'Smiles and laughter and all those really great things': Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability.
Laurel Mimmo, Michael Hodgins, Nora Samir and 3 others
PMID 35451515WHAT IT FOUND
Paediatric nurses identified that good care for children with intellectual disability relies on using play to build rapport, listening to parents' expertise to understand communication needs, and documenting these insights to guide future admissions.
They described time spent connecting as central to safe care.
Key findings
01Nurses stated that using play and rapport to get to know the child helped them feel safe and comfortable, and that knowing the child's specific communication methods before admission allowed for better care planning.
02Effective care depended on learning from parents about the child's needs and preferences, particularly regarding how the child communicates pain or distress, and sharing this information across the multidisciplinary team.
03Nurses reported that time constraints and lack of resources, such as playrooms and Child Life Therapists, conflicted with their ability to provide the individualized attention and play they viewed as essential for quality care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were drawn from only two hospitals within a single healthcare organization, limiting generalizability to other settings. The study was conducted during the COVID-19 pandemic, which may have influenced nurses' reflections on resource constraints and visitor restrictions. No demographic data such as age, gender, or years of experience were collected for the participants. The analysis was guided by a pre-existing conceptual model, which may have limited the discovery of themes outside that framework.
Declared interests
No conflicts of interest were declared. The study was funded by the University of New South Wales.
The easy way to misread this
Do not interpret these themes as evidence that play and rapport improve clinical outcomes like length of stay or safety incidents. The study reports nurses' perceptions of what constitutes good care, not measured effects of these practices.