B761 Learning Disabilities Nursing

Over-Medication of People with a Learning Disability

The lack of proper communication in people with the learning disability has been a significant challenge in healthcare. The challenge between people with learning disabilities and nurses is a major concern. Changing this barrier of communication between the people with learning disability and nurses is crucial in enhancing in change management, leadership and quality improvement. As a leader, you are required to initiate a change that has a positive impact. Communication refers to the passing of information from one person to another. Communication is crucial in assisting people to express themselves (Bulman, Lathlean and Gobbi, 2014, 1222). It is of much significance to have enhanced communication for nursing and people with a learning disability. Hence improve the change quality of management and leadership. It has resulted in many unprecedented results on people with learning disability such as over-medication that in turn affects their health. In this change, the proposal is going to address the various effects of challenges, the change proposal, and the results or the consequences the change has on the other aspects of delivering health care to disability. The aim of this proposal is to achieve excellent communication with people with disability and as well as facilitating perfect healthcare services. This is to ensure their needs are fully met and cover up the fact that they are challenged so as to ensure they equally receive healthcare equally with people with no disability.

It is evident that people with learning disabilities often face challenges in communicating with other people. Equally, it is difficult for healthcare providers such as nursing to communicate well with people with a learning disability. This result in providing of services of healthcare that is dangerous to their entire lives. Thus, this is an issue that needs to be addressed. The most common difficulties are sending of messages and difficulty in understanding one another. This, however, results into health crisis because people with learning disabilities are not able to express themselves and thus resulting in cases such that of overmedication.

The social model is the most effective model of instigating this change. The social model describes that people are disabled not by the difference or impairment but by the barriers of the society (Gabel and Peters 2004, 590). Removing the barriers enables people to have more choice, control and independence on themselves. This model is good as it improves the wellbeing of the learning disabled people to help them conquer the challenge of learning by equipping them with measures of overcoming the challenge of communication. It is an effective method even in the healthcare system as it will ensure people.

Working with people with a learning disability may often be challenging in communication. It might be more difficult for other people to make sure they are understood or the communication is effective. Communicating with people with disability is a challenge and they support to effectively communicate and understand complicated information Suter et al, 2009 48. In nursing, however, the nurses have a greater role to play to an individual who has a learning disability. This is to ensure that the service and care they receive especially medication is perfect hence improving their health.

People who have a learning disability have greater social care and needs. However, many additional adjustment and support are needed.  It is evident that health inequality exists mostly among the learning disability. This poses a real threat to them and they might end up dying prematurely and from preventable conditions. The learning disability people requirements and needs vary. Someone suffering a mild learning disability requires things like understanding the medical or health information, accessing the health screening and managing complex needs of health compel them might possess.

A learning disability has major impacts on how people understand information and the way they communicate themselves. Many people suffering from learning disability have difficulties with language, speech, communication and sensory impairment and this significantly have effects on the access to health services. This often occurs where is important to provide information concerning the history of health, symptoms, medications and other conditions. And due to this needs of health are overlooked and the mistakes that can be avoided occur in the common conditions and diseases. Meanwhile, the behaviours seen or challenging conditions such as expressing pain or the condition attributed to the person learning disability may be left untreated.

Therefore, it is of much significance to be familiar with the needs of communication of the person with a learning disability and as a leader in nursing make a change to improve this condition. This is to ensure that there is effective communication between the individual with learning disability and the nurses. For example, using gestures, Makaton, symbols, easy to read and the objects for reference.

Health services can reduce or minimize issues that contribute to difficulties in communication and make the changes or the adjustments that are required. The families and cares are an important resource services care in health as they have a wide knowledge on the patient’s communication requirements and can share information advice and plans on the individual and this leads to support of communities. The community learning disability team usually have the language and speech therapists and other professionals who can assist and advice the strategies of communication and support when those who have to learn disability when they access the health care and services.

It is essential to have a good understanding between the nurses and the people with a learning disability. This comprises of the way a person with a learning disability have difficulties in trying to get other people to understand them. They may develop difficulties in forming clear signs or articulating speech. In this situation challenging behaviour may be more likely in the situations where people are not able to understand what is expected from them or they cannot control their environment through communication.

Meanwhile, the nurses need to make sure they are communicating in a way that the people with a learning disability. This includes using short, simple sentences and consequently avoiding saying something that cannot be understood. They can apply pictures, objects and symbols and in particular reminding the disabled people of the events that will happen to them. This is often referred to as anticipated for the future. This is also done with spoken language supplementation as this is a signed language.

However, it of much essence as a nurse to consistently respond to what a person with a learning disability is trying to communicate especially in the context where they do not have clear communication. The communication intervention requires all aspects of individual life and thus it is important to include the entire people who communicate to the person regularly.

There are various common challenges of communication with people with a learning disability. This often a major threat to the delivery of care and services and hence change of quality and management is essential. Thus interventions are required at this point to show leadership. Without defeating this challenge of lack of proper communication within the healthcare systems, the concepts of change management, suitable and successful improvement cannot be achieved. A communication barrier between the nurses and the people with a learning disability often occurs in two ways which include the following.

Difficulties understanding

People with a learning disability usually experience hardship in understanding what other people are saying. Many people and mostly nurses in this context or situations includes knowing what usually happens in that situation, rather than the actual words expressed by the person. They interpret it to make sense of what might be expected from them.

There is the overestimation of understanding the skills of communication in people with learning disability. This often results in bringing confusions for example if the person with learning disabilities does not understand what that is being asked to do, or in some situation perceive wrong information. Usually, there is exacerbation in understanding difficulties due to unrecognized hearing loss. This problem is most frequent in adults and children who have a disability in learning and thus requires a lot of investigation to his condition and hence treatment.

Difficulties in sending messages

A wide range of factors makes it hard for people with learning disability into having other people understand them. They may have hardships in speech articulations or forming clear sights. They usually lack the necessary words to deliver the message they want other people. Meanwhile, they may apply the correct words but in the wrong order or a sentence without a body language that is supportive. Their problems may be problematic in a variety of messages. Often frustration arises as a result of this for example if a person with a learning disability is not well understood.

What implementation that can be done.

A changing concept in a general approach or general notion to change that has been seen as useful in the development of ideas that are specific and that results to improvement  (Doody, 2013, 1213). It involves combining creatively these changes that result into improvement. The change concepts with knowledge about specific subjects help generate ideas testing new change. The change in nursing of learning disabilities is to ensure that the nurses are confident and that they are applying the appropriate method of in a way which is effective and is reciprocal. This change should also enhance understand people with a learning disability might not be able to communicate in a verbal manner and they go through a wide range of strategies that can enhance, support and improve their expression. Also is appreciating that people who are suffering from learning disability may an understanding of the information differently and experience a wide range of mechanism to support people who are receiving the information. This change initiated will, therefore, reduce the errors of health care that results from poor communication between the nurses and the people with a learning disability. Thus this change management will improve the quality of care in nursing and consequently improve the level of healthcare service delivery to the patients.

The Plan-Do-Study-Act is the best method to initiate this change of ensuring there is effective communication between the persons with learning disabilities and the nurse. This model has four prescribed steps that guide the process of thinking in breaking down the tasks into various steps and eventually evaluating the income, enhancing on it and testing over again (Gillam & Siriwardena, 2013). The plan is a situation where a concise statement us wrote on what you plan to do in the testing. This stage will include including a highly skilled education for nurses in communication. This comprises setting of specialized care and units that are designed completely for communication and information between the specialized team and the people with disability. The nurses are going to be notified of the increased miscommunication between the people with learning disabilities; this is awakening them on the importance of appreciating the newly introduced care and units of communication between the nurses and the clients (Taylor et al 2014, 295). The limit for this set will be for studying the relationship of communication between the nurses and the client will take 1 – 4 weeks after which the results of one cycle will determine the termination of the cycle.

Do is the second stage in this model and involves setting in the motion or executing the plan (Stikes, and Barbier, 2013, 46). This will be an observation of the results of what happens after there is improved communication between the nurses and people with disabilities. These will also value the outcomes of the results. In this case, however, the change implemented with has effects on both ways, which are the nurses and the people with learning disabilities. Both the nurses and people with disabilities reactions will also be assessed. Also, the outcomes of the results will elaborate on whether the plan initiated has impacted some changes on the healthcare. The objectives of this proposal will also be assessed.

The act is the fourth step of the model and involves examining and reporting whether the implementation worked or did not work(Stikes, and Barbier, 2013, 46). This will include examining whether the highly specialized established units and care will improve communication and consequently improve health among the people with a learning disability. The outcome of this change will determine its spread to other parts of the country.

Leadership involves establishing decisions that are sound and sometimes difficult, articulating and creating a clear vision, setting goals that are achievable and providing followers with tools and knowledge required to achieve these objectives (Chan et al. 2009). In regard to the change model proposed I consider myself a leader. This is because of the clear vision I have of enabling people with learning disabilities healthcare enhanced due to improved communication. Meanwhile, the proposed specialized units and care acts as a platform for achieving this goal, thus making the goal realistic.  

The concept of co-production states that anything that is produced in any circumstance has implication on others. Healthcare systems are often seen as producers of goods which is regarded as health outcomes (Chan, Mok Po-ying and Man-chun, 2009, 2667). The health outcome, however, is simply not created by the healthcare hospitals or professionals but is regarded as a variety of multiple between the patients, clinicians and the healthcare system. The pillars of the co-production include dialogue, transparency, access to the collaborative patient-clinician relationship and the balance of benefits balance and the dangers of the proposed interventions of health (Ewert and Evers, 2014, 430). The co-production value and the approach of collaboration can be applied as a means to reevaluate how healthcare is delivered. This is not only done in the face-to-face context where this collaborative efforts are but also in systems designing that can aid in improving care and enhancing people’s lives (Batalden et al, 2015, 1214). The value of co-production occurs when the health care begins from the facts that the clinicians and the patient exist with a wide system that can impede or promote progress toward the optimal care. The availability of partnership that is healthy the clinicians and the patients work together for several reasons that are ideal. Meanwhile, increased willingness and confidence to take control of their health is promoted when the patients are engaged. In addition, patients who are more engaged report consistently more positive experiences that comprise of high-quality interaction and with the clinicians and their care is coordinated with fewer problems (Realpe and Wallace, 2010, 8). Also, engaging patients in their own care can yield more benefits that go above the individual patients. Benefits of health systems can also be brought by revising the existing protocol on the patients’ feedback basis.

 The measure of any change is crucial in identifying the impact of the change. The change of introduction of specialized care and units for communication in hospitals require measurement to determine its influence on health. This is to assess the efficiency of the proposal. The increase in efficiency and effectiveness of care for people with a learning disability will significantly be brought by this model. More people with a learning disability will have an opportunity to access care and services with ease because they will find places where they can be served. The communication barrier, however, will decrease and this will be an advantage to both the people with learning disabilities as well as nurses who desire to improve the quality of health service delivery. Consequently, the increase of health among the people with disabilities as they will be able to express themselves in the care and units and thus help to curb the premature death or avoidable deaths that arise as a result of miscommunication or misinformation. In general, this will be a major boost to the health sector and especially to the nursing of learning disability who need quality improves and change management that is portrayed through leadership.

The proposed change will require funding from the government to ensure the proposed change comes to effect. The funding will help in facilitating the building and construction of specialized care and units for the combination. This care and units will need specialized skills that will enhance proper communication between the health providers and people with disabilities especially people with a psychiatric disorder (Weiss et al. 2009, 356). Also, the government will need to employ people who have specialized skills in communicating and interacting with disabled people. This change will start with few hospitals and after it has been proven to be successful will be introduced to another hospital in the country.

The change will have much importance in the country. Change improves the lives of people (Farrar, Troxel, Duncombe and Jensen, 2008, 980) especially those who have learning disabilities. This program will enhance both the skills of the nurses who desire to improve the quality of and service and also the people with learning disabilities. Also, the nation as whole life will be enhanced as the deaths caused by miscommunication in hospitals will significantly be lowered. Secondly, the personal skills of the nurses will be improved in relation to change management, leadership and quality improvement. Moreover, this change wills results to flexible where the people with severe learning disabilities are going to be assisted in interpreting and expressing themselves thus making their medication easier. The change comes with new opportunities and defiantly this will be an opportunity for both the people with learning disabilities and the nurse’s quality of service improvement. The leadership skills will be enhanced because of this change. The change has a lot of strength in ensuring that people’s lives are not in danger or a threat because they are communicated well.

The leadership skill is crucial in initiating this change proposal. This is because the characters of a good leadership are required to ensure that the change is efficiently and effectively implemented (Cook and Hyrkäs, 2010, 247). The leadership has various advantages and in relation to this change, the proposal is going to discuss the importance of leadership. The leader is responsible for initiating actions and this involves communication the plans and policies to the subordinates from where the work actually begins (Northouse, 2018). A leader is also required to provide motivation. This is playing a major role in working as a general. The motivation should be provided to ensure that nurses embrace the new change that enhances the lives of people with a learning disability. The building of morale for nurses in the field is of much significance. This morale gives the willing cooperation towards and getting them into confidence and winning their trust in implementing the change.

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