Article Text

Download PDFPDF

Original article
Patient safety vulnerabilities for children with intellectual disability in hospital: a systematic review and narrative synthesis
  1. Laurel Mimmo1,
  2. Reema Harrison2,
  3. Reece Hinchcliff3
  1. 1 Clinical Governance Unit, Sydney Children’s Hospitals Network, Sydney, New South Wales, Australia
  2. 2 School of Public Health and Community Medicine, Faculty of Health, University of New South Wales, Sydney, New South Wales, Australia
  3. 3 Centre for Health Services Research, University of Technology Sydney, Ultimo, New South Wales, Australia
  1. Correspondence to Laurel Mimmo; laurel.mimmo{at}


Purpose Adults and children with intellectual disability (ID) are vulnerable to preventable morbidity and mortality due to poor quality healthcare. While poor quality care has been commonly identified among children with ID, evidence of the patient safety outcomes for this group is lacking and therefore explored in this review.

Data sources Systematic searches of six electronic bibliographic research databases were undertaken from January 2000 to October 2017, in addition to hand searching.

Study selection Keywords, subject headings and MeSH terms relating to the experience of iatrogenic harm during hospitalisation for children with ID were used. Potentially relevant articles were screened against the eligibility criteria. Non-English language papers were excluded.

Data extraction Data regarding: author(s), publication year, country, sample, health service setting, study design, primary focus and main findings related to measures of quality and safety performance were extracted.

Results of data synthesis Sixteen studies met the inclusion criteria, with three themes emerging: the impact of the assumptions of healthcare workers (HCWs) about the child with ID on care quality and associated safety outcomes; reliance on parental presence during hospitalisation as a protective factor; and the need for HCWs to possess comprehensive understanding of the IDs experienced by children in their care, to scientifically deduce how hospitalisation may compromise their safety, care quality and treatment outcomes.

Conclusion When HCWs understand and are responsive to children’s individual needs and their ID, they are better placed to adjust care delivery processes to improve care quality and safety during hospitalisation for children with ID.

  • health service
  • patient perspective
  • general paediatrics
  • multidisciplinary team-care
  • children’s rights

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors LM and RHi conceived and designed the study. LM searched the literature, screened abstracts and full-text, extracted the data. All named authors contributed to the thematic data analysis, drafting manuscripts and have approved the final manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.