Family-Centered Care Flashcards
Family-centered Care
partnership develops between families and health care professionals
Family-centered Care is focused on the needs of
all family members, not just the child’s needs
Benefits of Family-centered Care
Providing care to the patient while also supporting the psychosocial needs of the family.
Providing family-centered care requires creativity, flexibility, and a willingness to partner with patients and their families.
When parents stay with their children in the hospitals, the children are
quieter
happier
recover sooner
decreased anxiety during procedures
need less pain meds after surgery
cope better
Elements of family-centered care
Family is the center
Collaboration
Sharing information
respect for cultural diversity
Broad array of supports
flexible systems of support
appreciating families
When assessing the child what is the most important thing to remember when the parent tells you something?
they know their child better than anyone
they are the experts
Families have important knowledge about their children’s
health condition
responds to various actions/events
Family Systems Theory
illness or injury affects all members of the family system (including siblings)
Siblings involved in family-centered care may feel
May feel left out as parents spend time at the hospital
May worry that they will also get sick
May feel they are to blame for their sibling’s illness
May believe their bad behavior is causing their parents obvious distress
May feel and show resentment toward their parents at the perceived loss of attention
May exhibit ailments, such as minor illnesses, eating less, and/or difficulty sleeping
This is an example of what
“Providing comfortable places for the family to stay at the hospital (promote sibling visitation)”
Family-centered care
This is an example of what
“Providing a place to stay away from the hospital for families who spend long hours at the hospital or travel long distances.”
Family-centered care
What is a place to stay for families when the child patient is in the hospital in Lubbock?
Ronald McDonald House
Participation is achieved by
actively encouraging patients and families to participate in providing care and making decisions.
- encouraging parents to participate in care provision
- encourage them to be with their child during procedures and treatments
Is providing care the same as participation in a question?
no
Collaboration
seeking a “partnership” role
Collaboration is characterized by what features?
Effective communication
active listening
negotiation
Effective communication
Establishes rapport
Respectful
Avoids medical jargon/terminology
Asks open-ended questions
Summarizes/reflects
Demonstrates empathy
Non-judgmental attitude
What does this quote reference?
“Knowledge has never been known to enter the head through an open mouth”
active listening
What implies discussion is being conducted?
negotiation
When communicating, remember to
understand the family and patient perspective and take their questions seriously
“How does your child look today?”
Include parents in the decision-making process by
Multidisciplinary Meetings and Care Conferences
Bedside reports
interdisciplinary rounds
Collaboration examples
understand perspective
include in the decision-making process
eval care involved in their care
family advisory councils
When sharing information with the family including siblings with developmental appropriate level the data should be?
complete
honest
unbiased
Empowerment allows the family to have a
interaction of professionals with families in a way that the family maintains or acquires a sense of control over their family lives
Acknowledge positive changes from
fostering their strength, abilities, and actions
When sharing information with the family it helps them feel?
empowerment
The RN can share information about
diagnosis (only reinforce)
equipment
lab results if it is not diagnostic example if not knowledgeable
Medications (terminology simple teachings)
routines (e.g., mealtimes & activities)
Rooms involved for fun
The parent can let you know when sharing information back to you about the child’s response to:
pain
medication experiences
illnesses
Respect cultural diversity by
understanding cultural and religious beliefs - respect and sensitivity
racial, ethnic, cultural, socioeconomic, and previous backgrounds
coping differences
explain terminology and religious practices learning
Texas Nurses Association, Rule 217.11 to provide care without discrimination is an example of what element of family care
Respect for cultural diversity
Providing translators/interpreters with written info in their primary language is an example of
cultural diversity
Broad Array of Supports have the family needs
support system and appropriate resources
Mentor/navigators for chronic conditions
-asthma and DM
examples of
Broad Array of Supports
Navigators
help guide care outside of the hospital by maintaining the resources and needs of the patient
support groups for parents and children
Anger Management Groups
Parent Support Groups
Sibling Support Groups
Asthma Camps, Diabetic Camps, and other diagnosis-based camps (may have scholarships available)
Camp Boggy Creek
Flexible systems of care
choice - maintain routines established by the family (when taking meds or bath)
need for respite for parents and siblings
- clients open past 5 and on Saturday
- Satellite clinics
Appreciating Families by facilitating
normalization
- schoolwork, hobbies, recreation, independence
- never assume who the parents are
avoid terms such as Mom, Sweetie, or Honey
Include siblings
sensitive to terminology
Stressors for families
Loss of the caregiver role
Uncertain about how to best help their child
Adjusting to an unfamiliar environment
Financial stress
Fear for the child’s survival and/or lasting impairment
Lack of understanding of information provided by the health care team or inconsistent information
General family is defined as
“Whatever the client considers it to be”
Family System Theory
continually interacts with its members and the environment
Emphasis is on interaction between members
problems within type of interactions used by the family
Family System Theory emphasized
interaction between members
Family Systems Theory makes who the patient
family
high level of adaptability
The major influences on adaptability
imaginary lines that exist between the family and the environment, or the boundaries
Family Stress Theory
encounter stressors, both predictable and unpredictable
- overwhelm their ability to cope lead to crisis
adaptation requires a change in the family structure
ABC-X Model of Family Stress and Coping
A = The stressor event
B = The resources available to a family
C = The family’s perceptions of the stressor
X = The likelihood of crisis (dependent on B and C)
Nuclear Family
Traditional:
Consists of a married couple and their biologic children
Blended or Reconstituted
Includes at least one stepparent, stepsibling, or half sibling
A stepparent is the spouse of a child’s biologic parent but is not the child’s biologic parent
The biologic parent of one child is the stepparent of the other
Extended Family or Household
Includes at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling
For example, grandparents living with a child who is a young parent and their grandchild.
Single-Parent
A women or man and their child/children – biologic or adopted.
Lesbian and Gay
One in which there is a legal or common-law tie between two persons of the same sex who have children.
Children may be:
biologic from a former relationship
foster or adopted
conceived through artificial fertilization or through the use of a surrogate mother
Polygamous
Refers to multiple wives (polygyny) or rarely, multiple husbands (polyandry)
Communal
Share common ownership of property
They provide security for children & share homemaking & childrearing functions
Authoritarian parenting
Control child’s behavior and attitudes through unquestioned rules and expectations
They expect the child to follow the rules rigidly and unquestioningly
“Do it because I said so”
Authoritarian is known by
N = Not ideal
Cons of Authoritarian
This can result in rigidly conforming behavior in the children who tend to be sensitive, shy, self-conscious, and submissive
Pros of Authoritarian
more likely to be courteous, loyal, honest, and dependable
Authoritarian style to work then
it takes very close supervision and affection.
Authoritarian does not work and can ultimately lead to
defiant and antisocial behavior
Permissive parenting
Parents exert little or no control over their children’s actions
Allow children to regulate their own activity as much as possible
Parents aren’t ‘role models’, but rather a resource
Very few rules, almost no punishment
Mean girls
Authoritative parenting
Combine practices of both authoritarian and permissive
Direct children’s behavior and attitude by explaining the reason for the rules and negatively reinforcing deviation
Firm but fair and consistent
Which parenting style is this?
“Control is focused on the issue, not on withdrawal of love or fear of punishment”
Authoritative
-behavior is bad not the person
Pros of Authoritative
Kids feel encouragement, understanding, and security from parents**
Which is considered the best parenting style
Authoritative
A nurse is assisting a group of parents of adolescents to develop skills that will improve communication within the family. The nurse hears one parent state, “My son knows he better do what I say.” Which of the following parenting styles is the parent exhibiting?
A. Authoritarian
B. Permissive
C. Authoritative
D. Passive
A. Authoritarian
A nurse is preparing to assess a preschool-age child. Which of the following is an appropriate action by the nurse to prepare the child?
A. Demonstrate the assessment process using a transition object
B. Use medical terminology to describe what will happen.
C. Separate the child from the parent during the examination
D. Keep medical equipment visible to the child
A. Demonstrate the assessment process using a transition object
A nurse is preparing a toddler for an intravenous catheter insertion using atraumatic care. Which of the following actions should the nurse take? Select all that apply.
A. Explain the procedure using the child’s favorite toy
B. Ask the parents to leave during the procedure
C. Perform the procedures with the child in the bed
D. Allow the child to make choices during the procedure
E. Apply lidocaine and prilocaine cream to three potential insertion sites
A. Explain the procedure using the child’s favorite toy
D. Allow the child to make choices during the procedure
E. Apply lidocaine and prilocaine cream to three potential insertion sites
The nurse makes sure that a toddler has a teddy bear and that a night-light is on in the hospital room at bedtime. What concept would these nursing actions demonstrate?
A. Nonmaleficence
B. Justice
C. Atraumatic Care
D. Advocacy
C. Atraumatic Care
A well-educated successful woman who gave birth to twins finds the care they demand overwhelming to her and her husband and calls the pediatrician’s office. Which response by the office nurse to the mother would be most appropriate?
A. “No amount of preparation can fully prepare prospective parents for an infant’s constant and immediate needs, let alone twins. How can I help you?”
B. “Everyone feels like that. You just need to accept that it’s going to be difficult for a while and get as much help as you can. Understand?”
C. “You should be enjoying the miracle of having twins and that they are fine and healthy. You had a great delivery. What more could you want?”
D. “Get out of the house whenever you can and put the twins out of your mind for a short period of time, or take a nice long walk to relieve the stress you’re feeling.”
D. “Get out of the house whenever you can and put the twins out of your mind for a short period of time, or take a nice long walk to relieve the stress you’re feeling.”
The newest nurse on the pediatric unit is concerned about promoting family-centered care for the patient she cares for. She is working on an inpatient cancer unit and caring for a 7-year-old with leukemia. Which of the following are important actions for the nurse to consider that will promote family-centered care for the child and family on her unit? Select all that apply.
A. Striving to empower the family
B. Purchase toys and clothes for the child
C. Explore the family’s strengths that will support the child
D. Call the child frequently after discharge to offer support
E. Assess the families concerns and anxiety
F. Restrict visitor access to the child
G. Have a calming influence
A. Striving to empower the family
C. Explore the family’s strengths that will support the child
E. Assess the families concerns and anxiety
G. Have a calming influence
The Pediatric Nurse is admitting a child to the unit with a new diagnosis of asthma. What information from the family would be pertinent to the child’s care? Select all that apply.
A. “What experiences have they had with healthcare?”
B. “What medications have they taken in the past and what was their response?”
C. “How do they act when they are in pain?”
D. “What illnesses have they had in the past?”
E. “Have they had any injuries in the past?”
A. “What experiences have they had with healthcare?”
B. “What medications have they taken in the past and what was their response?”
C. “How do they act when they are in pain?”
D. “What illnesses have they had in the past?”
E. “Have they had any injuries in the past?”
The Pediatric Nurse understands that collaboration with family members is an important element of family-centered care. This concept is characterized by what features? Select all that apply.
A. Communicating with them about aspects of care
B. Listening to the family to assure they have a clear understanding
C. Negotiating care and how and when certain interventions are done
D. Reassuring them that they are receiving excellent care
A. Communicating with them about aspects of care
B. Listening to the family to assure they have a clear understanding
C. Negotiating care and how and when certain interventions are done
In providing a culture of diversity and inclusion, the pediatric nurse understands that that care should be equal to all children and their families. This would include which aspects? Select all that apply.
A. Diagnosis
B. Socioeconomic status
C. Gender Identity
D. Race
E. Religion
F. Sexual Orientation
A. Diagnosis
B. Socioeconomic status
C. Gender Identity
D. Race
E. Religion
F. Sexual Orientation
Family Systems Theory is based on which primary elements?
A. The emphasis is on the interaction between family members and the boundaries between them and the environment
B. It focuses on stressors and realizes that multiple stressors can overwhelm their ability to cope and lead to crisis
C. It addresses family change over time and the oldest child marks the stage transition
D. It focuses on family expectations of their children and on effective discipline
A. The emphasis is on the interaction between family members and the boundaries between them and the environment
- Eight-year-old Caitlyn Jones has been admitted to the ICU with sepsis. Caitlyn’s father, Michael, catches you in the hall. He’s frustrated that he doesn’t know today’s plan of care and doesn’t understand why her medications have been changed. Which core principle of family-centered care is most appropriate to Implement at this time?
A. Collaboration
B. Dignity and Respect
C. Information Sharing
D. Participation
C. Information Sharing
- Caitlyn’s mother, Janice appears to be feeling a loss of control. Those feelings are often evidenced by asking numerous questions and/or repetitively asking the same question and focusing on the technical aspects of care. She frequently asks about lab values and administration of medications. She rarely leaves her daughter’s bedside and insists that only certain nurses care for her. Which of the following will help the staff caring for Caitlyn build a partnership with Janice? Select all that apply.
A. Engage Janice in participating in care provision.
B. Identify, praise and build on Janice’s strengths.
C. Invite her to participate in the bedside shift report and interdisciplinary rounds.
D. Provide a phone number so that she can stay in touch when away from Caitlyn’s bedside.
E. Provide opportunities for Janice to express feelings and concerns without being judged.
A. Engage Janice in participating in care provision.
B. Identify, praise and build on Janice’s strengths.
C. Invite her to participate in the bedside shift report and interdisciplinary rounds.
D. Provide a phone number so that she can stay in touch when away from Caitlyn’s bedside.
E. Provide opportunities for Janice to express feelings and concerns without being judged.
- Describe the plan of care for the day, including the purpose of any procedures.
A. Collaboration
B. Dignity and Respect
C. Information Sharing
D. Participation
C. Information Sharing
- Encourage parents to be part of their child’s bedside shift report.
A. Collaboration
B. Dignity and Respect
C. Information Sharing
D. Participation
D. Participation
- Invite parents to provide feedback on their satisfaction with their child’s care.
A. Collaboration
B. Dignity and Respect
C. Information Sharing
D. Participation
A. Collaboration
- Work with the family to find ways for them to celebrate a cultural festival with their child.
A. Collaboration
B. Dignity and Respect
C. Information Sharing
D. Participation
B. Dignity and Respect
- Before and invasive procedure, the health care team discusses with caregivers what pain their child may experience afterwards and together they develop a plan of care to address this pain. After the procedure, the health care team regularly askes for the caregivers’ opinion on their child’s pain and if they think it is being appropriately managed. This is an example of what core principle of family-centered care?
A. Dignity and respect
B. Information sharing
C. Participation
D. Collaboration
D. Collaboration
