Family Centered Care : The Delivery Of Safe, Satisfying, High Quality Health Care

From a pediatric perspective, the family is an integral part of the healthcare team. Parents are the primary ally and resource in providing individualized care for their child. Even in adult patients, who they are is impacted by the relationships that they have. Serious or chronic illnesses and injuries affect the entire family. The family, then, becomes the patient, particularly when it is necessary to make lifestyle changes.

Nurses often use the aspect of time as an excuse not to conduct a family interview, however, Wright and Leahey (2009) clearly demonstrate how integrating families into patient care does not have to consume a lot of time. Using the Calgary Family Assessment Model (CFAM) and Calgary Family Intervention Model (CFIM), a family interview can be organized and conducted in a less amount of time, and end in a greater understanding of the patient and family. The CFAM contains three major categories including structural, developmental, and functional, which can be used to assess a family or help them address a specific health issue (Wright & Leahey, 2009). The CFIM uses assessments focusing on strengths, meaning that it uses the strengths of each individual family member, and the unit as a whole to provide positive interventions. This allows the interventions to focus on encouraging the family, rather than their deficits or dysfunctions (Wright and Leahey, 2009). During the 15-minute interview, it is suggested to have the entire family present so that the interviewer is able note reactions and collaborate with each family member, thus providing the most acceptable plan of care for the entire family.

Including the client as an expert member of the team creates an enhanced quality of care (Coad, Patel & Murray, 2014). In pediatrics, parents are often at the center of the child’s care. When asked to define what made the client care experience positive, parents stated that sensitivity, empathy and honesty were key factors (Coad, Patel & Murray, 2014). Working in healthcare, nurses can become desensitized to difficult experiences because they deal with them daily. Integrating the client and family as part of the healthcare team, allows the nurse to see the patient and family as a people first. By avoiding using illness as context, and instead using person as context, care will be more holistic (Coad, Patel & Murray, 2014). A family-focused approach helps to ensure that the whole family feels a part of the experience and is valued. In the case of bereavement, family centered care is particularly important. If the family is not included in the care from the start, it can provide barriers for grieving and impact how the family deals with loss (Jones, Contro & Koch, 2014). Nurses have an opportunity to help support the family through the grief process (Jones, Contro & Koch, 2014). Families have a significant impact on how the client heals, so by caring for the family’s needs, the nurse is indirectly caring for the patient. It is in the client’s best interest for the care to be holistic for the patient as well as the family (Jones, Contro & Koch, 2014). All

rganizing the delivery of health care around the needs of the patient may seem like a simple and obvious approach. In a system as complex as health care, however, little is simple. In fact, thirty years ago when the idea of “patient-centered care” first emerged as a return to the holistic roots of health care, it was swiftly dismissed by all but the most philosophically progressive providers as trivial, superficial, or unrealistic. Its defining characteristics of partnering with patients and families, of welcoming―even encouraging―their

According to Stanhope and Lancaster (2008) “Each family is an unexplained mystery, unique in the ways it meets the needs of its members and society” (p. 550). Family nursing is a special field that involves the nurse and family working together to achieve progress for the family and its members in adjusting to transitions and responding to health and illness. The Friedman Family Assessment Model serves as a guide in family nursing to identify the developmental stage of the family, environmental data, family structure, composition, and functions as well as how the family manages stress and their coping mechanisms. From this data, three nursing diagnoses with interventions are developed.

Human dignity includes personal qualities such as consideration, empathy, human kindness, respect and trust. It can be reflected in safeguarding the individual’s right of privacy, and treating others with respect, regardless of background. According to Yancey (1997) “It is respect for the inherent worth of and uniqueness of individuals and populations in professional practice, human dignity is reflected when the health care professional values and respects all clients and colleagues”.

All health care providers are familiar or have some idea of what family focused care entails. Family focused care can be practiced in any settings in healthcare, and nurses are familiar with this concept as this strong theory based teaching is emphasized throughout the nursing curriculum. With the trend of health care delivery shifting towards home based or community setting, it is now more than ever important for nurses and advance practice nurses (APN) to incorporate family nursing practice for improved outcomes for the patient and their families. This paper will discuss one of the many family nursing theory and its impact on the family nursing practice now and in the future.

Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.

Patient-centered care refers to the view that patients and their family members are partners in developing a care plan. This stems from the belief that the patient is in control and that the care provided is rooted in respect that addresses the patient’s personal needs and values (Barnsteiner & Sherwood, 2012). Creating a partnership with a patient that allows them to grasp the goals and methods of their plan of care and includes them in the decision-making process can prevent errors from occurring. This gives the patient the opportunity to correct any

The article goes on to address the importance of specifically designing practices related to family centered care in the pediatric setting. Four recommendations are set forth in this guideline: family visitation, family centered rounds, family presence during CPR and invasive procedures, and family conferences. Recurrent themes in these areas are listening to and respect the family. communication of information and answering questions, education, and collaboration in developing treatment. While most of the information in this article is focused on the parents and ill child, many of the suggestions are applicable and adaptable to siblings (Meert, Clark, & Eggly, 2013).

Family nursing is not all about patient centered care, it is focused on the needs of the family as a whole (Nursing theory). The main goal for family nursing is to improve any health concerns by assessing the needs,problems,influences, and strentghs of the family (Journal of nursing). There are four four types of approaches to family nursing. The four types of approaches to family nursing are, family as context, family as client, family as system, and family as component of society (the book). The purpose of this paper is to define, discuss, and give examples of the four types of approaches to family nursing.

-A succinct philosophy of family nursing is seen in The Association for the Care of Children’s Health standards stating the expectation for healthcare providers to facilitate family/professional collaboration at all levels of care, and to recognizing family as the constant in the patient’s life whereas the healthcare providers will fluctuate (p.40, 2003).

The purpose of this paper is to display how such assessment is essential not on an individual basis, but rather on a larger scale in relation to family nursing. Family nursing “centers on the family as a unit of care, addressing family needs in response to a member’s illness or threat to health, rather than focusing on the individual. An understanding of families’ needs at particular developmental stages, how they communicate and function, and an ability to undertake a family assessment is foundational knowledge for family nursing” (St John, 2009, p.6). Often, nurses encounter the families of their individual patients on a daily basis, yet family assessments are not performed. This is because nurses often feel there is little time to engage families effectively, and in fact lack of time, has been identified by nurses as the primary barrier to engaging families (Kaakinen, 2015, p.109). Evidence based practice however, has proven that “a 15 minute, or even shorter, family interview can be purposeful, effective, informative, and even healing” (Wright, 2013, p.264). This 15 minute interview has been adopted in many acute care settings in involves five key components; manners, therapeutic conversation, key questions, commendation, and the genogram. These ideas represent the theoretical underpinning and are a condensed version of the Calgary Family Assessment Model (Wright, 2013). This model is large, but can be customized and adapted to the function of each individual

Patient centered care is defined as “the practice of caring for patients (and their families) in ways that are meaningful and valuable to the individual patient, which includes listening to, informing and involving patients in their care” (Grenier and Knebel, 2003). Five challenges presented in patient centered care are patient obstacles, physician and practice obstacles, facility obstacles, community obstacles, and health literacy.

“Family-centered care” is a term heard often in healthcare settings and in nursing practice. Family-centered care has been recognized as being an integral part to patient health, satisfaction and health care quality (Kuo, et al, 2012). Family-centered care is implemented with the goal to increase partnerships between, families, patients and providers; and has been prioritized as a core-concept of quality healthcare (Gallo, Hill, Hoagwood & Olin, 2016) Many professionals, however, would be hard-pressed to state what the term “family-centered care” actually means and how it applies to nursing practice. They would be at a loss for how to implement family-centered care and what is absolutely necessary to have in order for family-centered care to be successful. Advanced practice nurses are faced with the challenge of adhering to family-centered care in their practice. Illness, both chronic and acute, and health does not just affect the patient involved in care. Illness and health affect the patient, their children, their spouses, their parents, their brothers, their sisters, their grandparents and anyone else involved in their life. Research by Davidson (2009) supports the idea that the perceived effectiveness of communication between healthcare providers and the patient’s family is related to the overall satisfaction of care. Advance