Family Centered Care

Family Centred CareCarol HilliardNPDC2007

1

Carol Hilliard 2007Overview of lectureDefinition of FamilyRole of the familyIdentify the members of a family

Family centred care (FCC)

2

Carol Hilliard 2007What is a family?

3

Carol Hilliard 2007What is a family?

4

Carol Hilliard 2007What is a family?Several interpretations of a familyOur interpretation often depends on our own experience of family

In todays world we must be open to the many types of families we meet.

Ultimately the family is defined by itself

Therefore as nurses, we need to establish who is in the childs family

5

Carol Hilliard 2007The Child in HospitalHospital can be new and frightening for children

Often, their families are the only familiar aspect

Hospital should not diminish the familys role in childrens care.

FCC recognises that nursing care is most effective if done in conjunction with the parents

6

Carol Hilliard 2007Family-centred care (FCC)Broadly defined as promoting a partnership between the parents and healthcare professionals in the care of the child (Smith et al. 2002)

7

Carol Hilliard 2007The familyAssess the family relationships:Are both parents involved?

How many siblings in the family?

Are the grandparents etc. involved in the childs care?

Any other important people?

Will someone stay with the child in hospital?

8

Carol Hilliard 2007

9

Carol Hilliard 2007The role of the nurseIntroduce yourself to the child & parents

Show the child & parents around the ward:-tell them about the hospital facilities

Ask parents if they:- slept well, had breakfast, etc.

Explain the care the child will receive that day / night

Explain what you are going to do, for example, measure blood pressure, dressing change

Ask parents what they would like to do

Ask them if they have any questions

10

Carol Hilliard 2007Parents have a right to make decisions about their child

Therefore:

Parents need to have information about their childs condition, treatment and nursing care

11

Carol Hilliard 2007Answering questionsDo not be afraid to say I do not know when a child / parent asks a question

Tell child / parents I do not know but I will get that information for you

12

Carol Hilliard 2007NegotiationHelping parents to be involved in their childrens care is an important part of FCC

Nurses and parents need to decide who will perform the care the child will need, for example:- Showering the child- Changing a wound dressing- Feeding the child

How does the nurses routine suit the parents routine?

13

Carol Hilliard 2007Family-Centered Care (FCC)Remember: Parents do not know that they can be involved in their childs care

Therefore, nurses must explain to them

But nurses should not expect parents to be involved

Therefore, negotiate with the parents what they can do and what they want to do

14

Carol Hilliard 2007A common myth is that family centred care involves the parents staying with their child in hospital.

This is not true

Family centred care means that we support the parents to be involved as much as possible in the childs care

15

Carol Hilliard 2007Reasons parents may not stay with their child in hospitalOther childrenExpenseTheir job Personal reasonsOthers

Remember: it is not our job to judge parents

16

Carol Hilliard 2007The cost of staying with a child in hospitalFoodParents accommodationTransportPossibly loss of earningsChild-minders for other siblingsTelephone billsToys & treats for the sick child

17

Carol Hilliard 2007Important PointsParents are not extra or unpaid nurses and should never be expected to replace nursing shortages

Parents should not be expected to be involved in their childrens care - Parents can decide if they want to be involved or not

Never assume that a parent will do something

Never judge parents because of your own personal opinions

18

Carol Hilliard 2007ReferencesBattrick C. and Glasper E.A. (2002) The views of children and their families on being in hospital, British Journal of Nursing 13(6), 328-336.

Callery P. (1997) Paying to participate: financial, social and personal costs to parents of involvement in their childrens care in hospital, Journal of Advanced Nursing 25(4), 746-752.

Casey A. (1995) Partnership nursing: influences on involvement of informal carers, Journal of Advanced Nursing 22(6), 1058-1062.

Children in Hospital Ireland (2002) The EACH Charter for children in hospital & annotations, Children in Hospital Ireland, Dublin.

Coyne I.T. (1995) Partnership in care: parents' views of participation in their hospitalised child's care, Journal of Clinical Nursing 4(2), 71-79.

Dudley S.K. and Carr J.M. (2004) Vigilance: the experience of parents staying at the bedside of hospitalised children, Journal of Pediatric Nursing 19(4), 267-275.

Espezel H.J.E. and Canam C.J. (2003) Parentnurse interactions: care of hospitalized children, Journal of Advanced Nursing 44(1), 34-41.

19

Carol Hilliard 2007ReferencesFriedman M (1998) Family nursing: theory and practice, 4th edition. Appleton-Century-Crofts, Norwalk, CT, USA.

Lindsay B. (2001) Visitors and childrens hospitals, 1852-1948: a re-appraisal, Paediatric Nursing 13(4), 20-24.

Lupton D. and Fenwick J. (2001) Theyve forgotten that Im the mum: constructing and practising motherhood in special care nurseries, Social Science & Medicine 53, 10111021.

Shields L. and Tanner A. (2004) Costs of meals and parking for parents of hospitalised children in Australia, Paediatric Nursing 16(6), 14-18.

Smith L., Coleman V. and Bradshaw M. (eds) (2002) Family-centred care: concept, theory and practice, Palgrave, Basingstoke, Hampshire.

Valentine F. (1998) Empowerment: family-centred care, Paediatric Nursing 10(1), 24-7.

Wang K.W.K. and Barnard A. (2004) Technology-dependent children and their families: a review, Journal of Advanced Nursing 45(1), 36-46.

20