Education and Patient Centered Care

Education and Patient Centered Care

Patient-Centered

Care and Professional

Nursing Practice

Chapter 11

What is Patient-Centered Care (PCC)?

• Care that is respectful of and responsive to

individual patient preferences, needs, and

values and ensuring that patient values guide

all clinical decisions (IOM, 2001)

• Recognizes the patient or designee as the

source of control and full partner in providing

compassionate and coordinated care based on

respect for the patient’s preferences, values,

and needs (QSEN, 2014)

PCC Competency

• The nurse “will provide holistic care that

recognizes an individual’s preferences, values,

and needs and respects the patient or designee

as a full partner in providing compassionate,

coordinated, age and culturally appropriate,

safe and effective care” (Massachusetts

Department of Higher Education, 2010, p. 9)

Dimensions of PCC

• Respect for patients’ values, preferences, and

needs

• Coordination and integration of care

• Information, communication, and education

• Physical comfort

• Emotional support

• Involvement of family and friends

• Transition and continuity

• Access to care

Picker Principles of Patient-

Centered Care

Videos featuring patients “in their own words”

http://cgp.pickerinstitute.org/?page_id=1319

http://cgp.pickerinstitute.org/?page_id=1319
Components of Patient-Centered and

Family-Centered Care Delivery Models

• Coordination of care conference

• Hourly rounding by the nurse

• Bedside report

• Use of patient care partner

• Individualized care established on admission

• Open medical record policy

Components of Patient-Centered and

Family-Centered Care Delivery Models (cont.)

• Eliminating visiting restrictions in relation to

family members

• Allowing family presence with a chaperone

during resuscitation and other invasive

procedures

• Silence and healing environment

Communication as a Strategy to

Support PCC

• Communication is defined as the nurse

interacting “effectively with patients, families,

and colleagues, fostering mutual respect and

shared decision making, to enhance patient

satisfaction and health outcomes”

(Massachusetts Department of Higher

Education [2010], p. 27)

Empathetic Communication

• Behaviors that facilitate empathetic

communication include:

– Listening carefully and reflecting back a

summary of the patient’s concerns

– Using terms and vocabulary appropriate for the

patient

– Calling the patient by his or her preferred name

– Using respectful and professional language

Empathetic Communication (cont.)

• Behaviors that facilitate empathetic

communication include (cont.):

– Asking the patient what they need and

responding promptly to those needs

– Providing helpful information

– Soliciting feedback from the patient

– Using self-disclosure appropriately

– Employing humor as appropriate

– Providing words of comfort when appropriate

Nonempathetic Communication

• Behaviors can also hinder empathetic communication:

– Interrupting the patient with irrelevant information

– Using vocabulary that is either beneath the level of

the patient or not understandable to the patient

– Using language that may be perceived as

patronizing or demeaning

– Using nonprofessional language

Non-Empathetic Communication (cont.)

• Behaviors can also hinder empathetic communication

(cont.):

– Reprimanding or scolding the patient

– Preaching to the patient

– Providing the patient with inappropriate

information

– Asking questions at inappropriate times or giving

patient advice inappropriately

– Self-disclosing inappropriately

Kleinman’s Questions

• What do you think has caused your problem?

• Why do you think it started when it did?

• What do you think your problem does inside

your body?

• How severe is your problem? Will it have a

short or long course?

Kleinman’s Questions (cont.)

• What kind of treatment do you think you

should receive?

• What are the most important results you hope

to receive from this treatment?

• What are the chief problems your illness has

caused you?

• What do you fear most about your

illness/treatment?

Patient Education as a Strategy to

Support PCC

• Patient education is any set of planned

educational activities designed to improve

patients’ health behaviors and/or health status

Learning Domains

• Cognitive learning encompasses the

intellectual skills of knowledge acquisition,

comprehension, application, analysis, and

evaluation

• Psychomotor learning refers to learning skills

and performance of behaviors or skills

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