Nd4002 Summative Assessment of Person Centred Care

Exploring the Person-Centred Coordinated Care in Nd4002 Summative Assessment

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Introduction of Nd4002 Summative Assessment of Person Centred Care 

In NMC or National Medical Commission, UK person-centred care is defined as offering care which is respectful of, responsive towards, and preferences of a single person, values and requirements and guarantees that patients' values usher every clinical decision. The person-centred care approach serves each person equally respectfully as the individual, irrespective of their treatment conditions. This person-centred care consists of searching and understanding the factors essential for the patients, and their respective families, supporting and cares people, promoting trust and developing mutual respect (Ding et al. 2019). There are four principles of person-centred care: serving people with respect, compassion and dignity, offering coordinated support, care and treatment, developing personalized care and treatment and supporting people in developing and recognizing individual abilities and strengths for a fulfilling and independent life. The main goal of the person-centred care approach is to focus on the person's as well as the patient's essential healthcare requirements and to motivate patients to become active members of their care (Safaeinili et al., 2020). There are some components of person-centred care, such as respecting the person, dignity, understanding of goals and experiences, confidentiality, responsibility and coordinated care. In obstacles, there needs to be more understanding, organizational barriers, and interdisciplinary and individual barriers found in interrupting the approach. To shed light on the concept of the person-centred care approach and its components and obstacles of it, the paper is going to discuss the components, like communication and privacy and obstacles, like lack of goal or motivation and lack of mental capacity. To understand the discussion more effectively, the writing will also elaborate on its applications in experiences.

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Discussion on implementing person-centred coordinated care

Critical components for implementing person-centred coordinated care

Respectful communication between health professionals and patients is essential as it reduces uncertainty and increases the enhanced person's engagement in decision-making, improves patients' cohesion towards treatment plans and medication, and increases support, patients' safety and satisfaction with care. As described by Santana et al. (2018, p. 430), communication in person-centred care consists of a commitment to counting the individuals' medical occurrences and understanding the person's whereabouts and preferences. As per NMC, successful communication in patient care is defined as the verbal or other communication style and methods for exchanging views to get the point across. As criticized by Bousquet et al. (2018, p. 45), communication in person-centred care includes obtaining the patients' plans with open-ended questions without interrupting them and engaging them in active, focused learning. By adopting positive communication in this care approach, an individual can understand the person and their personality, their history, respect the information and their roles in communication. Ensuring patient-centred communication is essential for guaranteeing the maximum health outcomes, reflecting the traditional nursing values, which are responsive and individualized towards patient heaths, contextual variables and beliefs. 

Privacy, or the ability to keep the individuals’ essential information safe, is the main idea behind dignified care. As per NMC and The Code for Professional Standards of Practice and Behaviour for Nurses and Midwives, it is essential to keep the patient's privacy to increase the person's willingness to seek care. As noted by Ballard et al. (2018, p. e1002500), the creation of a faithful environment by giving respect to patient privacy stimulates the patient to seek care and remain honest during healthcare visits. Protecting data security is also significant as health research demands the storage, usage and collection of vast amounts of identifiable personal health information, maximum of which is potentially embarrassing and sensitive. Naldemirci et al. (2018, p. 55) contradicted that privacy is also essential in maintaining the dignity factor in the fundamental aspects of the Person-centred care Approach. It maintains that the individual has the idea that no one will enter his or her personal space, rooms or other belongings until proper permission is given by the same person (Afulani et al. 2019). There are some strategies for protecting the patients’ privacy in the person-centred care approach, such as building a security culture in the institution, performing a solid risk assessment on security, creating a security improvement plan and lastly, encrypting the patients’ data.      

Application to experience

In the case of communication, it is essential to have the best effective relationship with the patients and colleagues. During my placement days, I also had the responsibility of finding the patients' wishes and requirements and avoiding any significant miscommunications and misunderstandings. I had to maintain proper communication with the service user, and they were likely to get confidence from the conversation and put trust in me. One of the patients gave feedback on supporting communication among the patients and clinicians through the contribution of safety, and that feels safe both physiologically and psychologically. He also wrote about the helpful nature of the consultant (me) and the register who were explaining the operations, and they are after-effects in such a way that it minimizes the tensions in half, and he was not at all felt concerned about eth operation.

One of the scenarios describes the significance of overriding confidentiality or privacy while handling patients by professionals. I was the care worker, and I went to assist an older man in his home, I did not usually look after the man, but this regular care worker was absent for the week. While I was changing his clothes, I found many bruises on his back, and when I asked him about the marks, he said his regular worker attacked him last week, which resulted in the bruises. He thinks that he said something illogical, due to which the co-worker became angry and started calling and hitting him. Though I was very concerned about the old man's safety, he said that the fault was entirely him and that his silly jokes made him do this thing, and he became upset and didn't want the worker in trouble. This situation felt me in a dilemma as, on the one side, I had the responsibility to inform the authority about eth incident; on the other hand, the older adult advocated for the workers is being pleasant and telling the incident in confidentiality and not break the trust. However, here I had to break the privacy and override the duty to protect the man from further harm and to save the older man's interests.

Obstacles to implementing person-centred coordinated care

Besides poor communication, there are other prominent barriers like lack of goal or motivation and lack of mental capacity that limit the entire understanding of the professionals and service users and make things complicated and delayed in response. Bousquet et al. (2019, p. 16) demonstrated that motivation is closely related to job satisfaction that retains workers in their respective jobs over time. Retention of health workers decreases the costs of the health system for hiring, orienting and recruiting new workers and even reduces the possibility of vacant posts. In NHS, the lack of motivation or goal resulted in not only job dissatisfaction but also the lower quality of the working performances, and the quality of the care they are offering becomes less efficient and less effective. This person-centred care consists of searching and understanding the factors essential for the patients, and their respective families, supporting and cares people, promoting trust and developing mutual respect. As said by Larson et al. (2019, p. 563), by using solid motivational techniques like the detection of motivational requirements and non-compliance, adopting motivational communication, interacting with patients, and using contextualized games and applications, employers can put some control back into their hands. Thus, the professional can encourage the service providers as well as the patients to take part in self-management activities by involving particular strategies catered to the individuals.

Mental capacity is often defined as the legal ability to make decisions about treatment, care, their place of living, like the concept of Power of Attorney. Mental capacity is the time and decision specific, and it is the ability to take own decisions in terms of person-centred care when a person becomes unable to take any big decision regarding care or treatments due to dementia, prominent learning disability, brain injury, stroke, mental health illness and so on (Cardiff et al. 2018). As per the Mental Capacity Act 2005, patients’ behaviour, appearance or diagnosis should not lead someone to an early presumption of an individual's mental capacity. Kuipers et al. (2019, p. 4) said that this law protects the rights of people who lack the mental capacity to make decisions. Moreover, it also says an individual’s ability to make decisions should be optimized before any conclusion, and each practicable step, such as using interpreters, pictures or sign languages, giving sufficient time and repeating the assessments, should be taken this time. Clinicians are legally needed to read and understand the factor, offer guidance, and prove this if asked. Marchand et al. (2019, p. 8) argued that this act applies to people of 16 and over the age group and is prepared to empower and protect them from minor daily chores to significant decisions like surgery.

Application to experience

As noted by Fix et al. (2018, p. 302), most failures found in motivation between clinicians comprise miscommunication of essential information about a patient's condition or symptoms, poor communication skills, language difficulties, workload and weak documentation of the patient’s information. Though I was not directly involved in it, I had experienced the disastrous results of a lack of motivation in the health sector in terms of delayed action. There was a situation during the pandemic when a nurse failed to demonstrate the conditions of the patient to the surgeon. The patient suffered abdominal pains after the surgery and had a low count of red blood cells which was a sign of internal bleeding. Unfortunately, later the patient died due to a haemorrhage. 

Bokhour et al. (2018, p. 6) demonstrated that clinicians are often aware of issues like lack of mental capacity among the people and the Mental Capacity Act 2005 works to protect the interests of these people in the UK. A few times back, I experienced a situation that occurred due to the lack of these capabilities. A 76 years man visited the hospital with mild chest pain, and tests found an ST-elevation myocardial infarction; he was advised to admit to the hospital as soon as possible. But he was willing to do so as he would attend his son's wedding in some other place. He was very much anxious and distressed about taking any proper decision.     

Conclusion

In conclusion, person-centred care means working with the individuals and learning about their important factors of them, such as care options and treatments, strategies of self-management, accurate information about the care, treatment risks, benefits and choices. The main factor of confidentiality in the healthcare sector is protecting privacy and respecting individuals' wishes. Moreover, the person-centred care approach serves everyone equally respectfully as individuals being irrespective of their treatment conditions. It also depicted professionals like social workers, employers, nurses, doctors, and support workers don't have any right to share the personal details of any patients with others until there is permission from the person themselves or it is necessary. It is necessary to develop effective communication in the care as if any of the parties are unable to understand the conveyed information, the treatment will get delayed. Communication and privacy are two essential aspects of the patient's care that helps in making the treatment and care services easier through a strong bond of trust between the patients and the clinicians. Otherwise, the importance of motivation and mental capacity are also observed severely by medical practitioners because of relativity into the treatment and progress into the industry. Moreover, Retention of health workers decreases the costs of the health system for hiring, orienting and recruiting new workers and even reduces the possibility of vacant posts. While going through my placement, I got to experience some of the incidents regarding the communication, motivation, mental capacity and privacy-related issues in this sector that I had discussed earlier.

References

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Kuipers, S.J., Cramm, J.M. and Nieboer, A.P., 2019. The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research19(1), pp.1-9. https://link.springer.com/article/10.1186/s12913-018-3818-y

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Marchand, K., Beaumont, S., Westfall, J., MacDonald, S., Harrison, S., Marsh, D.C., Schechter, M.T. and Oviedo-Joekes, E., 2019. Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review. Substance abuse treatment, prevention, and policy14(1), pp.1-15. https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-019-0227-0

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Safaeinili, N., Brown?Johnson, C., Shaw, J.G., Mahoney, M. and Winget, M., 2020. CFIR simplified: Pragmatic application of and adaptations to the Consolidated Framework for Implementation Research (CFIR) for evaluation of a patient?centered care transformation within a learning health system. Learning health systems4(1), p.e10201. https://onlinelibrary.wiley.com/doi/pdf/10.1002/lrh2.10201

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