Family Centred Care

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Family Centred Care

• Carol Hilliard
• NPDC
• 2007

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Overview of lecture

• Definition of Family
• Role of the family
• Identify the members of a family
• Family centred care (FCC)

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What is a family?
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What is a family?
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What is a family?

• Several interpretations of a family
• Our 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

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The Child in Hospital

• Hospital 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

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Family-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)

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The family

• Assess 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?

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The role of the nurse

• Introduce 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

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• Parents have a right to make decisions about
• their child
• Therefore
• Parents need to have information about
• their childs condition, treatment and nursing
  care

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Answering questions

• Do 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

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Negotiation

• Helping 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?

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Family-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

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• A 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

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Reasons parents may not stay with their child in
hospital

• Other children
• Expense
• Their job
• Personal reasons
• Others
• Remember it is not our job to judge parents

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The cost of staying with a child in hospital

• Food
• Parents accommodation
• Transport
• Possibly loss of earnings
• Child-minders for other siblings
• Telephone bills
• Toys treats for the sick child

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Important Points

• Parents 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

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References

• Battrick 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.

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References

• Friedman 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.