title: Learning disabilities: a survey of community nurses for people with prevalence of challenging behaviour and contact demands.
abstract: BACKGROUND
  There is scant knowledge on the contacts community nurses for people with learning disabilities have with clients who display challenging behaviours, or the numbers of such people on these nurses' caseloads. This study was undertaken in a UK region with a population of 1.68 million people. In this region it is estimated that there are 8500 people with learning disabilities who are in contact with services, this includes around 500 people remaining in hospitals awaiting resettlement.
  
  
  OBJECTIVE
  The research aims were to identify the overall caseload sizes of the nurses, the prevalence of people with learning disabilities who have challenging behaviours on the nurses' caseloads and what contact demands these people required. An additional aim was to discover courses or training that helped the nurses to fulfill their roles.
  
  
  METHODS
  A postal survey was undertaken of the total population of community nurses for people with learning disabilities in the region. The method of data collection was a self-completion questionnaire.
  
  
  RESULTS
  The study found that people with challenging behaviours accounted for over a quarter of the combined caseloads, and these clients required the most frequent visits from the nurses. There was a wide range in the number of clients on the caseloads of each nurse but overall these were higher than in other parts of the UK.
  
  
  CONCLUSIONS
  It is concluded that community nurses for people with learning disabilities have large caseloads and people with learning disabilities who have challenging behaviours, who account for over one-quarter of the clients they visit, require much more frequent contact visits than other clients. The combination of high numbers of clients (or low numbers of these nurses) may impact on how such nurses are able to perform their role and functions.
  
  
  CONCLUSIONS
  An increase in the numbers of community nurses for people with learning disabilities and skill development in caring for people with challenging behaviours is recommended. If this is not performed the clinical effectiveness of this group of nurses with respect to their work with people who challenge services may be unduly hampered.
authors.affiliation: School of Nursing, University of Ulster, Newtownabbey, County Antrim, Northern Ireland, UK. je.slevin@ulster.ac.uk
authors.forename: Eamonn
authors.initials: E
authors.lastname: Slevin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence / Q000592:standards; D003152:Community Health Nursing / Q000193:education / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000150:complications* / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000451:nursing; D008875:Middle Aged; D020380:Needs Assessment; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015401:Nursing Administration Research; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D006113:United Kingdom / Q000453:epidemiology; D016526:Workload