The Online Newsletter for Children's Nurses
e-Edition, Issue 7
Patient and Family-Centered CareBy Randy Guerrero, MSA, BSN, RN, NE-BC - Executive Director, Critical Care
Leads to Patient and Family Satisfaction
“First of all, he said, if you can learn a simple trick, Scout, you’ll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view...until you climb into his skin and walk around in it”. (Atticus Finch to his daughter, Scout, from Harper Lee’s “To Kill a Mockingbird”)
It seems this basic principle, this value of seeing things from someone else’s vantage point in order to better understand and relate to him, applies to many aspects of our lives. It is a precursor to the Golden Rule, “Treat others as you want to be treated,” because it requires a deeper sensitivity to what others are feeling and experiencing in order to “treat” them well.
Clearly these values are the premise for “patient and family-centered care.” First by understanding what the family is experiencing, feeling and enduring, and then by altering and individualizing our approach to care and treatment based on that understanding to an approach we would want for ourselves or our own family members.
Interventions supporting patient- and family-centered care have become the best-practice standard for pediatric nursing. Several studies reflect improved patient outcomes as well as improvements in patient and family satisfaction as a result of the family’s involvement in the care of the child 1, 2, 3.
In order to achieve these positive outcomes and levels of satisfaction, there must be a focus on, and understanding of, the individuality of the patient and family. This allows us to determine the interpersonal approaches and nursing interventions best-suited for each patient and their family. So what is the best approach to achieve that focus? The answer is simple: “climb into the patient’s and family’s skin” by asking about their needs, wants and desired level of involvement. Ask, listen and look for cues regarding their beliefs, values, concerns and fears. Envision yourself or a family member going through the same experience and imagine how you would like to be treated. Visualize the care you are receiving, the compassion, responsiveness, respect and competency of the interactions exuded from each health care professional and the level of involvement you would desire. Place yourself in the environment of the patient and heighten your awareness of aesthetics, noise/sounds, light and overall calmness of your surroundings. Walk “in their shoes.”
In general, patients and families want the things consistent with the precepts of patient- and family-centered care: dignity and respect; information sharing regarding their clinical course and care, participation in their care and collaboration with physicians, nurses and the entire disciplinary team in delivering that care. Yet, each patient and family is unique from a clinical, cultural, psychosocial and emotional perspective. Their wants and desires and preferences for level of involvement and participation vary. In order for patients and families to derive a high level of satisfaction from the healthcare experience, the health care team must have a deep understanding of the patient’s and family’s perspective of their health status and related care. As a result, the healthcare team must also be flexible, respectful and reciprocal when providing that care.
Evaluate the impact of your patient- and family-centered interventions. You can do so easily and without waiting for retrospective, patient satisfaction survey reports. Again, merely ask the patient and their family whether their needs are being met and whether they are satisfied with their level of involvement in the care being provided. Determine if they sense a positive degree of collaboration with the healthcare team and if they are receiving the information they need regarding the care and the clinical outcomes of that care.
This “simple trick” of displaying concern for and sensitivity to the perspective of the patient and their family can lead to improved patient outcomes and phenomenal patient and family satisfaction.
Wood, D. Patient-Centered Care Helps Hospitals Boost Patient Satisfaction. 2008.
AMN Healthcare, NurseZone.com.
DiGioia, A. Patient- and Family-Centered Care Initiative is Associated With Patient Satisfaction and Outcomes For Total Joint Replacements. December 18, 2008. AHRQ Healthcare Innovations Exchange.
Harbaugh, B.L., Tomlinson, P.S., Kirschbaum, M.(2004). Parents’ Perceptions of Nurses’ Caregiving Behaviors in the Pediatric Intensive Care Unit. Issues in Comprehensive Pediatric Nursing, 27(3), 163-178.
In This Issue
A Walk On The Family Side
Patient Family Satisfaction
Family-Centered Medical Care
Nursing and Child Life
Pediatric Diabetes Care
Supporting Teens on Dialysis