Person centered care is a holistic approach to nursing that maximizes on the patients’ needs and preferences to achieve quality and effective care. It is governed by eight basic principles that include respect to individual, coordination and integration, information and education, physical support and access to care.
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Person cantered care Introduction Person centered care is the form of nursing care approach where nurses focus on holistic approach to the patient rather than focusing on diagnosis and the symptoms being experienced by the patient. It also seeks to ensure that the patient needs and choices are regarded and respected. Draper and Tetley in 2013 defined person centered care as a nursing approach that focus on the personal needs, wants, desires and goals of the patient (Buetow 2016). In other words, this should form the basis for care to the patient. This also implies that the healthcare professionals should overlook their priorities at the expense of the patient’s choices. Discussion Person centered care is governed by different principles. Respect for patients is the first principle of person centered care. Respect is defined as a feeling towards an individual elicited by their situation or abilities. In person centered care, the individual in question is the patient. In the nursing profession, there are certain ethics or principles that nurses ought to stick to. One of the ethical principle is autonomy (Coulourides Kogan, Wilber, & Mosqueda 2015). This implies that in patient centered care, the self-rules applies. The autonomy of the patients should be respected at all costs. The nurse is therefore supposed to respect any decision made by the patient regarding their own lives. If for example the patient feels that a certain nursing intervention is not conducive for him, then the nurse has the obligation to terminate it. The principle of respect in person centered care is more or less the same as respect for human dignity whereby nurses have no moral capacity to interfere with decisions made by patients be it adults or children (Dewi, Evans, Bradley, & Ullrich 2013). The nurse should therefore be keen to identify the
needs or desires of the patient receiving person centered care and stick to his/her personal wishes. By so doing, the nurse will be utilizing the principle of respect. Coordination and integration of care is another principle of person centered care. In person centered care, coordination and integration of care is defined as the deliberate efforts to organize patient care activities and sharing information among all individuals involved in patient care so as to attain safe and effective care (Fagerström 2017). What this principle means is that patient needs should be known in advance and communicated to the right people such as family members and healthcare providers. It is this information that forms the basis of providing safe and effective care .An example of the principle of coordination and integration in action is where nurses interrogates the patients on what should be done. The nurse can also coordinate with a family member who might be the mother, brother or father to the patient in providing care. The objective of this principle is to attain patient needs in providing high quality and high value care. Recent studies indicate two ways in which coordinated care can be achieved as either through using specific care coordination activities or using diverse approaches that can bolster health care delivery. Examples of care coordination initiatives proposed in the studies include assessing patients’ needs and goals and linking to community resources. Broad care coordination activities on the other hand include care management and teamwork. The principle of coordination and integration in person centered care ensures that the patient’s preferences are met in delivering high and quality care and nurses should therefore ensure that they incorporate this principle throughout. Patient education and information as a principle of person centered care is very important. While providing care to the patients, studies recommend that it is the duty of the nurse to educate and provide necessary information to the patient (Hewitt-Taylor 2015). The patient has the right to
information such as why a certain protocol or nursing intervention is being conducted on him or her. This according to studies, reduce anxiety among the patients and enables the patient to also participate in care. Patient education is known to be the best tool that assist patients make informed decisions. It is therefore necessary that nurses provide knowledge to the patient about their care and potential treatment options so that they can identify how they wish to or not to receive their healthcare. Physical comfort is an important principle of person centered care. According to a recent survey, physical experiences by patients has an impact on their well-being. Some of the most important areas under physical experiences of the patient include pain management. If a pain is not managed in a good way, it is likely to negatively affect the well-being of the patient. During patient centered care, the nurse has the obligation to manage pain in a more professional manner. If a patient experiences much pain, it is unlikely that he/she will be willing to be part of care. Other important factors in the physical environment are assisting the patient with daily activities and making the environment comfortable (McShane & Mitchell 2015). The aim of this principle is to ensure that the patient and the family members are as comfortable as possible and this will motivate their participation in health care. Eventually, the patient will receive safe and quality healthcare. Involvement of the family and friends in care. This principle basically outlines the position or the role of close family members and friends in person cantered care. During care, it is recommended that accommodation facilities should be provided to the family members and the friends. The healthcare providers should also ensure that they involve the family as well as close family members in the decision making process. Studies recommend that nurses should consult
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widely before they initiate care. The nurses should also recognize the needs of the family members. Continuity to transition and access to care are other principles of person cantered care. In access to care, studies recommend that patients should access healthcare whenever they are in need. The nurse or rather the hospital administration should ensure that they organize for transportation of the patient incase he/she can’t move like for the case of the foot injury in the case study (Riddett 2017). The nurses should also be available in case of appointments. The principle of continuity and transition on the other hand focus on care after discharge. The nurses should therefore provide a detailed discharge plan in person centred care. How nurses can partner with consumers to improve safety and quality of their care. In order to improve the safety and quality of their care, studies propose partnership between nurses and consumers. Consumers in this case are the patients. Studies recommend nurse-patient partnership as it has been associated with the best patient outcomes (Sharma, Bamford, & Dodman 2015). In the same studies, it is recommended that the partnerships can be attained through nurse providing information, educating patients and finally encouraging them. The other way to achieve partnership is through creating a trusting and professional relationship. This is mostly evidenced by the observable nursing work (Wolf et al 2017). Effective partnerships can also be obtained through patient education. Nurses-consumer partnerships have shown to be very effective in improving both the safety and quality of care. Nurses should therefore strive to ensure that they create and sustain such partnerships. Another way through which nurses can partner with consumer is through using the teach back method when formulating a discharge plan. A discharge plan is basically a protocol or
instructions what the patient will be supposed to do once outside the hospital. This includes issues such as monitoring of vital signs. The nurse is therefore supposed to partner with the patient by asking him/her some of his/her weakness and inquiring about the environment of the patient. This will be in return used by the nurse to formulate an inclusive discharge plan. Teach back method is the best as proposed by several studies. It involves educating the patient then asking them to repeat whatever was taught. This can be also be used as a method of evaluating whatever was educated. It is the role of any nurse to create partnerships with their consumers so as to improve their well-being. Conclusion Person centered care is a holistic approach to nursing that maximizes on the patients’ needs and preferences to achieve quality and effective care. It is governed by eight basic principles that include respect to individual, coordination and integration, information and education, physical support and access to care. Since studies link nurse-patient partnership to quality and effective care, both the nurse and patient should work hand in hand to create and sustain the partnership.
References Buetow,S.2016. Person-centred Health Care. doi:10.4324/9781315744247 Coulourides Kogan,A., Wilber,K., & Mosqueda,L.2015. Moving Toward Implementation of Person-Centered Care for Older Adults in Community-Based Medical and Social Service Settings: “You Only Get Things Done When Working in Concert with Clients”.Journal of the American Geriatrics Society,64(1), e8-e14. doi:10.1111/jgs.13876 Dewi,W.N., Evans,D., Bradley,H., & Ullrich,S.2013. Person-centred care in the Indonesian health-care system.International Journal of Nursing Practice,20(6), 616-622. doi:10.1111/ijn.12213 Fagerström,L. 2017. Staffing Structures for Effectiveness in Person-Centred Care.Person- Centred Healthcare Research, 119-130. doi:10.1002/9781119099635.ch9 Hewitt-Taylor,J. 2015. Introducing Person-centred Care and Practice Development.Developing Person-centred Practice, 1-9. doi:10.1007/978-1-137-39979-3_1 McShane,M., & Mitchell,E. 2015. Person centred coordinated care: where does the QOF point us?BMJ,350(jun11 2), h2540-h2540. doi:10.1136/bmj.h2540 Riddett,J. 2017. Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition)McCormack Brendan and McCance Tanya (Eds) Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) 288pp £29.99 Wiley Blackwell 9781118990568 1118990560.Mental Health Practice,20(6), 13-13. doi:10.7748/mhp.20.6.13.s14
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Sharma,T., Bamford,M., & Dodman,D.2015. Person-centred care: an overview of reviews. Contemporary Nurse,51(2-3), 107-120. doi:10.1080/10376178.2016.1150192 Wolf,A., Moore,L., Lydahl,D., Naldemirci,Ă–., Elam,M., & Britten,N. 2017. The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. BMJ Open,7(7), e016491. doi:10.1136/bmjopen-2017-016491