ADA PCC

TITLE: Patient Centred CareBYTHERESA OFFORMENTAL HEALTH NURSINGSTUDENT NO: 21341995The aim of this essay is to critically explore the core concept of care that relates to professional nursing practise and the concept chosen for this essay is patient centred care. The essay will be structured to explore what is care and patient centred care, its link to contemporary nursing practice and quality of care in mental health nursing. The rationale and importance of PCC in engaging with service users.A discussion on how PCC can facilitate the development of caring professional and ethical relationship to enable the delivery of person centred-care will be covered and the significant of communication in informing future nursing practice will be explored. There will be a conclusion that will summarise the key learning points that have emerged from the discussions above and recommendations will be provided.Marin Kawamura (2013) defined care as a general approach and vital in every individual, influenced by values, culture, gender and society. There are several definitions of what care is. For instance, when a nurse looks after a patient and makes an impact to the patients recovering process. In other words, care entails inter mutual understanding, connection, recognition and engagement between service users and nurses. Nelson and Gordon (2006) pointed out that nurses deliver care to people who use healthcare services by administering treatment and medication, assist them with medical procedures, clear their droughts, orientate and give explanation to patients on every step of their care and carry their relatives along. This implies that to get a satisfactory outcome on this, they have to place the patients in the centre of their care. Pincus et al (2007) supported this point by contending that health care professionals in the past and in some cases, assume that service users cannot make decision or speak out for themselves, therefore, tend to provide care for patient without involving them and also make decision for them. Person centre care according to Liberati et al (2015) is a concept that uses healthcare services to provide primacy to the voice, needs and concerns of the patients. This is a crucial aspect in healthcare system. The word patient centred care started from the conceptual writing of the 1960s (Baliant 1969). It was initiated by psychiatric group practicing in the United Kingdom who was teaching general practitioners and medical students to be more conscientious regarding the emotional issues of the service users. (Baliint 1969). Later in 1990s, it was employed as a means of examining inpatient hospital say (clearly et al 1991). PCC has grown from what it’s used to be initially to a conceptual system of how to deliver and provide care that is targeted to satisfy the needs of individual patient at the centre of their care and sees the patient as an individual with social, psychological and physical needs. Accepting the patient as a whole, care with dignity and respect is considered as a primary idea of PCC .A care plan specifically designed for an individual, putting into consideration of the individual’s needs, choices and preferences and that of their significant other is referred as PCC NHS England (2013). In addition to this, Robinson et al (2008) view of PCC as personalisation of service users care, involving the patient in their own care through information and shared decision making. Some principles of person centred care includes, patients should be seen by health care professional as an individual and not as a cluster of illness (McCormack and McCance 2010). PCC is a means of holistically viewing sickness and health that influence the wellbeing of an individual, supporting and giving the individual power by increasing his/her role in their care, bearing in mind of the patients viewpoint and permitting them to make inform decision (Ponte et al,2003).According to McCormack and McCance(2006), they pointed out that reassuring, comfort, legitimacy, support, confidence and acceptance are the primary functions of PCC. It is designed to educate service users with suitable health advice for them to make informed decision and also engaging them in decision making. PCC entails patient’s care via a scope of activities which includes considering patient’s values and beliefs, permitting them to have autonomy and control and building therapeutic relationship with them. PCC should be tailored and co-ordinated towards individual’s needs, continuousness, comprehensive and easily accessible not minding where care is given (Perez- Merino,2014).PCC can be viewed in two approaches which includes a process and a system model. A process model is an approach that adopts consciously the patients view and clarifies activities like coordinating and integrating the care, regarding the values and beliefs of the patient and expressed needs; giving information, support, communicating and enlightening on the care and treatment; as well as incorporating patients and their families in decision making and ensuring continuity and transition of patient’s care. It involves designing specified plan of treat that will be determined on the patient’s values and choices (Read.A,2011).A system model involves the understanding of person centred environment and placing patients in a suitable environment to establish the maximum recovery, is important in carrying out person centred care. Therefore, patients should be welcomed and accepted where PCC is delivered (Shaller,2007).Creation of a patient’s- centred environment is highlighted in the system model in order to implement PCC successfully in health care practice whereas the process model explains several activities for PCC (Roberts.D,2013)It is crucial that nurses develop skill, understanding, therapeutic relationship between service users and their families in relation with the 6cs( care, compassion, communication, commitment, competence and courage) for PCC to be provided.In a care process emotional support is vital, especially where a service user’s reality can be neglected by his symptom and stigma attached to a mental health patient (Corrigan, Watson, Byrne and Davis, 2005). Constructing or building an atmosphere of patient- centeredness involves range of changes which includes communication skills, excellent listening, employing new ways of rendering care and empowerment in PCC delivery is essential (Downey-Ennis,2006)In recent years as indicated by Pelzang (2010), health section is growing very fast and ways of carrying out PCC particularly in institutional levels are improving. Moreover, in order to assist health care professionals deliver PCC in their clinical practice, a framework called person – centred nursing (PCN) is developed (McCormack and McCance,2006).There are some limitations or barrier that hinders the implementation of patient centred care and these are poor knowledge of what PCC involves and again ambiguity of the meaning of PCC on its own is a problem to carryout PCC (Davis et al, 2007), poor teamwork, inadequate professional training, continuity of care, lack of coordination, insufficient staffing level for instance, in a clinical area, constantly being under staffing can pose a problem in delivering PCC. Preferences and beliefs as well as social and cultural background. Policies and procedures in some Trust can hinder the implementation of PCC ( Pelzang,2010). Some of the advantages of PCC have already been explained in the definition of the concept above. Additionally, PCC enhances continuity of care and unification of health care practitioners working unanimously in the patient’s best interest, minimising the movement of services users through the hospital, maintaining the autonomy of service users and again empowering the healthcare practitioners make plans on how to carry out their work in a way that is most appropriate to the needs of the patients. On the hand, there are some disadvantages of PCC which includes; a lot of time is required sometime in delivery PCC and resources most often becomes a barrier and mostly at organisational or practical level, the need for structural changes often becomes difficult (Robinson et al 2008).In conclusion, PCC motivation is targeted to transform healthcare system in a way that patients can actually feel that their needs, values, beliefs, dignity and preferences are respected. Satisfaction of health care outcome is not only according to healthcare definition but also in the best interest of the patients as well. PCC is believed to minimise cost of care, enhance the standard of patient’s care.Basically, involving and engaging patients in making decision, providing their physical needs, promotes satisfaction to healthcare professionals and patients to improve to the best of their ability. Healthcare professionals’ experiences in working with various service users with different conditions on day to day account and again develop therapeutic relationship with the patients enable them to be better and professional caregivers. As a result, a strategic and coordinated approach is required in PCC, with the provision of adequate staffing level, effective teamwork and provision of education to healthcare professionals in order for every nurse in their respective environment to be competent in delivery patient centred care.On recommendation, future nursing practice especially in mental health setting, awareness of PPC should be increased. For instance, in universities and other institutions of higher learning, there should be a modification of academic curriculum to make sure future health care professional or nurses acquires excellent education and training that will improve both experience and knowledge in PCC and create research and project to improve PCC in our environment.References:Adams, N. & Grieder, D.M. (2005). Treatment Planning for Person – Centred Care: The Road to Mental Health and Addiction Recovery. London: Elsevier Academic Press.Balint, E. (1969). The possibilities of patient-centered medicine. Journal of the Royal College of General Practitioners, 17, 269-276Cleary, P. D., Edgman-Levitan, S., Roberts, M., Moloney, T. W., McMullen, W., Walker, J. D.,& Delbanco, T. L. (1991).  Patients evaluate their hospital care:  A national survey.  Health Affairs, 10, 254-267Davis, K. E. (2005).  Mental illness stigma:  Problem of public health or social justice?  Social Work, 50 (4), 363-368Department of Health (2012). Compassion in Practice. Nursing, Midwifery and Care Staff. London: The Stationary OfficeDowney-Ennis, K. (2006) ‘Patient-centredness’, International journal of health care quality assurance, 19(5). doi: 10.1108/ijhcqa.2006.06219eaa.001Griffith, R and Tengnah, C (2014) Law and Professional Issues in Nursing, 3rd Edition, Learning Matters: SAGE.Liberati, E.G., Gorli, M., Moja, L., Galuppo, L., Ripamonti, S. and Scaratti, G. (2015) ‘Exploring the practice of patient centered care: The role of ethnography and reflexivity’, Social science & medicine (1982), 133, pp. 45-52. doi: 10.1016/j.socscimed.2015.03.050Marin Kawamura, K. (2013) ‘Understanding the concept of care in cross‐cultural settings: Toward a resource definition of care in work organizations’, Cross Cultural Management: An International Journal, 20(2), pp. 100-123. doi: 10.1108/13527601311313373.McCormack, B. and McCance, T. (2010) Person-centred nursing: theory and practice. Oxford: Wiley-Blackwell.McCance, T., Slater, P. & McCormack, B. (2009). “Using the caring dimensions inventory as an indicator of person-centred nursing.” Journal of Clinical Nursing. 18,(3), pp. 409-417. McCance, T., Slater, P. & McCormack, B. (2009). “Using the caring dimensions inventory as an indicator of person-centred nursing.” Journal of Clinical Nursing. 18,(3), pp. 409-417.McCormack, B. and McCance, T. (2010) Person-centred nursing: theory and practice. Oxford: Wiley-Blackwell.McCormack B, McCane, TV (2006) Development of a framework for personcentred nursing. J Adv Nurs 56(5): 472-9.Nelson S, Gordon S (2006) The complexities of care: nursing reconsidered. Ithaca, New York; ILR Press, London.NHS England (2013). Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16. London: The Stationary Office. Pelzang, R. (2010) ‘Time to learn: understanding patient-centred care’, British Journal of Nursing, 19(14), pp. 912-917. doi: 10.12968/bjon.2010.19.14.49050Perez-Merino, R. (2014). “Strategies for enhancing the delivery of person-centred care.” Nursing Standard. 28,(39), pp. 37-41.Ponte PR, Conlin G, Conway JB et al (2003) Making patient-centered care come alive: achieving full integration of the patient’s perspective. J Nurs Adm 33(2): 82-90Pincus,G., Page, A.E.K., Druss, B., Appelbaum, P. S., Gottlieb, G., and England, M. J. (2007). Can psychiatry cross the quality chasm? Improving the quality of health care for mental and substance use conditions. American Journal of Psychiatry, 164 (5), 712-719.Reed, A (2011). Nursing in Partnership with Patients and Carers. Learning Matters Ltd.Roberts, D. (2013). Psychosocial Nursing Care. A guide to Nursing the Whole Person. Open University Press.Robinson JH, Callister LC, Berry JA, Dearing KA (2008) Patient-centered care and adherence: Definitions and applications to improve outcomes. J Am Acad Nurse Pract 20(12): 600-7Royal College of Nursing (2009). Person-Centred Care. Online. Available from: http://www.rcn.org.uk/development/learning/learningzone/clinical_skills/dignity_introduction/personcentred_care (Accessed March 12, 2019)Shaller D (2007) Patient-centered care: what does it take? Picker Institute, Oxford and The Commonwealth Fund. Available from http://tinyurl.com/shaller (accessed 10 March 2019).

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