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Introduction
Patient-centered care is based on a holistic approach, where each patient is considered as an individual with a set of personal preferences, values, and religious beliefs. The clients lifestyle is accounted for, and the family is incorporated into the care process. According to Hood, Leddy, and Pepper (2014), nurses provide the knowledge, resources, and support that each client needs to be involved in informed decision-making processes (p. 408). It is essential to teach the client the important aspects of self-care and to promote a change in behaviors with the goal of improvement of health and the quality of life in the context of their disease. This paper is concerned with the notion of patient-centered care in professional nursing.
Patient-Centered Care in Professional Nursing
Patient-centered care evolved from the former paternalistic, doctor-centered approach via the promotion of health advocacy and patient participation. Family-inclusive care was formerly present in the areas of maternal and school care, and mental health nursing. The concepts include seeing the family as a client, the individual as a client, and the family as a system; there also exists the family stress model. A family may assume the caregivers role, or become the recipients of nursing care when committing to care for a sick relative in the home. In the context of providing care to the terminally ill, nurses often focus more on providing care for the remaining family than for the dying individual. Patients and the familys behavior and hardships encountered by them influence the approach to patient-centered care; however, it must be both multidimensional and ethical.
The term medical home was introduced by the American Academy of Pediatrics in 1967. The concept describes accessible, coordinated, continuous, and comprehensive family-centered care. Crucially, the care must be compassionate and culturally effective. It is stated that, as all professional nurses are leaders, they need to use cognitive and communication skills to empower others to make decisions, facilitate access to needed care services, share knowledge and coordinate care delivery, among other things (Hood et al., 2014, p. 486).
Discharge Planning Rounds Using Patient-Centered Care
Discharge planning rounds require communication and collaboration between the multidisciplinary healthcare members team, the patients family, and include the patient themselves. The involvement of financial managers leads to improvements in finance, while the inclusion of family members and nurses leads to an increase in patient satisfaction. As Wrobleski, Joswiak, Dunn, Maxson, and Holland (2014) notice, although reduction of hospital re-admission and ED visits is significant, it is not the only finding in the study that should be considered, as active, collaborative involvement of the patient and family in the discharge planning process is imperative (p. 116).
While bedside discharge planning rounds are more effective than the conference ones, resistance to change, lack of discipline, and the inability of the patient and the family to understand the importance expressed by the staff present additional complications. Lack of newer literature on the subjects presents barriers to knowledge sharing. Additionally, patients needs may contradict with the family members other needs, making it necessary to increase the nursing staffs involvement. Multidisciplinary care rounds have been found to reduce healthcare costs and improve health-related quality of life, as well as empower the patient (Wrobleski et al., 2014, p. 112).
Conclusion
Patient-centered care, a holistic approach, is highly effective but requires family-centered care and the input of different professionals for successful integration. The concept of the medical home as a caring approach introduces cultural understanding and compassion as two essential contexts of care. Discharge planning rounds require a multidimensional approach and the collaborative involvement of the patient and their family for maximum efficiency.
References
Hood, L. J., Leddy S., Pepper M.J. (2014) Leddy & Peppers conceptual bases of professional nursing (8th. ed. ). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
Wrobleski, D. M. S., Joswiak, M. E., Dunn, D. F., Maxson, P. M., & Holland, D. E. (2014). Discharge planning rounds to the bedside: A patient-and family-centered approach. Medsurg Nursing, 23(2), 111-116.
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