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Discuss how the ‘prioritising people’ section of the NMC (2015) code can guide the provision of person centred care in nursing.

NMC Code of Conduct: Protecting the Public and Upholding Standards

Nursing is a profession which is regulated by nursing and midwifery which is an organization set by the government to protect the public by ensuring that nurses and midwife provide high-quality healthcare service to the patients. According to NMC, healthcare professionals are accountable for their actions which they perform in the process of attending a patient. NMC provides education programs and training of nurses and midwives so that they can be provided with advice on how they should perform their operation (Reinhardt & Downs, 2018, p.207). According to NMC code of conduct healthcare professionals are charged with the duty of protecting and taking care of interests of those in their care regardless of their age, gender and occupation. Healthcare professionals according to NMC, should respect the decisions of a client. This is because going against the wish of a patient is breaching the code and ethics of NMC. The role of NMC is to set law and standards that tell members of the public and the patients on how healthcare professionals are supposed to behave. These standards are shown every day by members of the registry. For healthcare professionals such as nurses and midwives to be able to join the record, they should be able to renew their registration so that they can be able to uphold these standards (Kim & Park, 2017, p.381). Actions are taken against those who fail to enforce the code and rules, on more severe cases they are removed from the registry. Healthcare professionals who are registered as nurses or midwives in the UK have to be registered with NMC.

NMC code is divided into four sections regarding the core principles of nursing. The first section is prioritizing people.  This is because prioritizing people is essential and it involves healthcare professionals putting the interest of people as their priority. Treating patients with respect is a very significant aspect of nursing because in the process patients’ rights are upheld. This section of NMC code is against nurses and midwives discriminating patients and judging them despite their personal views and behavior (Snelling, 2017). The second section of NMC code is practicing effectiveness. Healthcare professionals should be able to assess the need of the patient, interpret the test result and advice the patient appropriately on the treatment techniques. It is also very essential that nurses should be able to deliver quality healthcare service to the patient who meets their medical requirements. Preserving safety is the third section of the NMC code. It is essential for healthcare professionals to give patients safety the priority in their decision making. As healthcare professionals interact and communicate with patients, they should know their limit. The last section is promoting professionalism and trust. This is because the reputation of healthcare professionals should be protected. They should, therefore, adopt all the essential attitudes and behavior as outlined in the NMC code.

The Four Sections of the NMC Code of Conduct

The purpose of the NMC code is to protect the health and well-being of individuals in society. The code also ensures that healthcare professionals which include nurses and midwives keep their skills and knowledge up to date and that they uphold the professional code standards (Moran & Banks, 2016). This code ensures that the confidentiality of people who are receiving healthcare services and healthcare institutions is upheld. To be able to achieve all these roles, nurses and midwives should respect patients’ rights in all aspects as they offer healthcare services to them. In person-centered approach care patients should be informed about how and why information about their health is shared among people providing care to them according to NMC code. Respect to a person rights to privacy should continue even after they are dead. Healthcare professionals also have to share essential information about the patients among themselves so that they can be able to share ideas which can be used to offer quality healthcare services to him/her. Lastly, to be able to achieve all NCM roles, family members and friends should be informed about the health condition of their loved one before nurses and midwives can continue with the treatment and medical procedure.

Prioritizing people in person-centered care in nursing means that patients have equal right in the planning of care and treatment plans which have to be used to treat their various infections. Healthcare professionals should note that patient decisions are critical and they should be respected. However, this does not mean that healthcare professionals should do precisely what the patient says, but they should keep their suggestions and decisions into consideration. Individuals who are accessing healthcare institutions to seek medical attention are referred to as clients. Countries in the UK are moving forward for integration and enhancement of health and social care services to ensure that they provide high-quality healthcare services to clients. Person-centered care is all about focusing healthcare on the need of the patient rather than the need of the healthcare service (Yevchak et al., 2017, p.21). Most individuals seeking medical attention in the UK are not comfortable with just sitting down and letting the healthcare professional do what they think is the best without them giving out their suggestions. Healthcare professionals should, therefore, be flexible so that they can be able to meet the client’s needs. Person-centered care in NMC also means that patients should be an equal partner in planning on the type of medical care which they should be given. However, in some cases patients can be unable to make decisions of their own they have mental disorders like dementia which can make communication between healthcare professional and client a challenge because the patient is not able to decide on their own. For healthcare professionals to be able to help them, they should ensure that they give them information in a format that can help them be able to make a decision.

Person-Centred Care: Prioritizing People's Needs

When a patient has dementia, it is straightforward for healthcare professionals to forget what they used to be. It was, therefore, necessary for the person-centered approach to be developed in the UK so that these incidences do not occur and that patient with dementia can stay focused. This approach was also designed to ensure that healthcare professionals are still able to respect them with respect and they do not expose them to discrimination. The fact about this approach is that it was developed in the 1980s by Thomas Kitwood to care for patients with dementia (Roberts, Morley, Walters, Malta & Doyle, 2015, p.106). According to various studies which have been conducted by a scientist is very clear that person-centered care has reduced agitation and aggressiveness in people living with dementia. The person-centered approach has reduced the number of people with dementia needing to be hospitalized. There are various ways in which a person-centered approach is utilized in NMC to care for patients with dementia. The first ways are by giving a choice of food at mealtime. Healthcare professionals can do this by asking the patient what they would like to have or just showing them pictures. It is, therefore, necessary that patient with dementia should always be provided with food that they enjoy the most. The little things that healthcare professionals do from a patient who has dementia mean very much (Barbosa, Sousa, Nolan & Figueiredo, 2015, p.713). This is because too many choices may be overwhelming, but sometimes they are very much important especially for someone who has dementia. An example is choosing which trouser, tie and shirt to wear which can be so much insignificant for an average person but for a patient with dementia they are essential; this is because they make them feel so much in control of their own (Edvardsson, Sandman & Borell, 2014, p.1171). The last way is that healthcare professionals should always ask themselves if they see the world through the eyes of a patient with dementia. If the answer is yes, it means that they are using a person-centered approach to care for their patients.

Most individuals who are taking care of people with dementia use person-centered approach without their knowledge. This has shown good results with patient responding positively to treatment and be happier and calmer which make their life much more comfortable and worth living. It is therefore essential for family members and friends to ensure that their loved ones who have dementia and in nursing homes are receiving person-centered care because they have the right to. The following are things which they should check to ensure the care plan is appropriate for their patients. The first essential is that they should be treated with dignity and respect (Lines, Lepore & Wiener, 2015, p.561). Next, they should provide that healthcare professionals taking care of their patients are aware of their likes and dislikes such as their favorite meals, music, and hobbies. Lastly, friends and family members should ensure that their patients are valued as human beings and that healthcare professionals do not take advantage of their health situation to mistreat them. NMC has provided that most care institutions and nursing homes in the UK have implemented a person-centered approach to cater for a patient who have dementia. This is because the number of people living with dementia was about 800,000 in 2012 and the number is expected to rise to almost 2 million by 2060 (Tay et al., 2018, p.19).

Person-Centred Care for Patients with Dementia

The person-centered approach has some benefits for patients with dementia. The first advantage is that this approach meets people expectations and needs. This is because most patients want to play a part in their care and they expect that healthcare professionals should help them achieve it.  Through sharing their decisions and opinions with healthcare professionals and making self- management support enables them to play an active role in their treatment (Fazio, Pace, Flinner & Kallmyer, 2018, p.10).. The second benefit of the person-centered approach according to NMC is that it improves clinical outcomes (Kogan, Wilber & Mosqueda, 2016, p.e1). This is because various kinds of self-management used by healthcare professionals to cater to patients with dementia improve their physical symptoms. Improved healthcare outcomes as a result of sharing opinion decision are made possible by the cooperation between healthcare professionals and patients (Metzger, Racine & Inouye, 2017). Person-centered care has led increased staff satisfaction and morale. This is made possible through the establishment of a strong therapeutic relationship between healthcare professionals and dementia clients (Roberts et al., 2015, p.106). Through this relationship, it is possible to relate well with clients who make healthcare professionals able to gain knowledge about the infection which the client is suffering from and thus they can offer high-quality healthcare services to them (Yasuda & Sakakibara, 2017, p.991).

Healthcare professional can testify that the person-centered approach has led to the provision of high-quality healthcare services to clients with dementia. This is made possible through the application of various principles of the person-centered approach. The first principle is respect for patients’ values and decisions. This is made possible by engaging them in decision-making activities so that they can be able to recognize their unique value and preferences. It is, therefore, necessary that healthcare professionals should treat patients with respect and dignity despite their cultural diversity and economic background.  Coordination and integration is the second principle (Testad et al., 2014, p.1083). This because when a patient has dementia their feelings are vulnerable and powerless due to the infection and in most cases, they lose hope. It is therefore essential for healthcare professionals to ensure proper coordination so that they can be able to eliminate this feeling because it affects their health negatively. The coordination is done in three areas which include clinical care, support services, and front-line patient care. The third principle is information and education. This is carried out in interviews where patients with dementia express their worries because they were not well informed about this infection and they are not fully aware of the effects of the infection (Desai, Wharton, Struble & Blazek, 2017, p.9). Physical comfort is the next principle of person-centered care. This is because the level of physical comfort that a dementia patient depicts has an essential on their experience — healthcare professionals’ reports physical comfort in pain assessment and hospital environment and surroundings.

Person-Centred Care: Meeting Patient Expectations and Improving Outcomes

Emotional support and alleviation of fear and anxiety is the fifth principle of person-centered care. This is because fear and anxiety which is experienced by a patient who has dementia can be debilitated as a physical effect by nurses and midwives (Kales, Gitlin & Lyketsos, 2015, p.369). The sixth principle of the person-centered approach according to NMC involves healthcare professionals involving family and friends of the patients in decision making. This involves the provision of accommodation for family and friends. Healthcare professionals according to NMC should be treated and supported as caregivers to the patient. The seven principle is continuity and transition. This happens when the patient has shown efforts of taking care of themselves after they are discharged from the hospital (Boersma, van Weert, Lakerveld & Dröes, 2015, p.19). The last law is access to healthcare services. This is done by ensuring that patient are aware that they can access healthcare services whenever they are sick because it is there right according to NMC.

Community nurses and midwives face a lot of challenges when trying to practice person-centered approach to cater to patients with dementia. The first problem experienced is an increased number of patients with dementia across the globe (Kogan, Wilber & Mosqueda, 2016). This makes it very hard for healthcare professionals to apply the person-centered approach to take care of the large population of individuals who need medical attention. Competition is another challenge which is facing the person-centered approach while providing medical care to dementia patients. This is because nurses and midwives think they already know what is expected to offer treatment to the patient and thus they don’t put into consideration the patient's decisions and suggestions. Organizational culture is another barrier to successful implementation of person-centered care according to NMC code.

Conclusion

The person-centered approach is a very significant treatment technique when caring for a patient with dementia. This technique enables patients to be able to make their own decision which is essential especially for patients with dementia as it makes them feel valuable and it enhances their health condition. It is therefore essential that healthcare institutions across the globe should be encouraged to use this approach as it makes patients take an active role in their treatment.

Barbosa, A., Sousa, L., Nolan, M. and Figueiredo, D., 2015. Effects of person-centered care approaches to dementia care on staff: a systematic review. American Journal of Alzheimer's Disease & Other Dementias®, 30(8), pp.713-722.

Boersma, P., van Weert, J.C., Lakerveld, J. and Dröes, R.M., 2015. The art of successful implementation of psychosocial interventions in residential dementia care: a systematic review of the literature based on the RE-AIM framework. International psychogeriatrics, 27(1), pp.19-35.

Desai, A., Wharton, T., Struble, L. and Blazek, M., 2017. Person-centered primary care strategies for assessment of and intervention for aggressive behaviors in dementia. Journal of gerontological nursing, 43(2), pp.9-17.

Edvardsson, D., Sandman, P.O. and Borell, L., 2014. Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience. International Psychogeriatrics, 26(7), pp.1171-1179.

Fazio, S., Pace, D., Flinner, J. and Kallmyer, B., 2018. The fundamentals of person-centered care for individuals with dementia. The Gerontologist, 58(suppl_1), pp.S10-S19.

Kales, H.C., Gitlin, L.N. and Lyketsos, C.G., 2015. Assessment and management of behavioral and psychological symptoms of dementia. bmj, 350, p.h369.

Kim, S.K. and Park, M., 2017. Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis. Clinical interventions in aging, 12, p.381.

Kogan, A.C., Wilber, K. and Mosqueda, L., 2016. Person?centered care for older adults with chronic conditions and functional impairment: A systematic literature review. Journal of the American Geriatrics Society, 64(1), pp.e1-e7.

Lines, L.M., Lepore, M. and Wiener, J.M., 2015. Patient-centered, person-centered, and person-directed care: they are not the same. Medical care, 53(7), pp.561-563.

Metzger, E., Racine, A. and Inouye, S.K., 2017. Advanced dementia in long-term care: avoiding the pitfalls of fall prevention.

Moran, M. and Banks, D., 2016. An exploration of the value of the role of the mentor and mentoring in midwifery. Nurse education today, 40, pp.52-56.

Reinhardt, J.P. and Downs, M., 2018. FACILITATING PERSON DIRECTED CARE FOR PERSONS WITH DEMENTIA ACROSS CARE SETTINGS AND DISCIPLINES. Innovation in Aging, 2(suppl_1), pp.207-207.

Roberts, G., Morley, C., Walters, W., Malta, S. and Doyle, C., 2015. Caring for people with dementia in residential aged care: successes with a composite person-centered care model featuring Montessori-based activities. Geriatric Nursing, 36(2), pp.106-110.

Snelling, P.C., 2017. Can the revised UK code direct practice?. Nursing ethics, 24(4), pp.392-407.

Tay, F.H.E., Thompson, C.L., Nieh, C.M., Nieh, C.C., Koh, H.M., Tan, J.J.C. and Yap, P.L.K., 2018. Person-centered care for older people with dementia in the acute hospital. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 4, pp.19-27.

Testad, I., Corbett, A., Aarsland, D., Lexow, K.O., Fossey, J., Woods, B. and Ballard, C., 2014. The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review. International psychogeriatrics, 26(7), pp.1083-1098.

Yasuda, M. and Sakakibara, H., 2017. Care staff training based on person-centered care and dementia care mapping, and its effects on the quality of life of nursing home residents with dementia. Aging & mental health, 21(9), pp.991-996.

Yevchak, A., Fick, D.M., Kolanowski, A.M., McDowell, J., Monroe, T., LeViere, A. and Mion, L., 2017. Implementing Nurse-Facilitated Person-Centered Care Approaches for Patients With Delirium Superimposed on Dementia in the Acute Care Setting. Journal of gerontological nursing, 43(12), pp.21-28.

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