Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice, 3rd Edition

The American Nurses Association (ANA) is a national professional association. This publication reflects the position of ANA regarding the scope and standards of intellectual and developmental disability nursing practice and should be reviewed in conjunction with state board of nursing regulations. State law, rules, and regulations govern the practice of nursing, while Intellectual and Developmental Disability Nursing: Scope and Standards of Practice, 3rd Edition guides registered nurses in the application of their professional skills and responsibilities.

About the American Nurses Association

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 4.2 million registered nurses through its constituent/state nurses associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

American Nurses Association

8515 Georgia Avenue, Suite 400

Silver Spring, MD 20910

Copyright © 2022 ANA. All rights reserved. No part of this book may be reproduced or used in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher.

ISBNs

Print 978-1-947800-89-2

ePDF 978-1-947800-90-8

ePUB 978-1-947800-91-5

Mobi 978-1-947800-92-2

SAN: 851-3481

Contents

Contributors

ANA Committee on Nursing Practice Standards

ANA Staff

About This Publication

About the American Nurses Association

Overview of the Content

Essential Documents of Professional Nursing

Additional Content

Audience for This Publication

IDD Nursing Scope of Practice

Definition of Nursing

Definition of Intellectual and Developmental Disability (IDD) Nursing

Description of the Scope of IDD Nursing Practice

Specialty Practice in IDD Nursing

Development and Function of IDD Nursing Standards of Professional Practice

Standards of Professional Nursing Practice in IDD

Standards of Practice in IDD Nursing

Standards of Professional Performance in IDD Nursing

The Function of Competencies in IDD Nursing Standards

What Is IDD Nursing?

When Nursing Occurs

The How of IDD Nursing

Integrating the Science and Art of IDD Nursing

The Art of IDD Nursing

Care and Caring in IDD Nursing Practice

Cultural Components of Care

The Science of IDD Nursing

IDD Nursing Knowledge

Research in IDD Nursing

Evidence-Based Practice in IDD Nursing

The Where of IDD Nursing Practice

Healthy Work Environments for Nursing Practice

Safe Patient Handling and Mobility (SPHM)

Fatigue in Nursing Practice

Workplace Violence and Incivility

Optimal Staffing

Supports for Healthy Work Environments

American Nurses Association

American Association of Critical Care Nurses Standards

High-Performing Interprofessional Teams

Key Influences on the Quality and Environment of Nursing Practice

Societal, Cultural, and Ethical Dimensions Describe the Why and How of IDD Nursing

The Code of Ethics for Nurses

Professional Registered Nurses Today: The Who of IDD Nursing

Statistical Snapshot

Licensure and Education of IDD Registered Nurses

Definitions and Concepts Related to Competence in IDD Nursing

Evaluating Competence

Professional Trends and Issues

Creating a Sustainable Nursing Workforce

Nursing Education

Technological Advances

Population Focus

Redefining Health and Well-Being for the Millennial Generation

Baby Boomers: Health and Chronic Illness

Summary of the Scope of IDD Nursing Practice

Standards of Professional Nursing Practice

Significance of Standards

Standards of Practice for IDD Nurses

Standard 1. Assessment

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD

Additional competencies for the APRN who specializes in IDD

Standard 2. Diagnosis

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD

Additional competencies for the APRN who specializes in IDD

Standard 3. Outcomes Identification

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD, including the APRN who specializes in IDD

Standard 4. Planning

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD

Additional competencies for the APRN who specializes in IDD

Standard 5. Implementation

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD

Additional competencies for the APRN who specializes in IDD

Standard 5A. Coordination of Care

Competencies

Additional competencies for the graduate-level prepared registered nurse who specializes in IDD

Additional competencies for the APRN who specializes in IDD

Standard 5B. Health Teaching and Health Promotion

Competencies

Additional competencies for the graduate-level prepared registered nurse, including the APRN who specializes in IDD

Standard 6. Evaluation

Competencies

Additional competencies for the graduate-level prepared registered nurse, including the APRN who specializes in IDD

Standards of Professional Performance for IDD Nurses

Standard 7. Ethics

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 8. Culturally Congruent Practice

Competencies

Additional competencies for the graduate-level prepared registered nurse

Additional competencies for the APRN

Standard 9. Communication

Competencies

Standard 10. Collaboration

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 11. Leadership

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 12. Education

Competencies

Standard 13. Evidence-Based Practice and Research

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 14. Quality of Practice

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 15. Professional Practice Evaluation

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 16. Resource Utilization

Competencies

Additional competencies for the APRN who specializes in IDD

Standard 17. Environmental Health

Competencies

Additional competencies for the APRN who specializes in IDD

Glossary

References

Index

Contributors

The American Nurses Association (ANA) thanks those who contributed their valuable time and talents to development of Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice, 3rd Edition. This resource builds on and replaces previous editions entitled Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice and the original Statement on the Scope and Standards for the Nurse Who Specializes in Developmental Disabilities and/or Mental Retardation. The terminology has changed over the years and is reflected in each edition of the scope statement and standards of this specialty nursing practice.

The authors of Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice, 3rd Edition, involved persons with disabilities and family members of individuals with disabilities and include:

Cecily L. Betz, PhD, RN, FAAN, Chair, University of Southern California, University Center for Excellence in Developmental Disabilities, Children’s Hospital Los Angeles; Task Force Member, IDD Nursing: Scope and Standards, 1st, 2nd Edition

Jennifer Adams, EdM, MSN, RN, ACCNS-P, CPN, CNE, Society of Pediatric Nurses (SPN) Representative

Karen W. Burkett, PhD, RN, PPCNP-BC, Division of Developmental and Behavioral Pediatrics; Leadership Education in Neurodevelopmental Disabilities (LEND), Cincinnati Children’s Hospital Medical Center

Wendy A. Chouteau, DNP, APRN, FNP-BC, Division of Neurology/Comprehensive Neuromuscular Center, Cincinnati Children’s Hospital Medical Center

Louvisia Lou A. Conley MEd, EdS, Boling Center for Developmental Disabilities

Eduardo del Rosario, PhD Student, FNP-BC, Barbara H. Hagan School of Nursing and Health Sciences, Molloy College

Jean Farley, DNP, RN, PNP-BC, Georgetown University, School of Nursing and Health Studies

Veronica Feeg, PhD, RN, FAAN, Barbara H. Hagan School of Nursing and Health Sciences, Molloy College

Laurie Fleming, MPH, RN, NCSN, National Association of School Nurses (NASN) Representative

Michelle S. Franklin, PhD, MSN, FNP-BC, PMHNP-BC, CNS, Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill

J. Carolyn Graff, PhD, RN, FAAIDD, University of Tennessee Health Science Center, Boling Center for Developmental Disabilities

Marilyn Krajicek, EdD, RN, FAAN, University of Colorado College of Nursing; Task Force Member, IDD Nursing: Scope and Standards, 1st, 2nd Edition

Rebecca Kronk, PhD, MSN, CRNP, FAAN, CNE, ANEF, International Society of Nurses in Genetics (ISONG) Representative

Lindsey Minchella, MSN, RN, NCSN, FNASN, National Association of School Nurses (NASN) Representative

S. Diane Moore, BSN, RN, CDDN, Developmental Disabilities Nurses Association (DDNA) Representative

Wendy M. Nehring, PhD, RN, FAAN, FAAIDD, Chair, Task Force IDD Nursing: Scope and Standards, 1st, 2nd Edition; East Tennessee State University, College of Nursing

Teresa A. Savage, PhD, RN, Department of Women, Children & Family Health Science, College of Nursing, University of Illinois at Chicago; Task Force Member, IDD Nursing: Scope and Standards, 1st, 2nd Edition

Nhu Tran, RN, PhD, MSN, CCRN, CCRP, Academy of Neonatal Nurses Representative

Susan Van Cleve, DNP, RN, CPNP-PC, PMHS, FAANP, FAAN, National Association of Pediatric Nurse Practitioners (NAPNAP) Representative

Cassandra Wolf, BSN, RN, Cincinnati Children’s Hospital Medical Center

ANA Committee on Nursing Practice Standards

Mona Pearl Treyball, PhD, RN, CNS, CCRN-K, FAAN (Co-Chair February 2019–December 2020)

Stacy McNall, MSN, RN, IBCLC, PMHNP-BC (Co-Chair February 2020–December 2021)

Patricia Bowe, DNP, MS, RN

Nena M. Bonuel, PhD, RN, APRN-BC, ACNS-BC, CCRN-K

Danette Culver, MSN, RN, APRN, ACNS-BC, CCRN-K

Elizabeth Liz O. Dietz, EdD, RN, CS-NP, CSN

Tonette Toni McAndrew, MPA, RN

Amy McCarthy, MSN, RN, RNC-MNN, NE-BC

Linda Inez Perkins, MSN, RN-BC (Alternate)

Shelly Wells, PhD, MBA, APRN-CNS, ANEF (Alternate)

ANA Staff

Carol Bickford, PhD, RN-BC, CPHIMS, FAMIA, FHIMSS, FAAN (content editor)

Erin Walpole, BA, PMP (project editor)

About This Publication

In September 2020, ANA’s Board of Directors approved the scope statement and acknowledged the standards of practice and professional performance of Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice, 3rd Edition, as defined herein. Approval is valid for five years from the first date of publication of this document or until a new scope of practice has been approved, whichever occurs first.

About the American Nurses Association

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 4.2 million registered nurses through its constituent or state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.

Overview of the Content

Essential Documents of Professional Nursing

ANA has been the vanguard for nursing practice for more than a century. The Code of Ethics for Nurses with Interpretive Statements (ANA, 2015b) and Nursing: Scope and Standards of Practice (3rd ed.; ANA, 2015a) are documents produced by ANA to inform the thinking and decision-making of registered nurses practicing in the United States and guide their practice. The Code of Ethics for Nurses with Interpretive Statements (ANA, 2015b) lists the nine succinct provisions that establish the ethical framework for registered nurses across all roles, levels, and settings. Nursing: Scope and Standards of Practice (3rd ed.; ANA, 2015a) outlines the expectations of the professional role of the registered nurse. It includes the Scope of Nursing Practice Statement and presents the Standards of Professional Nursing Practice and their accompanying competencies. These documents are intended to help provide the public with assurances of safe and competent nursing care.

Along with these documents, specialty nursing organizations have worked with ANA to publish specific standards of professional practice in their specialty. This document, concerning the care of individuals with intellectual and developmental disabilities (hereafter referred to as IDD), is a revision of the Intellectual and Developmental Nursing: Scope and Standards of Practice, 2nd Edition. This document has been revised to:

capture the changing practice of nursing in this specialty (i.e., encompassing all levels of education and all system levels of care from the individual to the system itself),

emphasize the unique healthcare needs and characteristics of individuals of all ages with IDD,

incorporate the ANA standards mentioned earlier (ANA, 2015a),

incorporate the provisions of the Code of Ethics for Nurses with Interpretive Statements (ANA, 2015b),

emphasize the importance of a family-centered and consumer-centered framework of care, and

incorporate the developments in the field since the last edition.

The previous edition of these specialty standards and scope of practice is found on ANA’s website, Nursingworld.org.

Adolescents and adults with IDD and their families or legal guardians engage in shared decision-making with healthcare professionals to make person-centered decisions about their health care. This self-advocacy has arisen in tandem with an evolving healthcare system that may or may not optimize healthcare options for all people. Therefore, in response to these changes, individuals of all ages and abilities with IDD and their families or legal guardians should be assured of safe and effective nursing care. This document addresses this care, the associated nursing standards, and the competencies expected of registered nurses who specialize in IDD practices.

Additional Content

This document should also be used in conjunction with other specialty nursing scope and standards of practice and professional performance such as but not limited to Pediatric Nursing: Scope and Standards of Practice, 2nd Edition (Society of Pediatric Nurses [SPN], National Association of Pediatric Nurse Practitioners [NAPNAP], & ANA, 2015); Genetics-Genomics Nursing: Scope and Standards of Practice, 2nd Edition (International Society of Nurses in Genetics, Inc. [ISONG] & ANA, 2016); Public Health Nursing: Scope and Standards of Practice, 2nd Edition (ANA, 2013a); Psychiatric-Mental Health Nursing: Scope