Medical Education Show Jan 2016 Aaron M. Clay, RN and Bridget Parsh, RN, MSN, EdD Patient- and family-centered care (PFCC) is changing the way hospitals provide patient care, increasing staff satisfaction, decreasing costs, and improving patient outcomes [1, 2]. Although hospitals make unique, organization-specific PFCC principles, all of them tend to endorse similar core values by recognizing the importance of family members’ roles in individual patients’ health care experience, establishing relationships with and supporting patients and families, and helping patients discover how their own strengths and weaknesses influence their health and health care. When patients’ needs are prioritized, they engage in treatment and the treatments are more effective [1-4]. Hospitals where PFCC is part of the organizational culture find not only that patient, family, and staff satisfaction ratings significantly increase, but also that patients’ health outcomes improve [2, 5]. Implementation of PFCC is also correlated with a decrease in patients’ emergency department visits, faster recovery, and decreased utilization of health care resources [2, 6-7]. PFCC has become widespread throughout health care [6, 8-12]. The PFCC concepts of patient-physician collaboration and treating the patient as a whole person are not new. Fifteen years ago, the Institute of Medicine (IOM) semi-annual report, Crossing the Quality Chasm [8], included PFCC as an initiative to improve quality in the list of ten rules for redesigning health care [13]. The IOM report emphasized the need to involve patients in their own health care decisions, to better inform patients of treatment options, and to improve access to information [8]. PFCC provides a holistic approach to patient care, including psychological, spiritual, cultural, and emotional considerations that contextualize experiences of illness or injury and go beyond a focus on disease processes only [1]. The term “family-centered” does not remove control from competent patients to make decisions concerning their own health care [11]. Instead, this concept emphasizes that a patient’s health care decisions should be contextualized in terms of a patient’s broader life experiences. This term also recognizes the role a patient’s family members play in extended and at-home care planning and care giving. As medical care continues to become more collaborative, with a focus on holistic care for patients and their sources of support, principles of PFCC are now commonly taught to medical residents [14, 15]. For example, to be recognized by the Magnet Recognition Program, developed by the American Nurses Credentialing Center, hospitals must implement family-centered care [16]. No longer just for pediatrics, patient- and family-centered care applies to patients of all ages and can be practiced in any health care setting and at any point in care delivery; the Joint Commission suggestions include providing discharge instructions that meet the patient’s needs, informing patients of their rights, and identifying patients’ dietary restrictions that affect treatment [1]. Giving patients control, customizing care according to patients’ needs and values, and providing information to patients and their loved ones are other IOM recommendations that promote PFCC [8]. Recognizing the importance of patients’ loved ones in patients’ health care experiences, clinicians try to work with patients and families to ensure their health and well-being in a mutually beneficial relationship [8, 11, 12]. Principles of PFCC include listening to families, facilitating choice, sharing information, and building confidence to participate in health care decision making [2, 11]. By implementing PFCC, clinicians benefit by gathering more information, improving follow-through, making efficient use of professional time, and decreased health care utilization [6, 9, 11]. Based on the latest research and guidelines [1, 4, 10, 14], these strategies for successful patient- and family-centered care are suggested:
Prominent organizations including the Institute of Medicine (IOM), the Institute for Patient- and Family-Centered Care (IPFCC), the Institute for Healthcare Improvement (IHI), the American Academy of Pediatrics (AAP), and the American College of Emergency Physicians have endorsed PFCC practices, helped to define PFCC, and illustrated the importance of incorporating patients and their loved ones into health care discussions and decisions [8-12]. PFCC improves quality and safety of care, chronic disease management, and patient satisfaction; reduces hospitalizations and medical errors; and lowers costs [1, 2, 6, 11, 17, 21]. References
When providing culturally competent care to clients a nurse understands that cultural competence involves which characteristics?Components of Culturally Competent Care
Culturally competent care consists of four components: awareness of one's cultural worldview, attitudes toward cultural differences, knowledge of different cultural practices and worldviews, and cross-cultural skills.
When planning care for a client which action is a priority for the nurse quizlet?The first action the nurse should take when using the nursing process is to assess the client; therefore, the priority action for the nurse to take is to determine why the client is refusing the treatment. A client who is postop is verbalizing pain as a 2 on a pain scale of 0-10.
Which is a cultural norm of the healthcare system?Cultural norms of the health care system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death.
|