Family-Centered Care in Pediatrics

This assignment delves into the concept of family-centered care (FCC) within pediatric nursing. It examines the definition, benefits, and core principles of FCC, emphasizing its importance in providing holistic care to children and their families. The assignment also discusses various strategies for implementing FCC in practice, drawing upon relevant literature and research findings.

INTRODUCTION
Only two third of 0-1 had been to a maternal and health care services and around
32% of 2-3 years old and approximately around 12% of 4-5 years old in the past 12
months (Tsai, 2015). Australian institute of health and welfare estimates that around
14% child under the age of 15 years i.e. around approximately 606,000 children consult
health and care service centre (Velardo, 2017).
Patient and family centred care (P&FCC) is a non-profit organization which was
founded in the year 1992, who provide health care services and support to patients,
individuals and families. They aim at building quality improvement, policy formulation
and safety initiatives. They aim to provide education to health professional and facilitate
research for better and effective health care outcomes which leads to improved
experience of care for patient and family members (McCormack, 2016).
This study will highlight positive impact of P&FCC on the child and family with
reference to traditional models of paediatric care. This study also includes concepts of
P&FCC for enabling empowerment and analysing how these concepts helps in applying
to paediatric nursing care. This study further highlights, principles of P&FCC and the
impact and outcomes of hospitalization on child. This study also includes strategies
which help reduce negative effect of hospitalization on child and family with reference to
case study present in report.
MAIN BODY
1.) One positive impact of P&FCC on the child and family, with features of traditional
models of paediatric care.
Patient and family centred care (P&FCC) is an approach of planning, evaluating
and delivering health care services with partnership to individuals, children, patients,
adolescents and families. The approach is beneficial in improving quality of health care
services in order to achieve best possible outcomes. According to (Committe, 2012)
P&FCC aims at delivering health and care services on partnership with patients, families
and with all those corporations and committees who are involved in the care of the child
and family members.

FCC is based on core concepts of care which comprise dignity, respect in which
it is important for the care providers to focus on choice and perspective of patient and
families. The main principles of family centred care are that they aim at improvising
quality and experience of care by actively involving patients and families for effective
treatment and care. Another major principle of FCC is that they work with dignity and
respect and value the choice of patients and family members. FCC aim at incorporating
knowledge, skills, values, culture, beliefs while formulation of plan and delivering of
health care services to patients and family members. Health care practitioners aim at
sharing complete and unbiased information which leads to effective decision making
and customer satisfaction (Davidson, 2017). This information helps in taking best
decision for effective treatment of patients which leads to effective results and
outcomes. Effective communication and sharing of information help in improved
performance of health care practitioners.
Family centred care improves paediatric nursing care by treating family and care
with respect care. They communicate with patients and families for effective results and
outcomes. They share information clearly with patients which help FCC to involve
patients and family members for effective and efficient decision making.
One of the most positive impact of FCC is that they involve patient s and family
members in specific issue or operations. The participation and collaboration of patients
and family members with FCC results in quality treatment and improved outcomes. FCC
main function is to provide excellent quality care and safe services to patients and their
family members.
Traditional approach of care centred, patients and family members do not
actively participate in decision making and they are merely an observer. Managing
holistic needs of patients and family members act as interference in the nursing care.
Paediatric care providers who follow family cantered service principles treat each child
as an individual and support family values and strengths to promote positive patient
outcomes. These professionals also engage families in a way that supports emotional
development and reassures family members that they are an important component in
their child’s treatment. In accordance with Baird, 2015) traditional model of paediatric

care that is family centred care there are policies and procedures that guide the actions,
responses and behaviour of a traditional nurse. To be more specific, aside from medical
treatment, comfort, advice, and kindness there is little else that a traditional nurse can
do to treat their patients. In this type of care, the family members of patients are not
being involved. In this type of care the methods used by nurses are limited. The nurses
in the traditional model of paediatric care are less trained in comparison to P&FCC
(Patient- and Family- Centered Care Defined, 2019).
On the other hand, (Pettoello-Mantovani, 2009) says that P&FCC consider child,
family and patients and work in partnership them to implement effective policies which
results high quality services and improved outcomes. The positive impact of P&FCC is
to improve health outcomes by implementing improved quality health and services
which leads to improved experience of care and patient satisfaction by wise allocation of
resources. The main strength of P&FCC is to treat patients with dignity and respect by
clearly sharing information which leads to effective and efficient decision making (Clay &
Parsh, 2016). P&FCC aims at improving hospitalisation together with patients and
family members by implementing effective techniques and surveys for best outcomes
and results. They provide high quality staff with effective training and research which
leads to higher outcomes and results. P&FCC have strengthened diversity in research
and development with improved technology and leads to effective seminars and
consultation. The family members can act as the service user’s advisors, committee
and task force for enhancing the best possible treatment outcome. Family centred care
encourages patients to be involve in the treatment process wilfully. Traditionally, health
care services used to exclusively focus on health professionals and how they assign
nurses to provide services to patients.
2.) Effective concepts of P&FCC are enabling and empowerment and how they can be
effectively applied to paediatric nursing care.
Enabling: Enabling means giving knowledge and skills to people who can
participate in decision making for effective results and outcomes. Enabling gives
someone authority to perform a particular task or action in an effective manner to
achieve desired results (Dunst, 1988).

Empowerment: Empowerment is the process of influencing other people to
participate in decision making for effective results and outcomes. It is the process of
sharing information by giving effective skills and training for improved service and
performance which leads to high quality outcomes (Dunst, 1988).
P&FCC is an approach of planning and delivering of effective health care
services to health care professionals, families and patients. It aims at redefining the
relationship by emphasising on collaboration with individuals of all age groups.
Two concepts of P&FCC are as follows:
 Recognize familial importance: The main concept of P&FCC is that they
enabling participation of patients and family in effective decision making which
leads to effective outcomes and results. A supportive environment enables family
members to improve quality and comply with safety committees. This concept is
being applied to paediatric nursing care as by keeping family members present
during treatment, paediatricians decrease stakeholder apprehension and create a
supportive setting for family members, while encouraging patient interaction and
promoting a healing environment.
 Empowering family members to support treatment- Professional perceptions
and attitudes can delineate the effectiveness of family cantered care. To deploy
the philosophy successfully, paediatric nurses relinquish some in order to
collaborate with family members. This concept is applied to paediatric care
nursing by guide and empower family members in caring, protecting, and making
decisions for paediatric patients. P&FCC empowers knowledge, skills, values,
culture, beliefs while formulation of plan and delivering of health care services to
patients and family members. Health care practitioners aim at sharing complete
and unbiased information which leads to better health conditions of patients. This
information helps in taking best decision for effective treatment of patients which
leads to effective results and outcomes. In this type of care focus is on the whole
person and not the just the medical condition (Byczkowski, 2016).

3.) Application of principles to nursing care of child.
According to the first case study, Thomas a 3-year-old child has been diagnosed
with acute asthma and it has been analysed that Thomas has reduced oral intake,
reduced wet nappies, tachypnoea, cough and wheeze. He has been suffering from
breathing problem and requires around 1 litre of oxygen due to oxygen saturation of
88%. He is extremely irritated and keeps pulling off the oxygen tubing mask. When
nurses administer Salbutamol, his mother leaves the room which makes Thomas more
distressed.
In accordance with this, the paediatric nurses of health and nursing care must
adopt participation principle of P&FCC where family members and patients are actively
involved to participate in care and decision making of the patients within the specific
development stage of child. Participation of family members helps nurses of paediatric
nursing care in developing effective plan and policy framework for effective results and
outcomes. Poor participation of family members leads to distressful patients (Harnagea,
2018). Effective participation of members helps paediatric nursing care in evaluating,
delivering and planning the quality treatment strategy for improved results and
outcomes (The Concept of Hospitalization of Children from the View Point of Parents
and Children, 2011).
In accordance with the following case, paediatric nurses must adopt nursing
intervention in compliance with participation principle of P&FCC to identify the cause of
breathing problem and quality treatment and results of patients (Family-oriented and
family-centered care in paediatrics, 2012). Paediatric nurses must use demonstration
nursing intervention technique to encourage sustainable deep breaths to highlight slow
inhalation and passive exhalation. They must also use incentive spirometer and asking
patient to yawn which helps in promoting deep inspiration which leads to increase in
oxygenation and prevention of atelectasis (Seyedfarajollah, 2018). Paediatric nurses
much adapt to various controlled breathing method which leads to slow respiration in
Thomas who is suffering from tachypnoea. Prolonged expiration helps in prevention of
air trapping which leads to effective breathing of child (Wayne and BSN, 2019).
Paediatric nurses also aim at providing oxygen and respiratory medication as per health
care practitioners and doctors which helps in improved medication and relax airway

muscles for smooth and open-air passages. Implementation and encouragement on
using diaphragmatic breathing which helps in relax muscles and leads to improved
oxygen level of Thomas (Barry, 2012).
In contrary, with another case study, where 16-year-old Alex is suffering from
abdominal pain, fever, vomiting and nausea because of perforated appendix removal.
Alex denies having any pain despite having several bad tries on PCA. Family members
of the patient were eating take away food which he still can't consume. Alex is also
having trouble with NGT and requesting doctors to remove that.
According to the following case study, the paediatric nurses of health and nursing
care must adopt collaborative principle of P&FCC where patients, families, leaders,
nurses and health care practitioners collaborate together for policy formulation,
implementation, evaluation for effective outcomes and results (Barry, 2012). Through
shared decision making, paediatric nurses should directly communicate with family
members to clearly and openly to not consume take away food in front of patients which
helps in effective results and outcomes. They should maintain privacy and helps in
building trust and support for quality improvement and recovery.
Paediatric nurses must adopt nursing intervention to reduce abdominal pain and
effective recovery. Nurses and health care practitioners must give Antibiotic therapy to
prevent infection and also focus on high flower's positioning to reduce stress on
abdominal organs and incision and helps in reducing pain (Mariaanne Belleza, 2017).
Nurses should take into consideration that patients must consume oral fluids and
communicate with family members that no outside food should be consumed in front of
patients.
4.) Impact of hospitalization for child and evaluation of strategies to reduce negative
effects of hospitalization for child and family.
Hospitalization helps in providing safe and healthy environment for child with the
most contemporary care and support which helps Thomas in effective recovery which
leads to quality results and outcomes. It also benefits patients in providing personal care
to reduce degree of illness and helps in improved oxygenation (Kuo, 2012).
Hospitalization also negatively affect the psychological state of patients and family

members and leads to continuous stress. Parental reaction of the patient also makes
Thomas distressful which leads to lower parent child relationship during hospitalization.
Strategies to reduce negative effect of hospitalization for child and family.
 Paediatric nurses much encourage parent's participation for effective treatment
and outcomes for Thomas and helps in reduced stress of child and helps build
strong psychological mind to cope up with illness.
 Paediatric nurses should provide patient centred care to children and make a
safe and healthy environment for effective results (Smith, 2015).
 Nurse will incorporate use of cognitive therapy for combined views and
examination of patients to function more effectively and efficiently.
Implementation of therapeutic touch will helps bring in caring attitude for child
and parents.
CONCLUSION
From the above study it has been summarized that, P&FCC is an approach of
planning, evaluating and delivering health care services with partnership to individuals,
children, patients, adolescents and families. The core principles of P&FCC are respect
and dignity, information sharing, participation and collaboration. One of the most
positive impact of P&FCC is that it involves participation of patients and family members
for effective results and outcomes. Furthermore, it also analyses impact of
hospitalization for child and effective strategies to reduce such negative effects of
hospitalization for both child and family.

REFERENCES
Books and Journals
References
Baird, J. (2015). What impact do hospital and unit-based rules have upon patient and
family centred care in the pediatric intensive care unit? Journals of Pediatric
nursing, 30 (1). 133-142.
Barry, M. J. (2012). Shared decesion making- the pinnacle of patient-centred care. .
New England Journal of Medicine, 366 (9). 780-781.
Byczkowski, T. (2016). Family- Centred pediatric emergency care: It's Not just for
Pediatrics anymore. AMA journals of ethics, 18 (1) 40-44.
Clay, A. &. (2016). Patient and family centred care: It's not just for pediatrics anymore.
AMA journals of ethics, 18 (1) 40-44.
Committe, O. I. C. (2012). Patient- and family centred care and the pediatrician's role.
Pediatrics. 129 (2). 394.
Davidson, J. E. (2017). Guidelines for family-centered care in the neonatal, pediatric,
and adult ICU. Critical care medicine. 45(1). 103-128.
Kuo, D. Z. (2012). Family-centered care: current applications and future directions in
pediatric health care. Maternal and child health journal. 16(2). 297-305.
Pettoello-Mantovani, M. (2009). Family-oriented and family-centered care in
pediatrics. Italian journal of pediatrics, 35(1). 12.
Smith, J. S. (2015). Involving parents in managing their child's long- term condition- A
concept systhesis of family- centred care and partnership-in -care. . Journal of
Pediatric nursing, 30 (1) . 143-159.
McCormack, B. &. (2016). Person- Centered Care practice in nursing and helath care:
theory and practice. . John Wiley.
Tsai, S. (2015). CE: Original Research the Efficacy of a Nurse-Led Breathing Training
Program in Reducing Depressive Symtoms in Patients on Hemodialysis A
Randomized Controlled Trial. . AJN The American Journal of Nursing, 115 (4).
24-32.

Velardo, S. &. (2017). Empasizing the child in child helath literacy research. . Journals
of chiold helath care, 21 (1) 5-13.
Dunst, C. J. (1988). Enabling and empowering families of children with health
impairments. Children's Health Care, 17(2). 71-81.
Harnagea, H., (2018). From theoretical concepts to policies and applied programmes:
the landscape of integration of oral health in primary care. BMC oral
health, 18(1). 23.
Seyedfarajollah, S., (2018). The Framework of NICU-discharge Plan System for
Preterm Infants in Iran: Duties, Components and Capabilities. Acta Informatica
Medica, 26(1). 46.
Online
Family-oriented and family-centered care in paediatrics. (2012). [ONLINE]. Avaialble
through:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691736/.
Patient- and Family- Centered Care Defined. (2019). [ONLINE]. Available
through:http://www.ipfcc.org/bestpractices/sustainable-partnerships/
background/pfcc-defined.html.
The Concept of Hospitalization of Children from the View Point of Parents and Children .
2011. [ONLINE]. Available
through:<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446164/>
Patient and Family Centred Care. 2019. [ONLINE]. Available
through:<https://www.rch.org.au/policy/public/Patient_and_Family_Centred_Care
/>
Wayne, Gil., and BSN, R.N. 2019. Ineffective Breathing Pattern. [Online]. Available
through: <https://nurseslabs.com/ineffective-breathing-pattern/>
Mariaanne Belleza, R.N. 2017. Appendicitis. [Online]. Available through:<
https://nurseslabs.com/appendicitis/ >.