Developing and Pilot Testing Decision-Making Tools to Improve Nursing Care of Adults on the Autism Spectrum Using Simulation

Nurses and other health care providers face daily challenges when delivering care in the acute care settings to adult patients on the autism spectrum (ASD). Secondary to a lack of disability-specific training, health care providers may struggle to establish and maintain a therapeutic rapport with patients diagnosed on the autism spectrum (Bury et al., 2020). The purpose of this paper is to describe the development and pilot testing of decision-making tools to guide healthcare providers as they interact with patients on the autism spectrum using a novel approach. This mixed methods project employed simulation technology and actors portraying patients. It was conducted in two phases. During Phase 1, the decision-making tools were created using video-taped encounters between nursing students (n = 11) and standardized patients (actors) who displayed a range of core characteristics and behavioral features associated with ASD. During Phase 2, we piloted the tools with a convenience sample of 17 nurses. A panel of experts using a modified Delphi technique, 17-item task completion, 22-item behavioral encounter checklists and debriefing sessions, analyzed the 17-recorded simulations. The decision-making tools show promise of being to guide nurses' efforts to establish and maintain a therapeutic rapport with hospitalized adult patients who are also on the autism spectrum.