Patient-Centered Care Flashcards
Patient-Centered Care (QSEN)
the nurse recognizing the client as the source of control and a full partner in providing compassionate and coordinated care based on respect for client’s preferences, values, and needs
The nurse understands that the client defines, chooses, and controls the care of him/herself- the nurse implements the plan of care based on the client’s wishes for his/her own care, regardless if the client’s plan is the same or different than the nurse’s plan
Attributes
Non-Judgmental Empathetic Cultural Competence Respect for Diversity Empowerment of Patient Integrity/Self-Aware Adaptive Advocate Present Optimal Healing Environment
Nurse Judgmental Examples
Nurse cannot be judgmental if the client is a drug dealer, prostitute, drug user, alcoholic, homeless, unwed with multiple children with multiple fathers; convicted of a crime, involved in an accident while driving drunk, requests minimum care or refuses treatment, requests maximum care when elderly or disabled, a specific religion, or needing treatment that relates to the life choice [needing narcotics for a drug user or alcoholic with pancreatitis]
Cultural Competence
Nurse is KNOWLEDGEABLE about client’s culture and develops plan that incorporates cultural considerations
Respect for Diversity
Incorporates components specific to the client’s culture and does not violate cultural considerations the client follows
Empowerment of the Patient
Empowers client to self-manage their ailments, teamwork and collaboration with client implemented, nurse-client team is utilized from illness to wellness
Integrity/Self-Awareness
Integrity and professionalism while developing plan of care and caring for client
Adaptive
The nurse understands that the plan is fluid and continually changes as the client gets better
“prioritizing individualized care”
Advocate
The nurse protects the client’s human and legal rights and provides assistance in asserting these rights if the need arises; acts on behalf of the client
Present
The nurse is at the client’s bedside providing professional care as needed
Optimal Healing Environment
nurse ensures all of the client’s needs are met and no harm is done; a safe environment
Empathetic
The nurse is caring and understands the client has a need for professional care
Antecedents
NURSE:
Respect for diversity/disparities/self-expression
Advocate for pt/family desires, wishes, needs
Cultural Competence
Empowerment coach
Coordinator of Care
PT/FAMILY:
Desire/exhibit behaviors for self-management
Engage in partnership
Active partner in cultural competence
Negative Consequences
Never events (wrong site surgery, suicide, delay in Tx, med errors, pt falls) Near Miss (errors noted prior to client injury: wrong med removed, nurse catches during med check; documentation error before saving in chart) Sentinel Events (loss of limb, wrong med resulting in death, rape) Discomfort [breach of patient centered care (pumping cuff too high, not turning pt, not medicating pt because they put themselves there (alcoholic, drug abuser), implying that pt doesn't deserve care due to beliefs, culture, etc)
Advocacy
The nurse advocates by keeping the client informed; empowering the client to become involved in his/her care; making sure all members of the healthcare team are informed of the client’s desires/wishes/needs so that appropriate care is given; providing resources so that the client has information or a means to obtain healthcare information or necessities; and by supporting legislation and policies that ensure safe conditions for client treatment in all care settings.
Role of Nurse Advocate
- provides resources for healthy literacy
- Empowers Client
- Informs healthcare team of client’s wishes
- Provides appropriate care
- Supports client’s rights
The Code of Ethics for Nurses
Guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession
Principles of the Ethical Practice of Public Health
Mandate to ensure and protect the health of the public
Public Health Nursing: Scope and Standards of Practice
Essentials of Public Health Nursing
home health
Plan focused on priority care
When the plan is focused on priority care, positive client outcomes occur leading to quality care, continuity of care, treatment compliance, client satisfaction, and client comfort; when the client agrees with and participates in his/her care, cost containment can be realized for both the client and the organization because care/ treatments are done efficiently without waste
Factors that affect the nurse’s ability to set and implement priorities for plan of care
- Organization of the nursing unit
- Staffing levels
- Interruptions from other care providers
- Available resources for collaborative care
- Policies and Procedures
- Supply access
Classifying priorities
Prioritizing is not just numbering client problems on basis of severity
Prioritizing is also based on time; nurse must ration time wisely
Timing Priorities
- Immediately (what needs to be done before anything else can be done for that client? antiemetic, preop meds/paperwrok)
- Within specific time frame
- By end of shift (I&O)
- Least amount of time
Classifying Priorities
- High-if untreated results in harm to client (airway, circulation, safety, pain)
- Intermediate-non-emergent, non life-threatening
- Low -not always specific to illness, but affects future wellbeing (long term health needs)
