THE PATIENT CENTERED CARE

Running head: PATIENT-CENTERED CARE
Patient-centered care- A case study
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Introduction
Patient-centered care is one of the most excellent methods of delivering care treatment to the
patients and is widely accepted and used by most of the healthcare personnel recently. It
helps in empowering patients to get actively involved in their treatment and recovery process.
Effective communication at the end of healthcare professionals such as physicians, nurses
and radiologists is an essential part of patient-centered care. It has demonstrated higher levels
of satisfaction, adherence and overall outcome of the patients. It has also displayed improved
outcomes and cost-effectiveness of the treatment. The criteria of patients’ judgments are
more inclined towards non-technical domains like the communication and soft-skills of the
health care professionals and transparency of the health experts. Recently, the primary health
care system is also strengthening the role of a multidisciplinary team in delivering patient-
centered care to the patients. Evidence suggests that involving an elaborate and organized
multidisciplinary team reduces the burnout of physicians with improved quality and
efficiency of the care (Bach et al., 2017). This essay discusses the case of Ivy, proposes a
patient-centered plan of care for the patient and the role of a multidisciplinary team in Ivy’s
treatment.
Discussion
Overview of the case
This paper is based on the case of an elderly woman age 93 years, called Ivy. Ivy experienced
an accident while traveling in a motor vehicle at a speed of 60 kph with her daughter, who
was driving when the incident took place. Ivy faced a head-on collision during the accident
and the suspected injuries include injuries in the chest and right knee, and fractures in the
right forearm. The medical history of Ivy includes hypertension, hyperthyroidism, cataracts

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and left total knee replacement. She also underwent sigmoid adenocarcinoma differentiated
moderately, which was resected with stoma formation. She generally stays at home and is
independent in her work. When she was admitted to the hospital, she was prescribed the
medications irbesartan 75 mg daily and propylthiouracil 25mg mane and 50 mg nocte.
Patient-centered care for Ivy
Patient-centered care is particularly crucial for Ivy’s treatment as multiple morbidities in
older adults are highly associated with disability, death or adverse effects. It also utilizes
lower healthcare resources and poor long-term effects such as quality of life. Older adults like
Ivy require more flexible options of care as each individual presents a different clinical
condition with differing multimorbidities and an increased sensitivity considering their age. A
severe problem faced by Ivy is her chest injury as thoracic injuries cause about one-fourth of
mortalities among patients (Bulger, 2017). Patient-centered treatment for Ivy includes
assessing her vital signs regularly in intervals of 4-5 hours. Ivy must be monitored for cardiac
dysrhythmia and also evaluate and record her reaction to dysrhythmias. The nurse must
encourage the patient to inform them whenever she experiences pain in the chest, which can
be subsequently examined for the specific location, duration, intensity and other related
factors such as precipitation and alleviation. Patient-centered care for Ivy’s chest injury also
involves monitoring her laboratory values of cardiac enzymes and levels of electrolyte. It is
also essential to check her respiratory response and any underlying issue that may have been
a result of her chest injury. Difficulties in respiration can be observed as rapid breathing,
shortness of breath, and labored respirations (Ignatavicius & Workman, 2015).
Other vital aspects of patient-centered care for Ivy include reducing her levels of stress and
that of her family as well. It is common for aged people and their family members to get
extremely worried when such accidents occur at higher ages. Staying stress-free is crucial for

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a faster recovery. Spiritual support to Ivy and her caregivers, which mainly include her family
members, can be of enormous benefit in the course of her treatment.
In older adults like Ivy, the fundamental cause of fracture in motor vehicle accidents is
trauma. As the medical history of Ivy represents osteoporosis, her risk of fracture increases.
Considering the age of Ivy, it is best to apply a splint or bandage at the sites of fractures, the
knee and her forearm. She and her family must be educated about the management of the
wound and primary care options to prevent infection in the area. Ivy required complete bed-
rest with minimal movement of the right arm and legs. Her diet must include foods that
contain high amounts of proteins and calcium as it helps in healing tissues and bones. It is
vital to inform Ivy and her family about the complications that may arise in her fracture due
to osteoporosis. This helps them identify any complication in the early phase and refer the
doctor immediately to reduce the progression of the complication. It is also essential to
encourage Ivy to describe her levels of pain in the areas of the fracture. This can also help the
healthcare provider to assess the intensity of the pain and prescribe painkillers if the pain
reported is higher than the average estimated levels (Ignatavicius & Workman, 2015). As her
movement of the right arm and legs due to injury in the knee is restricted, arrangements for
excretion facilities have to be made in the bed. She will also require external help to consume
her meals for at least two months in the beginning unless her fracture in the forearm shows
considerable improvement. Pharmacological treatment for Ivy has to be kept minimum as it
might have adverse effects considering her age and comorbidities.
Role of the multidisciplinary team in Ivy’s treatment
A well-organized, integrated multidisciplinary team helps in minimizing morbidity,
decreasing chances of mortality and optimize the overall care. It is widely being accepted by
doctors around the globe as it becomes difficult for the doctor to manage the complete care of

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the patient and consider every option carefully. A multidisciplinary team optimal for Ivy
would include orthopedic experts, trauma-specialized surgeons, dieticians, physiotherapists,
diagnostic radiologists, social workers and nurses (Mears & Kates, 2015). In Ivy’s case, the
role of an emergency physician and trauma surgeon is to ensure that no internal or external
bleeding occurs and if any such instance is observed then immediate action needs to be taken.
Similarly, the orthopedic surgeon has a vital part in providing an optimum treatment plan for
the fractures in her forearm and knee. She must be given immediate response such as a splint
or a bandage, whichever seems the most suitable at the time (Patrini et al., 2019). Nursing
professionals are responsible for the overall care and ensuring adherence of the patient to the
treatment plan prescribed by the team. The nurses also have to monitor the patient at all times
to observe any change or complication in the clinical condition of Ivy (Brent et al., 2018).
Thoracic physiotherapists ensure no additional complication in the respiration and thoracic
cavity of the patient. They help in mobilizing lung secretions, prevent fatigue and provides
respiratory therapy to ensure no trouble in respiration. They may also teach deep-breathing
exercises and related chest activities. Exercises of the arms and legs must be avoided for the
initial few months as Ivy will need sufficient time to heal and has to keep the sites of
fractures intact. Radiologists are primarily involved in the imaging and tests of the internal
parts and fracture sites of Ivy to determine and diagnose the exact cause and issue.
Radiologists are also called for routine X-rays of Ivy to check her progress of the fractures of
the forearm and knee and her improvement in chest pain. A nutritionist is also essential to
regulate the dietary requirements of Ivy and maintain the essential nutritional intake of the
patient. In the case of Ivy, her diet must be rich in proteins for rapid tissue healing and
calcium, which helps in faster healing of the fractures in the bone (Riemen & Hutchison,
2016). She also requires Vitamin D as she exhibits osteoporosis and her foods must contain
low amounts of salts to keep her hypertension under control. The nutritionist has to prepare a

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diet chart considering all of the clinical conditions displayed in Ivy’s medical history and her
current scenario as well. Last, of them, a social worker is often referred and included in the
multidisciplinary team which plays diverse roles. They provide moral support to the patient
and their family, assist in financial troubles in required and looks after the overall, general
needs of the patient. They are also sometimes hired as additional help that looks after the
patient at all times (Leach et al., 2017).
Conclusion
In conclusion, the best suitable option for Ivy’s treatment includes the patient-centered
approach. It focuses on the patient and their specific requirements. Involving the patient, Ivy
in developing her treatment plan ensures greater adherence to the plan and addresses the most
crucial and exact aspects that require attention. Adoption of the patient-centered plan for
patients like Ivy who also display multiple morbidities, can enhance the health outcomes of
the patient. It can also be summarized that the plan suggested must be designed and
implemented keeping all the factors and medical history of the patient in mind, especially the
age of the patient in this case. In addition, multidisciplinary teams are becoming an essential
element in delivering optimum care by providing a well-organized framework to accelerate
post-accident rehabilitation.

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