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What is Person Centered Care?

Section one   
The relationship of theory to practice in a healthcare workplace.
You should start by analysing the core values in healthcare that we covered in class (Individual identity, rights, choice, privacy, independence, dignity, respect, and partnership). Remember, analysing means breaking it down into its component parts and doing a thorough examination (3.1). Then apply and evaluate person-centred care to the practice undertaken in a target profession ‘in-situ’ (in the workplace). For instance, if you choose to do your report on people with learning difficulties, and you chose to use a care home as your workplace, then you would talk about how person-centred care would be used for those patients in that context. This is an important step in the report as it will be useful for your reflective piece (section 3). It is important that you ‘apply’ person centred care, and not just simply describe it. This section of the report will not require a huge description of what person-centred care is; a brief overview is sufficient. Most important is the ‘apply’ focus; make sure you provide evidence that you know how it is used in practice for the profession you have chosen (3.2).

Section two  
Critical evaluation of a healthcare workplace.
In this section you should explain and evaluate the social, and healthcare work undertaken in a workplace (2.1). This means ‘explaining’ the role of the profession and context that you have chosen for 2.1 and 3.2 and cover the duties and responsibilities of that healthcare worker, including duty of care and safeguarding patients/clients. You can include ‘desk work’ responsibilities such as keeping accurate records and liaising with other healthcare professionals. It is important to show that you understand the demands of the role as you will needing to know those for your critical reflection exercise in section 3.

Section three  
The concept of reflective learning.
In this section you should explain how reflective learning can be used to enhance clinical practice in the profession you have chosen (above). For this you will use an example from an enquiry (there are quite a few on Moodle for you to use, or you can find your own). You do not have to necessarily reflect on the whole situation. If it is a long and in-depth enquiry, you can focus on some of the aspects. An example might be that the emergency doctors should not have allowed baby P to go home. Whose failing was it? How could that have been prevented? Learning from past mistakes is a good example of reflective learning; how things could have been different and what changes could/should be made to the role in general, and/or the individual/s featured in the enquiry (1.1). All enquiries will have recommendations for future practice. You may use these as long as you apply them. It is important however, with reflection, is that you think about what you believe could have made things different and better.

What is Person Centered Care?

The term person centered care is still emerging in this generation and can be applied to a form of healthcare where the patients are mainly kept in the center of the care plans. Person centered care in nursing ensures that the patients are treated with dignity, respect and compassion making them feel included in the treatment procedures (Kogan, Wilber and Mosqueda 2016). This form of approach offer coordinated care, support and treatment to the patients that are highly personalized. Researchers and professionals appreciate this type of care as this form of care supports people for recognizing as well as developing their own strengths and abilities helping them to live a fulfilling and independent life (Wildevur and Simonse 2015). The report will thereby explain the approach of the person centered care, different aspects associated with it, importance of professionalism in healthcare and importance of reflection. All these ensure development of skills and knowledge of professionals making them provide the best care to patients.

A culture of caring is considered to be an integral part of the nursing profession. Such an attitude helps in the characterization of the concern as well as the consideration of the whole person that in turn helps in providing physical stability and well-being with the person. Nurses also need to have the core values by which they can maintain the human rights of patients and connect with them at an emotional level (Brown and Schmidt 2016). Every nurse is expected to maintain the ethics of maintaining the dignity as well as autonomy of the patients and work according to the wishes of the patients. This makes the patients feel respected and empowered that in turn has positive aspects on the patient’s health. Patients should be included in the decision-making situations as well as in effective partnerships as that makes the patients feel that their suggestions are considered important and this increases their self-esteem, and self-confidence. Nurses need to be very careful about maintaining the confidentiality and privacy of the patients thereby protecting their personal information and refraining to get involved in legal obligation (Noushi et al. 2018). This ethics come under data protection act and nurses should be careful in maintaining the legal rules while caring for patients. Nurses need to treat patients as unique being by respecting their individual identity and undertake interventions after ensuring informed consent, maintaining their rights as well as choice. If patients tend to reject the treatment, their choice should be given first priority according to ethics of autonomy and dignity.

Importance of Person Centered Care in Nursing

Person centered care can be defined as the approach undertaken by different healthcare as well as social services where patients and family members are considered as equal partners in planning, developing and monitoring care of the patients ensuring that it meets their needs. If for example geriatric patients are considered who mainly lead a dependent life or are suffering from chronic disorders, patient centered care develop their quality of life not only physically but provide strong emotional and mental support (Edvardon, Sandman and Borrell 2014). Dignity and autonomy are two important aspects where the values of the old patients would be respected. This increases their self-esteem and confidence and encourage them to participate in the care. Healthcare professionals take into account the preferences and the expressed needs of such patients before developing their care plan and interventions (Lines, Lepore and Winer 2015). This form of approach in caring also involves providing a coordinating and integrating care to patients by working together along with a multidisciplinary team in ways by which will ensure effective communication, passing of information and proper education to the patients and family members. For example, many old patients may suffer from diabetes. A coordinated care by a healthcare team like physician, nurses, diabetes educator, dieticians, podologists and others will ensure that the patients get high quality of care where proper communication, information and education will help patients to overcome symptoms and lead quality lives. Another important aspect of this form of care is that the healthcare professionals make sure that the patients are physically comfortable and safe ensuring high quality care and patient satisfaction. Professionals provide emotional support to patients and family members making sure that they have proper access to healthcare (Noushi et al. 2018). Old patients are highly vulnerable to developing depression and anxiety due to their degrading quality for life, dependency on others, restrictions in life and loss of mobility. Therefore, emotional support plays an important role in empowering such patients. Another important aspect of this type of care is that the professionals make sure that privacy and confidentiality of the patients are maintained where no information is disclosed to anyone without the permission of the patients. The care provided to them follows the ethical guidelines ensuring high patient satisfaction.

Patients who get person centered care from healthcare professionals are highly satisfied and they have developed quality of life. This approach helps in improving the experiences of the patients that they have regarding care and satisfaction. This also encourages patients to lead a healthier lifestyle such as exercising and eating healthily. For example, in case of the old diabetic patient, proper health literacy, proper diet and freehand exercises can help her improve her symptoms. This approach also encourage such old patients to be more involved in decision making so that they can get services and support, which are significant for their needs (Brooker and Latham 2015). Old patients feel that they are avoided and isolated for their inabilities and dependency. Therefore, making them included develops their will power and empowers them to lead better lives. This type of care includes a holistic approach where physical, environmental and psychosocial environment of the patients are assessed. They are then modified to ensure risk free lives that reduce readmission and longer stay at healthcare centers (Brown and Schmidt 2016).

The Approach to Person Centered Care Implementation

Nursing profession is a rewarding career for those individuals who want to provide service for the humanity and dedicate their lives for the well-being and healthy lives of their citizens. However, the profession is not an easy path, as nurses have to be highly skilled and knowledgeable to provide safe and quality care for the patients (LoBiondo et al. 2017). Their pathway is full of obstacles that they have to overcome through effective attributes and provide undisrupted service to patients. Nurses need to take undertake huge number of responsibilities while caring for patients like they have  to perform different physical examinations and record patient histories to diagnose the disorders of the patients and initiate preliminary interventions. Besides, they have to also provide health promotion, counseling and health education to the patients and communities. Often different geriatric patients have poorly controlled disorders like obesity, diabetes, osteoarthritis and others (Koivunen, Niemi and Hupli 2015). Therefore, nurses develop their health literacy and counsel them in ways by which they become independent and overcome their physical and emotional turmoil. Nurses need to maintain a safe workplace environment by properly assessing risks associated with the health of the patient and taking interventions accordingly to provide safe care (Yoo and Park 2015). Nurses also need to properly interpret the information of the patients and thereby make critical decisions about required actions through proper rationale development and critical thinking ability. Decision-making ability and problem solving abilities help them to create a healthcare workplace that is free from any miscommunication and revolts. Nurses need to have teamwork skills where they can act collaboratively with other healthcare experts to provide coordinated care to the patients. Developing a collaborative environment in workplace increases productivity, releases stress and ensure safe care of patients (Bramhall 2014). Nursing professionals also require to conduct evidence based practices so that they can keep up to date with the recent trades of healthcare provide the best service to patients. In order to develop a proper healthcare workplace, nurses need to possess skills like compassion not only towards patients but also to fellow colleagues. Effective communication and compassion helps in relationship development and strong bonds that result in development of workplace climate that is free from stress, pressures, tensions, and internal conflicts.  Proper knowledge about the professional codes of conduct and ethics ensure safest practice to patients that avoid any legal obligation and increase patent satisfaction. Nurses need to make choices at daily basis and hence critical thinking skills and attentions to detail ensure high quality care (Arnold and Boggs 2015). Confidence, adaptability, stamina and commitment towards development help in developing expert nursing professionals. While working with geriatric patients, compassion and communication are the key elements to make them feel vales and respected. Huge patience and dedication are required to understand their mental turmoil, assessing their cognitive skills, educate common health concerns like fall prevention strategies, proper healthy eating, incontinence issues, sexual issues and others (Koto-shimada et al. 2016). Educating them about personal safety and diseases prevention is time consuming. Therefore, nursing professionals have to develop skills that help them to master their professionals efficiently.

Professional Development in Nursing for Person Centered Care

Reflection can be considered as an effective tool in nursing profession as it gives the scope to such professionals to identify and develop personal and professional skills to incorporate in clinical practice (Schimdt and Brown 2016). It also enables them to better understand themselves and learn from the mistakes that they had conducted (Taschuk et al. 2017). They could thereby reflect on the experiences to solve problems, develop skills and hence modify their clinical expertise for betterment. Researchers therefore define this procedure as the process of reviewing an experience in the healthcare practice sessions for describing, analyzing, evaluating and thereby learning from the practice (Henry 2016). This tool gives scope to nursing professionals to critically think and deconstruct past experiences, learn from them, and then apply the modified skills or rationale before care planning and treating the patient. It gives an opportunity to all healthcare professionals for lifelong learning that provides them the scope to be an expert professional and be confident ensuring patent satisfaction (Eng and Pai 2015).

Peter Connelly also known as Baby P had died in London in 2007 due to severe abuses by his biological mother, his stepfather and brother of his stepfather. The enquiry has found out that the baby had suffered from 50 bruises over a period of about 8 months even when the baby was repeatedly monitored by the health professionals of NHS as well as the the London Borough of Haringey Children's services. This case had shocked the public as well as the parliament as the abuses of the baby had been a signal of cruelty, humanity can reach and because of the failure of the professionals included in the case. If one reflects back on this horrifying case, he or she can thereby come across several incidences which should be avoided by him or her in her own healthcare practices to ensure safety and satisfaction of patients. A failure of critical thinking and decision making was observed which had given an unfortunate fate to the child. The professional did not have followed the core principle of caring for the patient. They did not empathize with the situation of the baby P and did not undertake proper actions that they should have taken for the patient. Even after understanding the fact, that the baby was bruised and abuse repeatedly, social workers lacked the courage of convictions (Telegraph.co.uk, 2008). This has been clearly reported in the daily called the Telegraph. They were not sure about their professional judgment and though they were mistaken to consider the bruises caused by family members. Moreover, they kept importance to uniting the baby and the mother for developing emotional attachment overriding the importance of the safety of the child. This lack of decision-making power can affect healthcare practices and therefore professionals need to develop critical thinking skills, decision making ability and learn to trust their intuition. Risk assessment ability was also poor. It was also noted that when four child protection agencies were summoned to attend a meeting to discuss the case, the attendance was poor. The social workers only attended but the lawyers, doctors and police were absent as reported by the daily (Wardrop, 2010). Within that period, the baby was already having two sets of injuries. This states that the professionals were not undertaking their duty towards the public and were not maintaining their duties and oaths they had towards nation. Moreover, a lack of partnership was observed among the different healthcare centers like the social workers, nursing professional, doctors and others and for this the result of the case became very negative. Lack of professionalism in the case had been one of the major reasons for the death of the baby. Failure of appreciation of risks was noted when the report stated that in spite of repeated injuries; the healthcare professionals provided little importance to the rationale that why a baby would be repeatedly bruised if no abuses are really taking place. Therefore, when the current healthcare professionals would be reviewing such cases, they can easily learn from the mistakes the healthcare professionals had conducted. They can apply their own reflective skills and find out what else could have been done in order to avoid the situations. The new professionals would learn the importance of decision-making skills, risk assessment skills and critical thinking skills. They would learn that of the three skills would have been used by the professionals; the baby would have been alive today. Therefore, in this way, by reflecting on past events, professionals can develop their skills and knowledge ensuring patient safety.

Conclusion:

From the entire discussion above, patient centered care is seen to ensure service delivery tom patient that not only ensure patient safety but also provides high patient satisfaction. Patient feel empowered, valued, loved, educated and confident about themselves that have positive outcomes on their health. For this, nurses need to develop a large number of attributes for being expert professionals. Effective communication, compassion, critical thinking ability, good scientific knowledge, attention to details and others are some of them. Moreover, effective reflective practice also helps nurses to engage themselves in lifelong learning from the events experienced by them. All these help them to evolve as expert nursing professionals who dedicate themselves for healthy lives of citizens.

References:

Arnold, E.C. and Boggs, K.U., 2015. Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Bramhall, E., 2014. Effective communication skills in nursing practice. Nursing Standard (2014+), 29(14), p.53.

Brooker, D. and Latham, I., 2015. Person-centred dementia care: Making services better with the VIPS framework. Jessica Kingsley Publishers.

Brown, J.M. and Schmidt, N.A., 2016. Service–Learning in Undergraduate Nursing Education: Where is the Reflection?. Journal of professional nursing, 32(1), pp.48-53.

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.

Eng, C.J. and Pai, H.C., 2015. Determinants of nursing competence of nursing students in Taiwan: the role of self-reflection and insight. Nurse education today, 35(3), pp.450-455.

Henry, M.M., 2016. The effect of repeat simulation after reflection on nursing students critical thinking, satisfaction, and self-confidence (Doctoral dissertation, Capella University).

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).

Koivunen, M., Niemi, A. and Hupli, M., 2015. The use of electronic devices for communication with colleagues and other healthcare professionals–nursing professionals’ perspectives. Journal of advanced nursing, 71(3), pp.620-631.

Koto?Shimada, K., Yanagisawa, S., Boonyanurak, P. and Fujita, N., 2016. Building the capacity of nursing professionals in Cambodia: insights from a bridging programme for faculty development. International journal of nursing practice, 22(S1), pp.22-30.

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.

LoBiondo-Wood, G. and Haber, J., 2017. Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Noushi, N., Bedos, C., Apelian, N., Vergnes, J.N. and Rodriguez, C., 2018. Person-Centered Care: Perspectives of free dental clinic users in Montréal, Canada. International Journal of Whole Person Care, 5(1).

Schmidt, N.A. and Brown, J.M., 2016. Service learning in undergraduate nursing education: strategies to facilitate meaningful reflection. Journal of professional Nursing, 32(2), pp.100-106.

Taschuk, B., Zhang, W.T.V., Flint, R., Howlett, C. and Andersen, E.A., 2017. Gaining awareness: Cultivating clinical reflection in nursing students. Nurse education in practice, 23, pp.A1-A2.

Telegraph.co.uk. 2008. Baby P case: Serious Case Review identifies key failures. [online] Available at: https://www.telegraph.co.uk/news/uknews/baby-p/5369126/Baby-P-case-Serious-Case-Review-identifies-key-failures.html [Accessed 18 Mar. 2018].

Wardrop, M. 2010. Baby P 'failed by incompetent staff from every agency'. [online] Telegraph.co.uk. Available at: https://www.telegraph.co.uk/news/uknews/baby-p/8086957/Baby-P-failed-by-incompetent-staff-from-every-agency.html [Accessed 18 Mar. 2018].

Wildevuur, S.E. and Simonse, L.W., 2015. Information and communication technology–enabled person-centered care for the “big five” chronic conditions: scoping review. Journal of medical Internet research, 17(3).

Yoo, M.S. and Park, H.R., 2015. Effects of case?based learning on communication skills, problem?solving ability, and learning motivation in nursing students. Nursing & health sciences, 17(2), pp.166-172.

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