Delivering Patient-and Family-Centered Care at Home

Phase 1:

Students will read the following information to better understand the process of delivering Patient-and Family-Centered Care:

Step 1:

Core Concepts of Patient- and Family-Centered Care:

 � Dignity and Respect. Health care practitioners listen to andhonor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural

 backgrounds are incorporated into the planning and delivery of care.

 � Information Sharing. Health care practitioners communicate andshare complete and unbiased information with patients and families in ways that are affirming

and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.

 � Participation. Patients and families are encouraged andsupported in participating in care and decision-making at the level they choose.

 � Collaboration. Patients, families, health carepractitioners, and leaders collaborate in policy and program development, implementation,and evaluation; in health care facility  

design; and in professional education, as well as in the delivery of care.

 For more information go to site: http://www.ipfcc.org/pdf/CoreConcepts.pdf

 Step2:

Review Movenote: http://www.movenote.com/v/wepO4fq4psB

Review PLE from Pinterest: https://www.pinterest.com/nancylemos/nur650-physical-learning-environment/

Step 3: Understand:

Emotional health is an important variable in holistic patient care. Psychologist Doris Jeanette, PsyD has dedicated 30 plus years of study, development, and implementation of emotional healthcare.  Dr Jeanette defines emotional health by the degree to which you feel emotionally secure and relaxed in everyday life.  An emotionally healthy person has a relaxed body, open mind and open heart.  The more emotional health you have, the more self-esteem you have� To be emotionally healthy you must express your emotions in healthy assertive ways (Jeanette PsyD, 2012).  Additionally, when a teenage patient has good emotional health, the patient has both a better quality of life and prospects towards a healthy future.

 Phase 2:

Students are to work in a group and as a team to design a plan of treatment that will include delivering patient-and family-centered care.  Review this model case:

Model Case to Meeting Patient- and Family-Centered Care

Alexia G. is a 15-year-old female with Leukemia in active treatment of 4 months into therapies.  Treatment consists of Ara-c chemo weekly at Lucile Packard Children�s Hospital (LPCH) in Palo Alto,CA.  Patient resides in rural Northern California and travels to and from LPCH weekly, often times spending nights at family center.  Alexia has moderate to severe nausea with vomiting, headaches, and anxiety 2-3 days post-chemo.  The nurse casemanager (myself) makes home visits twice weekly to monitor her Nadir period and watch cell count recovery.  Collecting a trending report of her adverse symptoms; constructing a practice theory of how to prevent Alexia�s symptoms from causing a local hospitalization.  Moreover, developing a nurse-patientrelationship to begin meeting the patient and families needs. 

The case manager (myself) meets with Alexia in private to begin to discuss how she is feeling.  After a thorough assessment, the case manager collects the emotional issues that need to be met immediately and brings them for open discussion at our PCC.  For Alexia, the loss of her hair has put a deep strain on her desire to be socially active, including joining facebook.  Additionally, Alexia is fearful of the unknown aspects of her care, (oftentimes, communication is directed towards the adults in regards to the trajectory of pediatric patient care) and wonders if she�ll ever be healthy enough to go back to school to be a normal teenager.  The case manager can then construct a viable plan to include Alexia into the decision making process, assist with wigs vs. hats, and encourage the teen to be social. Utilizing our MSW along with nursing staff for home visits and to assist in meeting our patient- and family-centered goals, we can ensure that Alexia�s care is tailored to fit her needs as an individual.  At final assessment, the case manager notes that Alexia is happy, wearing her wig, involved with her care in regards with discussing her own needs during rounding, and making a HIPPA appropriate facebook site where she can connect with her peers.  Lastly, Alexia states that she can now see herself free from cancer and going back tohigh school to join her friends.

Phase 3:

Create a case study to deliver patient-and family-centered care for this case:

Lindsey is a 16-year-old female with a rare case of ovarian cancer.  Lindsey has been treated at Stanford�s woman�s center due to the nature of her cancer, being atypical for children or teens.  Although Lindsey looks much like a woman, she is not. In fact, Lindsey states to her nurse that she would have preferred to go to Lucille Packard Children�s Hospital to be around younger patients.  Furthermore, Lindsey has staff that are trained and accustomed to tending to the needs of adults.

 1.    1. Encourage patient to discuss her feeling in medical rounding.

a.     How does having the multidisciplinaryteam help care.

b.     Does the patient prefer to discussadverse effects self vs. nurses reading trending reports?

2.    Allow patient options to care delivery.

a.     Life port insertion vs. central lines for comfort of dressing

b.     Choice of activities to participate in (e.g., social networking vs. classroom environment).

c.     Shaving hair for quick removal vs. falling out gradually. And choice of wigs vs. hats/ scarves.

Take Quiz:

1.    Itis important to meet patient-centered goals by?

a)    To improveyour score for a raise

b)   To increasepatient happiness

c)    To makethe family feel inspired

d)   To meetquality patient-centered outcomes

2.    Inthis course, the student will understand the core competencies ofevidence-based practice, patient-and family-centered care, and ____________.

a) Informatics

b) Safety

c)  Quality Improvement

d)  Teamwork and Collaboration

3.    Whyis community health nursing an important course?

a)    To teachthe nurse to working in the public

b)   To assistwith public health

c)    To understandthe global aspect of health care

d)   The communityis an integral part of health care

4.    Areteenagers capable of making their own healthcare decisions?

a)    Teenagerscannot bc they are children

b)   Teenagerstend to make poor choices

c)    Teenagersare encouraged to assist in decision-making.

d)   Teenagersare reckless

5.    Whyis teamwork and collaboration in healthcare important?

a)    Workingtogether to meet patient goals

b)   Getsthe work done faster

c)    Putsother members responsible

d)   You canbe lazy

6.    Shouldnurses act out care prior to delivering care?

a)    Yes �role play is needed to demonstrate competence

b)   It isfun

c)    It�sa waste of time

d)   It isstupid

7.    Whatis a Broviac line or life port?

a)    A placeto rest

b)   A wounddressing

c)    A centralaccess line for meds or blood draws

d)   A funnyjoke

8.    Wherewould you practice Broviac line care?

a)    On anadult

b)   In thesimulation lab

c)    On eachother

d)   On yourteacher

9.    How wouldyou encourage a teenager to become social?

a)    Ask theirteachers

b)   Talkto the social worker

c)    Ask themhow they like to interact with others

d)   Answersare b and c

10.  True or False: The Nurse should encouragepatient to discuss her feelings during medical rounding, as an active member ofher healthcare team?

a)    True