Service Improvement: A Quality & Safety Initiative

Niamh Walsh
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).
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,
The HSE Change Model (2008) has 4 phases, with a
combination of 7 elements in total
1. Preparing to lead the change.
2. Building commitment, 3. Determining the detail
of change,
4. Developing the implementation plan.
5. Implementing change.
6. Making it ‘the way we do our business’,
7. Evaluating and learning.
◦ 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,
◦ Staff Meetings: suggestions were put forward
and agreed upon - education session on Ageing
process in Intellectual Disability and
Musculoskeletal Disorders.
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.
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.
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.
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 –
Body systems,
Care planning,
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 bimonthly capturing a large mixed skill audience at once.
Nurses actively engaging in clinical research, bridging the
theory-practice gap.
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).
“The best outcomes for people with Intellectual
Disabilities result when their needs are
aligned with the needs of the rest of society”