The roles of learning disabilities acute liaison nurses in acute healthcare settings: an exploratory sequential multiple methods study

Kupara, Dorothy

The roles of learning disabilities acute liaison nurses in acute healthcare settings: an exploratory sequential multiple methods study

Lists

Kupara, Dorothy ORCID: https://orcid.org/0009-0000-3583-269X (2024) The roles of learning disabilities acute liaison nurses in acute healthcare settings: an exploratory sequential multiple methods study. Doctoral thesis, University of West London.

Preview

PDF (PDF/A)
Dorothy Kupara PhD Thesis (March 2025) The roles of learning disabilities acute liaison nurses.pdf - Submitted Version
Available under License Creative Commons Attribution.
Download (4MB) | Preview

Official URL: https://repository.uwl.ac.uk/id/eprint/14114

Abstract

Background: The Healthcare for All inquiry (Michael, 2008) highlighted barriers in healthcare for people with learning disabilities and recommended the appointment of 'acute liaison nurses'. The Confidential Inquiry into Premature Deaths of People with Learning Disabilities (CIPOLD) report (Heslop et al., 2013) found that care quality for people with learning disabilities was insufficient and stressed the need for reasonable adjustments and named healthcare coordinators. People with learning disabilities continue to face risks and poor care in hospitals (McCormick et al., 2021). The role of Learning Disabilities Acute Liaison Nurses is crucial for ensuring patient safety and maintaining care quality during hospital admissions (White et al., 2023). However, there is still a limited understanding of their responsibilities and the factors that either facilitate or hinder the enactment of the role.

Research aim: To investigate through exploring, describing and explaining the role of Learning Disabilities Acute Liaison Nurses when supporting people with learning disabilities in acute healthcare settings using role theory as an underpinning conceptual framework.
Key research question: What is the role of Learning Disabilities Acute Liaison Nurses in acute healthcare settings in the context of role theory?
Research sub-question 1: What is expected of Learning Disabilities Acute Liaison Nurses as articulated in their job descriptions? (Stage 1).

Research sub-question 2: What are the factors (correlates) that influence how Learning Disabilities Acute Liaison Nurses experience their role, and what are their perceptions and experiences as they enact it? (Stage 2).
Study design: A two-stage exploratory sequential multiple research design was employed. In Stage 1, a qualitative approach was utilised, where documentary analysis was conducted using reflexive thematic analysis to examine the job descriptions of Learning Disabilities Acute Liaison Nurses. The themes identified in Stage 1 were then used to create an online survey in Stage 2, aimed at describing the factors (correlates) that influence how these nurses experience their role and explaining their perceptions and experiences as they enact it. In Stage 2, quantitative data was analysed using statistical methods, while qualitative data was analysed using reflexive thematic analysis.

Findings: The role of the Learning Disabilities Acute Liaison Nurse is very diverse and that there are inconsistencies in what they are expected to do. Furthermore, evidence shows that there are several key activities that Learning Disabilities Acute Liaison Nurses are expected to undertake as they enact their role and do this differently according to their Agenda for Change (AfC) pay band and where they work. Lastly, there are intrinsic and extrinsic factors (correlates) that were demonstrated to influence how Learning Disabilities Acute Liaison Nurses experience and enact their role, with some having a positive impact whilst others had a negative or limiting influence. The nurses themselves identified several areas for improvement to enhance their role.

Significance of the research: This study reveals that the lack of regular reviews of job descriptions for Learning Disabilities Acute Liaison Nurses leads to them performing tasks not specified in their job descriptions, indicating limited role clarity. There are also inconsistencies in how Learning Disabilities Acute Liaison Nurses from different AfC pay bands enact their roles. Various intrinsic and extrinsic factors were shown to influence how these nurses enact their role in acute hospitals. Collectively, the results suggest that Learning Disabilities Acute Liaison Nurses face barriers and challenges that need to be addressed to enhance the role and ensure clear role definitions (role clarity). The knowledge gained from this study have significant implications for acute healthcare services and will enable the development of a more consistent approach to defining, managing, and supporting the Learning Disabilities Acute Liaison Nurse role. The research has implications for healthcare policy, further research, nurse education, and clinical practice.