evidence and practice
An alternative admission process for patients with an autism spectrum disorder and/or an intellectual disability
David Schopf Psychiatric Nurse, UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, US
Stacy Stark Magnet Project Coordinator, UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, US
Laurel Chiappetta Statistician, UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, US
Khadejah Mahmoud Doctoral Nursing Student, University of Pittsburgh, Pittsburgh, Pennsylvania, US
Dina Fradkin Doctor of Nursing Practice Student, University of Pittsburgh, Pittsburgh, Pennsylvania, US
Ann M Mitchell Professor of Nursing and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, US
• To recognise the need for accurate, complete and patient-specific information during the assessment of people with an autism spectrum disorder (ASD) and/or an intellectual disability for admission to an inpatient psychiatric unit
• To be aware of the important role of family members and carers in providing relevant, specific and complete information about people with ASD and/or an intellectual disability
• To acknowledge that people’s experiences can be improved by ensuring a smooth transition to inpatient care
Patient satisfaction in psychiatric emergency departments (EDs) largely relies on the knowledge and training of the staff providing care, and patients report higher satisfaction when they are assessed by professionals with psychiatric experience. Patient care is negatively affected by missing or incomplete patient-specific information. People with an autism spectrum disorder (ASD) and/or an intellectual disability are often unable to communicate pertinent information when admitted to hospital, and nurses rely on family members or carers to obtain information.
The aim of this quality improvement project was to evaluate whether nursing admission assessment data collected in the psychiatric ED by a nurse specialist in ASD and/or intellectual disability while family members or carers were present were more complete than nursing admission assessment data collected in the inpatient unit after triage in the psychiatric ED.
Data were collected for a period of two months from patients, carers and staff on a specialist inpatient unit for ASD/intellectual disability. Completeness of assessment information and staff satisfaction were compared between the psychiatric ED and the inpatient unit. Outcome measures included location of assessment (ED or unit) and quality of information provided, which covered 17 key patient-centred items. There was a significant relationship between the source of the information and the location where it was obtained. In the psychiatric ED, nurse specialists were able to obtain more information from family/caregivers compared with the inpatient unit.
Initiating the admission assessment in the psychiatric ED while the patient’s family members or carers are present may provide a more complete assessment and will establish rapport, supporting an easier admission process and transition to the inpatient unit.
Learning Disability Practice. doi: 10.7748/ldp.2020.e2026Peer review
This article has been subject to external double-blind peer review and has been checked for plagiarism using automated softwareCorrespondence
Schopf D, Stark S, Chiappetta L et al (2020) An alternative admission process for patients with an autism spectrum disorder and/or an intellectual disability. Learning Disability Practice. doi: 10.7748/ldp.2020.e2026
Published online: 28 January 2020