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Clinical Nursing Skills

2.2 Patient-Centered Care

Clinical Nursing Skills2.2 Patient-Centered Care

Learning Objectives

By the end of this section, you will be able to:

  • Define the fundamentals of patient-centered care
  • Explain benefits of patient-centered care
  • Describe ways in which patient-centered care is a more transparent form of healthcare delivery

Picture this: a patient walks into a hospital or clinic, feeling vulnerable and uncertain about what lies ahead. Suddenly, the patient is greeted by a team of healthcare providers who prioritize their unique needs, preferences, and values above all else. They listen attentively to the patient’s concerns, involve the patient in decision-making, and tailor their care to align with the patient’s goals. That is the power of patient-centered care. It goes beyond treating the physical symptoms: it recognizes that the patient is a whole person with individual emotions, needs, and desires.

Patient-centered care puts the patient at the heart of the healthcare experience, empowering them to actively participate in their own care and leading to better outcomes, increased satisfaction, and a truly collaborative partnership with their healthcare team.

Fundamentals of Patient-Centered Care

A fundamental concept in nursing that places the patient at the forefront of healthcare delivery is patient-centered care (AACN, 2023). It recognizes the importance of understanding and respecting the unique needs, preferences, values, and beliefs of each individual patient. Patient-centered care takes a holistic view of the patient, considering their physical, psychological, emotional, and social well-being. Nurses assess and address not only the patient’s medical condition but also their personal and psychosocial needs. This approach recognizes that patients are unique individuals with their own life experiences, values, and beliefs that impact their health and healthcare decisions.

Patient as a Team Member

Patient-centered care involves a collaborative approach in which nurses work together with patients, their families, and other interdisciplinary team members. Shared decision-making empowers patients to actively participate in their care by providing information, discussing treatment options, and jointly deciding on the best course of action as a member of their own healthcare team. Nurses act as advocates, facilitating communication between patients and other healthcare professionals.

Although the patient is a member of their own healthcare team, patient-centered care ultimately recognizes patient autonomy, or the concept that patients have the right to make decisions about their own health care. Each patient is unique, with distinct physical, emotional, and social needs. Nurses should respect patients’ choices, values, and preferences and involve them in the decision-making process. This requires effective communication and active listening to understand and address the patient’s concerns. Nurses should strive to provide personalized care that considers the patient’s specific circumstances. This involves tailoring interventions, treatment plans, and education to meet the patient’s individual needs, cultural background, and beliefs.

Communication is crucial in patient-centered care. Nurses should use clear and concise language, avoiding medical jargon, and ensure that patients understand the information provided. Active listening skills are essential to comprehend patients’ concerns, fears, and expectations. Open and honest communication builds trust and fosters a therapeutic relationship between the nurse and patient. Respecting privacy and maintaining confidentiality are also integral aspects of patient-centered care.

Patient Conversations

Patient-Centered Care in Treatment Plan Development

Scenario: Registered nurse (RN) walks into the patient’s room. The patient just received news from the APRN that he has a diagnosis of chronic obstructive pulmonary disease (COPD). The RN is coming to talk to the patient about his new diagnosis, provide education, and help him establish an effective treatment plan.

Nurse: Hello, I’m going to be your nurse today. I understand you have COPD. Have you heard of COPD before?

Patient: Hello. I just got the news about having COPD, and honestly, it’s hitting me hard. I used to love hiking and gardening, but now it feels like even simple tasks are a struggle.

Nurse: COPD can be tough, and it’s normal to feel overwhelmed. One thing that’s important is to stay active. Let’s talk about your hobbies and activities. What is the one thing that matters most to you right now?

Patient: Well, I miss hiking more than anything. It has been a big part of my life, and I hate that it has become so difficult.

Nurse: I can tell how much hiking means to you. Let’s work on a plan to get you back on the trails, one step at a time. First, we’ll focus on managing your symptoms. We’ll go over the medications and how to use them effectively so you can breathe better.

Patient: Thank you. That’s helpful, but I also know I need to quit smoking. I’ve tried a few times, but it has been really difficult.

Nurse: You’re absolutely right. Quitting smoking is vital for managing COPD. I’ll connect you with some written and online resources to make it easier. We can talk to your provider to see if medication is an appropriate option. We’ll also talk about creating a smoke-free environment at home.

Patient: I appreciate that. But, let’s get back to hiking. I miss it so much, and it feels like a huge part of who I am.

Nurse: I hear you. Hiking is a significant part of your life, and we’ll work toward getting you back out there. We’ll start with an exercise plan tailored to your abilities, gradually building your strength and lung capacity. I’ll also provide techniques that you can use if you get short of breath during your hikes.

Patient: All of this sounds really helpful. But honestly, I’m worried I’ll forget some of it. Is there a way we can put this plan down in writing?

Nurse: Of course! We’ll create a personalized COPD action plan that outlines our goals and the steps we’re taking. I’ll make sure you have it in writing, along with some reliable resources for reference.

Patient: That sounds like a great plan. Thanks for being here for me and working on this together.

Nurse: You’re welcome! Remember, I’m here to support you and your goals. Let’s focus on getting you back on those hiking trails and enjoying the outdoors again.

Coordinated Health Care

Patient-centered care extends beyond individual encounters. Nurses should strive to provide continuity of care by promoting coordinated transitions between different healthcare settings and providers in order to improve patient outcomes. This includes clearly communicating patient information, practicing proper handoff procedures, and ensuring that patients feel supported throughout their healthcare journey. By promoting coordination and continuity, nurses help prevent fragmented and disjointed care.

Benefits of Patient-Centered Care

There are multiple benefits of patient-centered care, both for the patients and for other involved parties.

  • It enhances the overall patient experience, leading to higher levels of satisfaction. Effective communication promotes trust and rapport between patients and healthcare providers. When patients feel respected, heard, and involved in their care, they are more likely to feel satisfied with the healthcare services they receive.
  • It contributes to the job satisfaction of healthcare providers, including nurses. When nurses are able to establish meaningful connections with patients, collaborate in decision-making, and witness positive health outcomes, it can increase their professional fulfillment and motivation.
  • It can lead to cost savings in the long run, although patient-centered care requires an investment of time and resources. By actively involving patients in their care and tailoring interventions to their needs, unnecessary tests, procedures, and hospital readmissions may be reduced. Additionally, improved adherence to treatment plans can prevent complications and the need for more expensive interventions.

Improved Patient Outcomes

When patients are actively involved in their care and their preferences are considered, it can lead to improved health outcomes. Patients who feel empowered and engaged are more likely to adhere to treatment plans, manage chronic conditions effectively, and achieve better overall health. Table 2.3 lists some ways in which patient-centered care leads to improved patient outcomes.

Outcome Description Example
Enhanced treatment adherence Patients who are actively involved in their care and have a good understanding of their conditions and treatment options are more likely to adhere to prescribed treatments and medication regimens. This improved treatment adherence leads to better health outcomes and improved individual patient well-being. A 67-year-old patient with type 2 diabetes actively participates in setting her treatment goals, collaborates with her healthcare team to make treatment decisions, receives comprehensive education, and follows a personalized care plan that aligns with her lifestyle. This patient-centered approach enhances her treatment adherence, resulting in better blood sugar control and improved overall health.
Increased patient safety Patient-centered care encourages patients to ask questions, voice concerns, and provide important information about their health history and current conditions. This collaborative approach helps identify and address potential safety risks, reducing medical errors and improving patient safety. A 43-year-old male patient is scheduled for a surgical procedure, and informed consent is a priority. The medical team thoroughly discusses the surgery, explaining risks and benefits in plain language. The patient’s preferences, like anesthesia and pain management, are considered, and he actively participates in medication reconciliation. This approach enhances patient safety by ensuring clear communication, tailored care, and a comprehensive understanding of the procedure.
Enhanced patient communication and trust Patient-centered care prioritizes clear and effective communication between healthcare providers and patients in order to build trust. Trusting relationships foster a safe environment for patients to ask questions, seek clarification, and actively participate in their care. A 43-year-old female patient with a new breast cancer diagnosis visits her healthcare provider. During the routine checkup, the provider takes the time to actively listen to the patient’s concerns regarding her cancer treatment options and the lifestyle challenges they encounter. They engage in a collaborative conversation about treatment options. Complex medical information is conveyed in a clear, understandable manner, with visual aids to assist with comprehension. Importantly, the patient’s preferences, including dietary choices and exercise routines, are respected and integrated into the treatment plan. The provider listens patiently and with a nonjudgmental attitude. By respecting the patient’s preferences, a sense of ownership over their health is cultivated, strengthening the patient-provider relationship. The ideal outcome is that the patient experiences enhanced communication and trust with their healthcare provider.
Patient empowerment and self-management By providing education, information, and support, patients are equipped with the knowledge and tools to self-manage their conditions effectively. Empowered patients are more likely to engage in healthy behaviors, make informed decisions, and take responsibility for their own well-being. A 73-year-old male patient is diagnosed with high blood pressure. A nurse provides education on practical tools and strategies for self-management. This includes guidance on meal planning, exercise routines, blood pressure monitoring, and medication adherence. The patient is encouraged to actively monitor his blood pressure, record his progress, and attend regular follow-up appointments. Regular follow-up appointments allow him to discuss his achievements, challenges, and any adjustments needed in his care plan.
As a result of this patient-centered approach, the patient becomes increasingly empowered. He possesses the knowledge, skills, and confidence to make informed choices about his daily activities, diet, and medication. With the ongoing support and partnership of the nurse, the patient successfully manages his diabetes, achieving improved blood pressure control and an enhanced overall quality of life.
Improved patient satisfaction Patient-centered care focuses on meeting the unique needs and preferences of each patient. By actively involving patients in their care, listening to their concerns, and respecting their values and choices, nurses help patients feel heard, valued, and respected. They are more likely to have positive experiences with their healthcare providers and increased overall satisfaction. A 24-year-old female seeks care for a chronic health condition at a healthcare facility committed to patient-centered care. Upon arrival, the patient is greeted by a warm and empathetic receptionist who takes the time to ensure the patient is checked-in and ready for her appointment on time. During her consultation with the healthcare providers, the patient feels actively engaged in her care. Her treatment plan is developed collaboratively between the patient and her treatment team, incorporating her unique preferences and values. Her providers explain her condition and treatment options clearly, ensuring that she fully comprehends her choices. The patient feels respected and heard throughout this process.
As the patient progresses through her treatment plan, she experiences consistent communication with her healthcare team, including follow-up calls and emails. This proactive approach assures the patient that her well-being is a top priority for the healthcare facility.
The patient's overall experience reflects the principles of patient-centered care, where her values, needs, and preferences are honored. As a result, she not only experiences improved health outcomes but also expresses high satisfaction with her healthcare journey. Her confidence in the healthcare system grows, contributing to her commitment to the treatment plan.
Table 2.3 Improved Patient Outcomes of Patient-Centered Care

Improved Population Outcomes

Patient-centered care is a healthcare approach that prioritizes the individual patient’s needs, preferences, and values. While its primary focus is on the individual patient, patient-centered care has a broader impact by improving the overall quality of care provided and promoting better health outcomes for the whole community. Table 2.4 lists some ways in which patient-centered care improves population outcomes.

Outcome Description Example
Enhanced preventive care and health promotion Nurses work collaboratively with patients to develop personalized preventive strategies and educate them about disease prevention and health maintenance. A nurse establishes regular community health fairs that offer free or low-cost health screenings, such as blood pressure checks, cholesterol tests, and glucose monitoring.
Improved access to care Nurses advocate for equitable access to healthcare services, facilitate referrals, and help patients navigate the healthcare system. A nurse helps set up a telemedicine center in a rural community, equipped with technology such as videoconferencing equipment and diagnostic tools like digital stethoscopes and remote monitoring devices.
Reduction of health disparity Nurses recognize that different populations may face varying healthcare challenges and provide individualized care to address these disparities. Nurses understand and respect diverse patient needs and cultural backgrounds. A nurse creates a community program that collaborates with local farmers’ markets to provide fresh, affordable produce to low-income residents. Cooking classes are also offered to teach healthy meal preparation on a budget.
Empowerment of communities Nurses collaborate with community leaders and organizations, educate communities about health promotion and disease prevention, and facilitate access to resources. A neighborhood has limited access to fresh, healthy food options and a lack of green spaces. The residents in this community have expressed a desire for better nutrition and a stronger sense of community. A nurse helps establish a community-led urban garden initiative to address these concerns and empower the residents.
Feedback and quality improvement Nurses actively seek patient input, listen to their concerns, and use their feedback to make necessary improvements in care delivery. A nurse works at a community health clinic. The nurse institutes a program for the clinic where multiple ways are given for patients to provide feedback, including suggestion boxes, online surveys, and in-person feedback sessions. The goal is to make it easy for patients to share their experiences and suggestions.
Table 2.4 Improved Population Outcomes of Patient-Centered Care

Transparency of Healthcare Information

Patient-centered care emphasizes the importance of providing patients with accurate, understandable, and relevant information about their health conditions, treatment options, and care plans. This includes discussing risks, benefits, and alternatives to treatment in a transparent manner. Using transparent communication ensures that patients have the necessary information to make autonomous decisions about their care. This approach ensures that patients are fully informed and actively involved in all relevant decisions. By empowering patients with knowledge, nurses can ensure that they actively participate in decision-making and have a clear understanding of their healthcare journey.

Use of Technology

Modern technology facilitates patient-centered care by making it easier for patients to access their medical records, test results, and other relevant health information. This transparency allows patients to review their healthcare information, verify its accuracy, and actively participate in discussions about their care. Access to medical records enables patients to stay informed, engage in meaningful conversations with healthcare providers, and make informed decisions.

Better Resource Allocation

One broader benefit of transparent communication is that it can contribute to improved resource allocation in a number of ways. Resource allocation refers to the equitable and efficient distribution of healthcare resources to meet the diverse healthcare needs of patients and communities. When patients can easily access information about healthcare services, costs, and outcomes, they can make more informed decisions about their treatment options. This allows the patient to consider the value and cost-effectiveness of different interventions and choose the most appropriate and cost-efficient course of action. In addition, transparent healthcare information enables patients to understand their medical history, test results, and treatment plans. With access to this information, patients can effectively communicate with healthcare providers, reducing the risk of duplicate or otherwise unnecessary tests or procedures. Informed decision-making thus reduces unnecessary utilization of resources on treatments that may not provide significant benefits, thereby optimizing resource allocation.

Transparent communication holds healthcare systems, providers, and payers accountable for their resource allocation decisions. When patients have access to information about costs, quality, and outcomes, the monitoring and evaluation of healthcare services are facilitated. This transparency can drive providers and healthcare systems to optimize their resource allocation, improve efficiency, and deliver value-based care.

Increased transparency of healthcare information also enables patients to compare prices, quality, and outcomes across different providers or healthcare organizations. It allows them to compare such factors as accreditation standards and hospital rankings. This promotes competition and market forces within the healthcare system, as providers strive to deliver high-quality care at competitive prices. This competitive environment can incentivize providers to allocate resources efficiently and improve the value of services they offer.

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