In 2019, the NDIS Quality and Safeguards Commission sought a review of the causes and contributors to deaths in people with disability to better understand these reasons and take action to reduce identified risks of death and serious injury.

Professor Julian Trollor, Chair, Intellectual Disability Mental Health in the Department of Developmental Disability Neuropsychiatry at UNSW was engaged to complete this research.

A number of recommendations were highlighted in the review, some of which guided the development of Practice Alerts.

Key risks identified related to the need for greater knowledge and skills to reduce respiratory-related deaths and decrease the risk of aspiration pneumonia among people with disability. The Practice Alerts give clear, straightforward information and advice on steps towards reducing these and other risks.

NDS strongly encourages members to review and share these alerts with your staff and clients.

Practice Alert: Dysphagia, safe swallowing and mealtime management

Dysphagia is a medical term for any difficulty with swallowing.

Information and advice in the Dysphagia, safe swallowing and mealtime management practice alert includes:

• Signs and symptoms of Dysphagia
• Provider obligations
• Recommended ways to support participants with dysphagia and what all staff should know

Practice Alert: Medicines associated with swallowing problems

Certain medicines, commonly given to people with disability, can increase the risk of choking.

Information and advice in the Medicines associated with swallowing problems practice alert includes:

• Considerations, including peak risk times and when to get a medical review
• Medicines associated with drowsiness that impact swallowing
• Medicines associated with swallowing problems, including Risperidone, Sodium valproate, and Olanzapine.

Practice Alert: Polypharmacy

The Commission advises that 'polypharmacy is often defined as the use of five or more medications, or two or more psychotropic medications, at the same time'.

The Polypharmacy practice alert includes:

• What is polypharmacy
• The risks associated with polypharmacy
• How to seek a Home Medicines Review (HMR) for participants
• Recommended supports for participants receiving polypharmacy – including the frequency of reviews
• Provider obligations

NDS’s Assist with Medication eLearning may also be useful for providers in meeting the Provider obligations outlined in the Alert.

Practice Alert: Epilepsy management

Supporting staff to understand epilepsy can help to reduce the risk for people with disability.

The Epilepsy management practice alert includes:

• What is epilepsy
• Risks associated with epilepsy
• Recommended ways to support participants with epilepsy
• Provider obligations, including the need to develop an epilepsy management plan in consultation with a medical practitioner

NDS also has four Epilepsy related eLearning courses available for providers

Practice Alert: Transitions of care between disability services and hospitals

In Australia, transitions between hospitals and disability services can present a risk of harm to participants. Safe transitions of care require clear communication and coordination.

Information and advice in the Transitions of care between disability services and hospitals provider alert includes:

• The risks of mismanaging the movement of people with disability between places or services providing care
• Recommended ways to support participants admitted to hospital
• Guidance for when a participant leaves hospital
• How to support participants during transitions of care
• Provider obligations

NDS will advise members when future Provider Alerts are created and links to these can be found on NDS’s NDIS Quality and Safeguards Resource Library.