Patient-Centered Care

1. Patient-Centered Care Group 1 Mariel Lontoc Josephine Macaraig JignasaPancholy

2. DEFINITION • Recognize the patient or designee as the source of control and full partner in providing and coordinated care based on respect for patient’s preference’s,values and needs. (QSEN).

3. KNOWLEDGE • Information and skills acquired through experience or education • The theoretical and practical understanding of a subject.

4. Critical Thinking using Knowledge • Definition • Creative thinking vs reflective thinking • Application in professional Nursing practice.

5. Clinical Judgment in Patient Centered Care • Gather all pertinent information • Collaborate with the team • Use critical thinking and problem solving skills • Consider patients values, beliefs and goals when appropriate.

6. Nursing Process as a Continuous Cycle Assessment Diagnosis PLAN Evaluate Implement

7. Key Nursing concepts • 4 Central Concepts: • Human beings • Environment • Health • Nursing

8. Nursing roles in Patient Centered Care • Continuity of Care • Assuring coordination • Integration • Communication

9. CASE STUDY • Ms. N 70 y.o. female • c/o left labial pain, hematuria x3d • Hx: DM, HTN, CKD, CAD, PVD, DN • Arrived from Philippines. ‘97 • Separated from husband • 6 children • $300 income SSI • Guest friends house

10. Vital signs • Temp 98.2 • BP 155/42 • HR 55 • RR 22 • No mention of pain • A & Ox3 • Ambulatory

11. Plan of Care • Day 1 HD, treated for UTI • Day 3 Gyn Consult noted fluctuance on labial lesion 4x3cm • Transferred to ACE unit

12. Patient in ACE unit • Assess patient cognition- MINI COG • Monitor ADL, baseline function • Ambulation • Communal dining • Activities • IPOC rounds

13. Discharge Plans • HD 3x week While waiting for a HD slot-pt transferred to a regular floor Two weeks-developed progressive difficulty ambulating Gait unsteady, assist with ADL’s D/C to SNF

14. Ethical and legal implications of patient-centered care • Law and Ethics • Ethical standard: Consider the patient’s wishes and goals • Care for the whole patient • Legal standard: What would a reasonably prudent nurse in like or similar circumstances do?

15. Attitude • Respecting, Recognizing and Understanding patients cultural and social values along with ethical responsibilities in patients outcome.

16. Understanding Culture • Culture • Transcultural nursing • Multicultural nursing

17. Establishing Cultural Competences • Examination of personal Values, Beliefs , Biases, and prejudices. • Cultural Awareness • Specific Communication Strategies • Interaction with Different Cultures • Mistake Identification and Acknowledgement • Remediation for Cultural Mistakes

18. Professional Role • Culturally Congruent Care • Multi Cultural Professionalism must occur. • Understanding physical appearance variations • Understanding variation in philosophy

19. Case Study-Evidence based • Ms. N was one of the victim of Hospital –Associated Disability • Ms. N was an immigrant from Philippines and her primary language was Tagalog • Ms. N came for pain on her libia • Ms. N was placed in long term care

20. Lesson Learned • Preventing Hospital Acquired Disability • Team collaboration • Continuity of care • Client Advocate and Attitude

21. Patient Centered Care

22. References Betancourt, J. R. (2004, September 2). Cultural Competence — Marginal or Mainstream Movement? The New England Journal of Medicine, 351(2004), 953-955. Covinsky, K. E., Pierluissi, E., & Johnston, B. C. (2011, October 26). Hospitalization-Associated Disability. JAMA, 306(16), 1782-1793. Retrieved from jama.ama-assn.org QSEN - Quality & Safety Education for Nurses. (n.d.). Retrieved February 19, 2012, from http://www.qsen.org/ Jama.ama-assn.org@ucsf.edu http://www.youtube.com/watch?v=SSauhroFTpk Assessment tools (see forms) Hood 7th edition 2009

23. Resources • www. QSEN.ORG • Jama.ama-assn.org@ucsf.edu • http://www.youtube.com/watch?v=SSauhroFTpk • Assessment tools (see forms) • Hood 7th edition 2009

24. Questions?