Family Centred Nursing in Healthcare: Enhancing Patient Care and Outcomes

Family-centered nursing in healthcare emphasizes the role of family nurse practitioners (FNPs) in delivering comprehensive care to critically ill patients. FNPs build relationships with families, integrate with them in decision-making, and utilize electronic health records (EHRs) and data warehouses for accurate and timely care. Communication, education, and cultural understanding contribute to positive patient outcomes in a family-centered care setting. Regional Health Information Organizations (RHIOs) and National Health Information Network (NHIN) facilitate information exchange among healthcare providers. Proper clinical settings and HIT tools enhance the effectiveness of FNPs in family-centered care.

Running head: FAMILY CENTRED NURSING IN HEALTHCARE
FAMILY CENTRED NURSING IN HEALTHCARE
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Healthcare professionals should ensure quality service for patient satisfaction and
positive patient related outcomes. Family nurse practitioners (FNP) deliver comprehensive
care to an individual which is a part of the family centred care. The FNP has a vital role in a
family centred care of critically ill patients (Goodyear, 2018).The nurses practicing family
centered care take care of physical, mental and psychological health of the patient. The FNP
needs to build a healthy relation with the family and especially with the parents to get critical
information and support if it is required. It is important for the FNP to integrate with the
family while practicing family centered care of the critically ill patients. It helps them during
clinical facility designing, evaluation and assessment of the critical situations, schedule
treatment, decision making and delivering precise healthcare at the vulnerable situations
which is critical for a critically ill patient in a family centred care facility. In this paper
various aspects of family centred care of critically ill patients by family nurse practitioners
will be discussed in detail.
The content, feature, requirement of family centred care in relation to critically ill
patients will be discussed in the report. The valuation of database and information system
related to nursing to gain knowledge which can help in critical decision-making of a FNP will
also be deliberated in this report.
EHR use
An EHR makes health information instantly accessible to authorized providers across
practices and health organizations (Practice Fusion, 2017). Family centred care of the
critically ill patients by the Family nurse practitioners (FNP) has some specific contents and
features about it. Critically ill patients require special care and empathy from the FNP as they
cannot make their own decisions in most of the cases. Family-centred care is a method where
healthcare is delivered to the patients with mutual consent from the family of the patient and

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the healthcare providers (King & Chiarello, 2014). In case of critically ill patients the family
makes the decision for the patient along with the nurse to plan, evaluate and deliver
healthcare to the patient. Further, use of HER helps the healthcare professionals to
record critical patient data for example, the past medical history, allergies, progress
notes, medications, vital signs, surgeries/procedures, immunization dates, lab data,
diagnoses and imaging reports so that while undergoing the care process, healthcare
professional could implement effective care process in the treatment. EHR further,
helps the healthcare professionals and patients to make shared decisions and determine
goals for the process. For example, if any patient is suffering from type 2 diabetes and
in the process puts on excessive weight, the healthcare physicians would be able to
assess the level of diabetes and all other primary symptoms associated with it. These
would be the BGL level, hypertension condition, patients respiratory and heart rate and
then depending on that would be able to provide him with diet and exercise plan so that
both the overweight and diabetes condition could be treated simultaneously. Hence,
through this EHR system, the physicians would be able to implement effective and
accurate care without waiting for the lab reports, medication condition, allergic
condition or others. Further, the patient would also be provided with depression
assistance and counselling sessions would be arranged for him so that his mental and
physical health and wellbeing could be balanced. This is an effective approach as the
healthcare physicians would be able to assess all the important information from the
EHR system of the healthcare facility so that timely and effective care could be provided
to the patients.
Regular communication between the FNP and the family of the patient results in
increased satisfaction for the family as they feel they are also part of the decision-making
(Shields, 2015). At the same time the morale of the nurse goes and subsequently the

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performance level increases. At the time of any unfortunate clinical error the communication
helps to clarify the criticality of the situation leading to positive patient related outcome.
Family plays an important part along with the FNP in family centred care of critically
ill patients. Some patient may have some special need and care and families can belong from
various socio-economic background. Prioritising and respecting the family in every stage of
healthcare and treatment improves the overall experience of the family members and provides
them a sense of assurance. The family can participate in the clinical decision-making of the
patient along with the FNP. This results in a healthy environment for the patient and enhances
the healing procedure (Ramezzani et al., 2014).
Educating family members about the treatment procedures and primary healthcare is a
secondary responsibility of the FNP. It makes the job of the FNP easier as the family
members can participate and understand the treatment better and the patient care is ensured
even further. In a family centred care of a critically ill patient the family nurse practitioner
requires to understand the cultural aspects of the patient and the family associated in the
healthcare. It is quintessential for the nurse to understand the cultural background of the
family and respect that for a better environment for healthcare due to superior level of
communication. The critically ill patient can recover faster and with less medication if the
environment in the family centred care is apt for healing.
The sickness of a patient generates anxiety and panic in the family. The patient
becomes physically and mentally vulnerable and needs special care. To ensure maximum
care of the critically ill patient family centred care is adopted by the health professionals and
the family nurse practitioners play the most vital role in that. As the family centred care of
critically ill patient is based on the collaboration of the FNP, patient and the family of the
patient all the stakeholders take part in planning and decision-making. The nurse evaluates on

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that and provides care to the patient. Family knows about their patient more than the
healthcare professionals and their participation in family centred care eases the trauma that
the patient goes through during sickness (Coyne, Hallström & Söderbäck, 2016). The best
possible planning for the patient can be done only after the intervention from the parents.
Presence of the family members decreases the anxiety of the patient. The family members
also remain relaxed when they stay in the close proximity of the patient (Altimier, Kenner &
Damus, 2015). This nonchalant environment helps the nurse to deliver care more efficiently
resulting in higher frequency of positive patient related outcome.
Data warehouse
Clinical databases are crucial in family based nursing and healthcare for the critically
ill patients. The FNP can research and gather knowledge about a specific problem and
provide care to the patient accordingly. Databases provide quality information about clinical
complications, help in clinical setting and administration for the patient. This helps the nurses
to make precise decision-making and ensure positive patient outcome and from the
warehouse, the updated patient data becomes available for other providers to access. Data can
also be collected from data warehouse which stores huge quantities of chronological data. It
can use Online Analytical Processing (OLAP) to analyse intricate data very quickly. It can
extract and store data from different sources in one site. The data warehouse can be used by
the nurse for clearing any query or analysing specific set of information which relieves stress
during family centred care of the critically ills (Tang, 2016). For example, if the nursing
professional visits the home of the diabetes and obesity affected patient for follow up or
further medication implementation, the doctor back in the healthcare facility would be able to
review the patient condition and medication status from the collected notes which would be
shared to the healthcare professional through Epic- Care home Health.

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Regional Health Information Organization
Information system is key to family centred nursing care of the critically ill patient.
Regional Health Information Organisation (RHIO), data warehouse, electronic medical report
(EMR), NHIN and PHIN networks are the tools of gathering information. RHIO is a
collection of organizations of a specific region sharing information related to healthcare in a
specific geographical area (Rouleau et al., 2017). RHIO exchange informations among
different Government agencies and helps to establish the Nationwide Health Information
Network (NHIN).NHIN is a collection of standards, policies and services that regulates
exchange of health related information over the internet. PHIN is a networking system
exchanging information regarding public health among different organisations related to
healthcare industry. EMR works like a patient portal system where the all the clinical aspects
and medical history of the patient are recorded. These networking systems and healthcare
informatics systems ease the pressure of the healthcare professionals like family nurse
practitioners (FNP) in the family centred care of critically ill patients (Nazi et al., 2016). In
the case of the patient with diabetes and obesity, RHIO would remove the need to utilize
providers all from the same HealthCare Network. Through utilization of healthcare EHR
Link, accurate and up-to-date information would be able to influence the point-of-care
decisions provided by the healthcare professionals. By sharing information between the two
health care organizations through utilization of RHIO EHR link, the patient’s healthcare
providers in neighbouring systems would have the access to accurate patient information.
National Health Information Network
Inception of various tools of health information technology (HIT) is providing the
healthcare professionals like the FNP in precise clinical decision-making. Electronic medical
report (EMR), practice management software (PM), electronic health report (HER), National
Health Information Network, PHIN, RHIO, medical database and data warehouse are some

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of the significant tools of HIT which provide information through various networking
systems(Carrington et al., 2018). These tools provide a digital patient portal delivering all the
clinical informations of the patients and the nurse can clear their query by using the health
networking and information systems. These data driven tools are of particular help for the
FNP who is looking after a critically ill patient in family centred care setting. Clinical
decision making of the nurse and diagnosis of the patient is more accurate if the HIT tools are
used resulting in positive patient outcomes and more efficient nursing practice (Williams,
Oke & Zachary, 2019).
An ideal clinical setting that the FNP requires for a critically ill patient in a
family centred care are associated to rooms which are nosocomial infection proof and
can accommodate the parents, location of the bed should be ideal for care and
electrical outlets, edges and locks should be covered and protected for the patient
safety and oxygen and suction equipment adjacent to the bed should be arranged.
Besides that Provision of education and recreation should be present to boost the morale of
the patient and resuscitation cart and defibrillator exclusively for use of the critically ill
patients should be available. Pulse oximeters, electro-cardiograph machine, stadiometer,
thermometer, monitors tracking cardio respiration blood pressure gauging device should be
arranged suitable for critically ill use. Motorised nebulizers, wheelchairs, crutches should be
available for the critically ill patient and computed tomography, routine x-ray facility,
pharmacy service for referencing of drug dosage, administration and drug interaction should
be facilitated to ensure proper care in the family centred care setup by the FNP (Makworo,
Bwibo&Omoni,2016). In the case of the diabetes and obesity affected patient, this national
exchange of information could be helpful if the patient travels abroad and visits an
emergency department of healthcare facility in that country or state. If the healthcare facility
is associated to the similar NHIN framework, the out-of-state hospital would have access to

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this patient’s HER and then would be able to allow the access to up-to-date patient
information which could aid in clinical decision making.
Conclusion
The purpose of the paper is to discuss about family centred care of critically ill
patients by the family nurse practitioner (FNP). The clinical setting for this purpose should be
precise as the requirements for a patient is unique. To ensure proper healthcare the nurse who
is practicing in family centred care should be proactive. Building a healthy relationship with
the family, setting up a proper clinical setup and using all the tools of HIT for data,
networking and information should be done by the nurse. It will ease the challenges of the
nurse and create a better environment for the patient. The nurse can provide better healthcare
with precise decision making ensuring positive outcome of the critically ill patient in the
family centred care setup.

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