sign language, PECS, and AAC
Met needs for child and family
Contributions to Nursing Profession
Dissemination of Project
Power Point Presentations Professional Nursing Groups (Local and State) Schools of Nursing Parent-Based School Organizations (PTAs)
Webinars Acute Care Facilities Pediatric Nursing Units Special Needs Families Support Groups
Scholarly Publications
YouTube.com
References Billings, D. M. & Halstead, J. A. (2012). Teaching in Nursing A Guide for
Faculty. (4th Ed.), St. Louis, Missouri: Elsevier.
Brown, A. B. & Elder, J. H. (2014). Communication in autism spectrum disorders: A guide for pediatric nurses. Pediatric Nursing, 40(5), 219-225.
Collins, P., Golembeski, S., Selgas, M., Sparger, K., Burke, N., & Vaughn, B. (2007). Clinical excellence through evidence-based practice—A model to guide practice changes. Topics in Advanced Practice Nursing eJournal, 7(4).
Commission on Collegiate Nursing Education. (2013). Standards of accreditation of baccalaureate and graduate nursing guidelines.Retrieved from http://www.aacn.nche.edu/ccne-accreditation/standards-
procedures-resources/baccalaureate-graduate/standards.
References cont’d
Davis-Evans, C. (2013). Special needs populations: Alleviating and preventing panic attacks in the surgical patient. AORN Journal, 97(3),
354-364. doi: 10.1016/j.aorn.2012.12.012
Drake, J., Johnson, N., Stoneck, A.V., Martinez, D. M., & Massey, M. (2012). Evaluation of a coping kit for children with challenging behaviors in a pediatric hospital. Pediatric Nursing, 38(4), 215-21.
Dreyfus, S. (2012). Life's a bonding experience: A framework for the communication of a non-verbal intellectually disabled teenager. Journal of Interactional Research in Communication Disorders, 4(2), 249-
271. doi: 10.1558/jircd.v4i2.249
Ely, E., Chen-Lim, M. L., Zarnowsky, C., Green, R., Shaffer, S., & Holtzer, B. (2012). Finding the evidence to change practice for assessing pain in children who are cognitively impaired. Journal of Pediatric Nursing,
27, 402-410. doi: 10.1016.j.pedn.2011.05.009
References cont’dFan, J. Y., Wang, Y. H., Chao, L. F., Jane, S. W., & Hsu, L.L. (2015). Performance
evaluation of nursing students following competency-based education. Nurse Education Today, 35, 97-103. doi: 10.1016/j.nedt.2014.07.002
Gaylord, N., Chyka, D., & Lawley, G. (2012). Developmental evaluation of preschool children: A service-learning experience for nursing students. Journal of Nursing Education, 51(12), 710-713. doi: 10.3928/0184834-20121030-03
Harris, J., Abbott, L., & Jukes, M. (2012). Improving care for children with Down's syndrome. Learning Disability Practice, 15(6), 25-29.
Hemsley, B., Balandin, S., & Worrall, L. (2012). Nursing the patient with complex communication needs: Time as a barrier and a facilitator to successful communication in the hospital. Journal of Advanced Nursing, 68(1), 116-126. doi: 10.111/j.1365-2648.2011.05722.x
References cont’dKyle, G. (2012). Caring for a child with Down's syndrome in the acute care
setting. Nursing Children and Young People, 24(4), 18-22.
Nielson, S. (2014). Patients and staff have benefited from our sign language initiative.Nursing Standard, 28(30), 35-35. doi: 10.7748/ns2014.03.28.30.35.s45
Obrecht, J. A., Van Hulle Vincent, C., & Ryan, C. S. (2014). Implementation of evidence-based practice for pediatric pain assessment instrument. Clinical Nurse Specialist, 28(2), 97-104. doi: 10.1097/NUR.0000000000000032
Phillips, L. (2012). Improving care for people with learning disabilities in hospital. Nursing Standard, 26(23), 42-48.
Pinto, M. & Gardner, H. (2014). Communicative interaction between a non-speaking child with cerebral palsy and her mother using an iPad. Child Language Teaching and Therapy, 30(2), 207-220. doi: 10.1177/0265659013518338
References cont’dShewan, J. (2014). Starting out-learning signing was so rewarding for me
when nursing a deaf student. Nursing Standard, 29(1), 29-29. doi:10.7748/ns.29.1.29.s35
Singer, B. (2012). Perceptions of school nurses in the care of students with disabilities. The Journal of School Nursing, 29(5), 329-336. doi: 10.1177/1059840512462402
Temple, B. & Mordoch, E. (2012). Nursing student perceptions of disability and preparation to care for people with intellectual disabilities. Journal of Nursing Education, 51(7), 407-410. doi: 10.3928/01484834-20120515-01
Weldon, J. M., Langan, K., Miedema, F., Myers, J., Oakie, A., & Walter, E. (2014). Special needs populations: Overcoming language barriers for pediatric surgical patients and their family members. AORN Journal, 99(5), 616-629. doi: 10.1016/j.aorn.2014.02.005