Patient- and Family-Centered Care
The patterns of contemporary care and treatment are different from the ones of the past, with the focus being on the mutual partnership with colleagues, patients, and their families. This approach in nursing focuses on patient- and family-centered care (PFCC) with an accent on the concepts of partnership and cooperation. To fix the gaps in the modern nursing practice, the experts have established the Quality and Safety Education for Nurses (QSEN) initiative, which makes it possible to enhance various Graduate Level Competencies with the promotion of PFCC. One of the most critical features of the process of obtaining this education is the acquisition of knowledge, skills, and attitudes (KSAs) for the nurses to learn and share the basics of PFCC, establish and develop this framework in their workplaces and achieve better patient outcomes. To better understand the KSAs associated with PFCC, it is necessary to review relevant literature, discuss the practical benefits of implementing the PFCC framework and develop an effective strategy for fostering PFCC and its KSAs in a pediatric care unit.
The concept of patient- and family-centered care is a specific issue recognized by different institutions of nursing education and practice, which is why it is premised on the developed theoretical and practical frameworks relevant for an actual clinical setting. Experts define the validation of PFCC as the provision of care “that is respectful of and responsive to individual patient preferences, needs, and values ensuring that patient values guide all clinical decisions” (Disch, n. d.). The ultimate goal of this initiative is to give patients and their families information, resources, access, and support to engage them in the healthcare process and direct their healthcare experience as they wish (Disch, n. d.). However, having a PFCC-related goal in nursing is not enough, as health care practitioners require relevant theoretical and practical training to validate their mission accurately. For this reason, there are institutions, which focus their educational programs specifically on PFCC and improve patient outcomes indirectly.
The patients and their families significantly benefit in the case the nurse, who takes care of a patient, possesses PFCC-relevant knowledge, skills, and attitudes. One of the primary reasons for this is that these health care practitioners are free from the common misconceptions associated with PFCC. These issues range from the understanding of PFCC’s mission as being nice, providing all caring initiatives to families, bypassing the boundaries of professional communication, and others (Kaufman, 2013). In contrast, the patients and their families benefit from the new therapeutic value of PFCC-relevant care, which focuses on their emotional, psychological, social, and spiritual needs (Harrison et al., 2014). Similarly, such nurses understand the value of enhancing the aspects of patient care and recovery due to cooperation with their families. For instance, Herrin et al. (2016) argue that the extension of the visiting hours in the ICU, as a manifestation of cooperation with patient families, can reduce cardiovascular complications in ICU patients. Therefore, families and patients should seek the care of PFCC-aware nurses to experience enhanced levels of care and treatment.
In contrast, the practice of the health care initiatives not associated with PFCC-relevant KSAs may lead to drastic patient outcomes covered in different literature sources. For instance, a literature review performed by Seys et al. (2013) argues that nurses and physicians suffer from the lack of PFCC-aware practices in the first place. The reason for such an issue is the lack of awareness of the fact that individual-level support provided by patients and families can reduce the level of professional distress (Seys et al., 2013). In its turn, high levels of stress prevent nurses from validating timely and relevant clinical and outpatient care initiatives. Likewise, experts indicate that modern nurses tend to face barriers during nurse involvement in a relevant care process, as they lack KSAs required for establishing a rapport with colleagues, patients, and their families (Harrison et al., 2014). As a result, nurses, who lack PFCC competencies, tend to fail to deliver culturally aware and emotionally supportive care to the patients’ values and beliefs.
Patient- and Family-Centered Care in Practice
The positive effect of the patient care enhanced by PFCC-relevant KSAs can be observed through the analysis of an example taken from individual professional experience. As a nurse working in a pediatric unit, I typically have many children patients, who are often shy to speak of their problems due to various issues, including the presence of the clinical setting, their parents, and others. For this reason, I admit that PFCC-relevant KSAs are especially useful in pediatric care, as they allow establishing a quick rapport with children patients and their families. One of such patients was Emily, a seven-year-old girl, who had shortness of breath, repetitive cough, and swelling of her throat. Her parents supposed that the girl had a sore throat, as the patient required clinical assistance in winter. However, the analyses did not confirm any bacterial or other infection, thereby fostering a decision-making problem, as I had certain doubts about my further actions.
The awareness of PFCC goals in nursing led me to the conclusion that I had to deliver an interview with the girl and the patients in a playful manner, which later revealed the source of the problem. The interview uncovered the fact that the girl got accustomed to soybeans and even used to steal them from the pantry of the family’s house. Due to the girl’s age, she did not characterize her attempts as stealing but perceived it as a form of a game. As a result, I understood that the inadequate consumption of soybeans by the girl caused the development of an allergic reaction. The analyses of the girl’s blood confirmed that she had an allergic reaction to soybeans, which is why we took appropriate clinical and educational measures during the treatment process.
In case I lacked PFCC awareness, I would have possibly failed to timely discover the source of the problem, and Emily might have possibly developed an allergic shock. The negative case scenario of this type typically occurs when nurses and physicians have no PFCC-relevant KSAs and fail to implement the contemporary framework of clinical care. One of the infamous real-life examples of the failure to deliver adequate pediatric care is the case of Lewis Blackman, a 15-year-old male patient, who died of the septic shock, which was possible to avoid (Acquaviva, Haskell, & Johnson, 2013). Experts claim that the major reasons for the boy to die unnecessarily after a successful surgery session was anchoring, the misidentified role of the clinical power and authority personnel, and the fragmented care delivery system (Acquaviva et al., 2013). These issues are the outcomes of the deficit of PFCC awareness of the nursing staff at the hospital discussed in the case.
Strategies for Promoting Patient- and Family-Centered Care
For nurses to avoid different failures in delivering care associated with PFCC-irrelevant practices, hospitals and clinics have to develop partnering educational and training programs with institutions advocating for PFCC. One of them, the Healthcare and Patient Partnership Institute (HPPI) offers an H2Pi program, which trains healthcare organizations to work with patients for improving treatment outcomes (The Healthcare and Patient Partnership Institute, 2017). The institution offers numerous initiatives and tools that allow the participants of its training programs to develop an awareness of the framework of care according to the guidelines of PFCC. The educators of HPPI claim that their programs educate nurses on how to work together with patients and families to increase the safety of the delivery of care (The Healthcare and Patient Partnership Institute, 2017). Similarly, they argue that their training initiatives help nurses to reduce medical costs and treatment-associated risks and deliver care by being aware of the authentic culture of patients of different ethnic backgrounds (The Healthcare and Patient Partnership Institute, 2017). Participation in HPPI’s initiatives would also be useful for the nurses of pediatric units, as it would allow the former to establish a quick rapport with their younger patients and their families.
Participation in training programs at HPPI also means that the nurses would gain awareness about PFCC through cross-professional learning in the practical setting, which increases the speed and efficacy of training. For instance, scholars claim that the training of nursing personnel delivered by more skillful specialists in a practical setting is effective due to higher levels of preparation, support, and facilitator training (Kelley & Aston, 2011). Therefore, such cooperation with more experienced colleagues activates the processes of cooperative and experiential learning (Kelley & Aston, 2011), which is why the nurses, who are part of the H2Pi program, can effectively learn the educated competencies and skillsets. Consequently, collaboration with HPPI and other institutions that specialize in the training of PFCC competency and associated KSAs is the most successful strategy for the nurses to gain the theoretical and practical skills of the modern nursing profession.
Summarizing the presented information, it becomes evident that the engagement of nurses of pediatric units with institutions that train PFCC competencies and associated KSAs is the best way for them to acquire the missing knowledge and skills. The analysis of the subject, the goals, and the outcomes of the framework of patient- and family-centered care demonstrates that modern nurses are obliged to develop the competencies and KSAs associated with them. The major reason for it is the ability to achieve better patient care outcomes such as culturally- and individually-aware care through the establishment of cooperation with patients and their families. For the nurses of pediatric care units to develop the missing KSAs, their medical facilities require to partner with the institutions that offer the corresponding training initiatives. The analysis of one of them offered by the Healthcare and Patient Partnership Institute proves that this educational institution can educate nurses on all the missing competencies most appropriately and effectively.
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