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Lecture

NUR1 220 Lecture Notes - Dignity, Document Collaboration


Department
Nursing
Course Code
NUR1 220
Professor
Sonya Laszlo

Page:
of 3
Practice Recommendations:
Client Centred Care
Values and Beliefs of Client Centred Care:
- The client is the one who decides if and who will participate in
his/her care.
- Respect
- Human dignity
- Clients are experts for their own lives
- Clients as leaders
- Clients’ Goals coordinate care of the health care team
- Continuity and Consistency of Care and Caregiver
- Timelines
- Responsiveness and universal access
o Responsiveness to their wishes, values, priorities,
perspectives, and concerns
Core Processes of Client Centred Care:
- Identifying concerns/needs
- Making decisions
- Caring and service
- Evaluating outcomes
Nursing actions:
1. Identifying concerns/needs
o Initiate discussion or strategies to understand the
client’s perspective regarding his/her health and quality
of life.
Questions:
What is this situation like for you?
What are the most important goals to you?
What are your goals?
What does quality of life mean for you?
How involved do you want to be?
What would you like to know about?
What gives you the strength to carry on?
What has worked for you before?
Who in your family or friends would help you?
How will you know what you will be able to
manage on your own?
o DETERMINE HOPES - Seek to clarify the hopes, wishes,
preferences, strengths, needs, and concerns of the client,
from his/her perspective (GOALS):
Questions:
What do you hope happens?
What do you see down the road?
What are your concerns?
What do you need/expect from your health care
team?
o CLARIFY WISHES Clarify the client’s wishes and follow
his/her lead in determining the involvement of others in
their health care:
Questions:
What do you want to involve in your care?
Who else should be involved in this
meeting/project?
What is important to you?
Who would you like to make decisions for you, if
you were unable to make them yourself?
o Represent the CLIENT’S/COMMUNITY’S PERSPECTIVE
on health, goals in life, as well as their concerns when
making recommendations to others
o Follow the client’s lead when providing information or
teaching that the client wants with respect to his/her
health/illness situation.
must be taught in a way that is relevant to the
client
based on their readiness
o Document the client’s perception with regard to health and
quality of life, goals, wishes, choices regarding info and
concerns.
2. MAKING DECISIONS
o Client is key decision-maker
To find out what the client thinks = spend time
figuring out what their perspectives are
o Identify priorities for change or action
What’s most important to you now?
o Identify options from client’s community’s perspective
What do you think your options are?
How do you see that happening?
Can you picture that?
o Act as a resource for clients in deciding care strategies
Clarify and provide info or teaching that clients want and
say they need, with respect to their health/illness
situation or possible health strategies
What do you need in order to...?
What would help you....?
o Advocate for the client’s/community’s values and
decisions::
Encourage participation
Present their point of view in
conferences/program planning
Document collaboration in care plan/reports
3. CARING and SERVICE
o Involve clients throughout
o Acknowledge that they are experts
Encourage to share
Use their language
o Respect and honour their choices
o Use trust-building strategies to develop the nurse-
client relationship
o Demonstrate respect and value for clients
Listen
Be open
Be available
Accept and validate
o Use positive language
Use client’s own words
Strength-based language
Do not describe clients as compliant/non-
compliant
They are not problems or diagnoses
o Involve family and other significant others
o Ensure that the client’s goals are central to the
coordination, continuity and consistency of care:
Customised plans
Inform other professionals about the client’s
perceptions
Act as a resource
4. EVALUATING OUTCOMES
o Engage the client in evaluating care delivery and health
related outcomes
How is the care you are receiving?
How do you feel about your progress?
What is important to you in achieving your goals?
o Support the client if or when goals cannot be met
Is there another way to achieve the same
outcome?
What would help you?
What else can I do to help?
o Utilize specific processes/evaluations of what the client
thinks of the care given to them
How was your care/service today?
o Demonstrate an attitude of openness to change. There
may be ways to improve care.
What could we have done better?
o Change care plans and practice approaches in order to
improve quality from the client’s perspective – do what
is best for the client