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Ns. Rinik Eko Kapti, S. Kep. M. Kep.

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ChilduniqueNot adult

DependentGrowth and development in healthy and sickcondition

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The family is the constant in a child’s life.Parents are experts in their child’s careand know more about their child then wecan ever learn through assessments orcharts.The family is also the child’s main sourceof support providing stability in what canbe an otherwise traumatic period in achild’s life.The presence of the family during healthrelated procedures can significantly reduceboth the child’s and parent’s anxiety

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Nurses must work with the family todevelop the best plan of care for a child.Decreased anxiety from the patient and

family decreases the stress on healthcareworkers, positively affecting their ability toprovide treatment.In essence the nurse must attend to both

the needs of the family and child in orderto maximize a child’s outcomes.

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Pediatric care has adopted the philosophyof a family-centered care approach inorder to maximize the well being of pediatric patients.The philosophy is founded on thecollaboration of the family, nurses andhospital staff to plan, provide, andevaluate care.

The philosophy is grounded on severalprinciples that revolve around the centralidea that the family is the constant in achild’s life

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Family-centered care is a model of health caredelivery that emphasizes providing information,

giving parents control over decision making, and respecting and supporting parents (King, King,osenbaum, & Goffin, 1999).

Family-centered care is a model of health care inwhich families and medical professionals workcollaboratively to determine the content and processof children’s health care services (Letourneau &Elliott, 1996; Macnab, Thiessen, McLeod, & Hinton,2000; Woodside, Rosen-baum, King, & King, 2001).Family-centered care is an approach to healthcarethat shapes health care policies, programs, facility design, and day-to-day interactions among patients,

families, physicians, and other health care professionals.

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Family-centered care emerged as animportant concept in health care, at a timeof increasing awareness of the importance of

meeting the psychosocial and developmentalneeds of children and of the role of familiesin promoting the health and well-being of their Children.

Family-centered care has long been acharacteristic of an effective medical home.Much of the early work focused on hospitals.

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RespectInformationParticipation

Colaboration(Institute for Family-Centered Care (2009))

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Respecting each child and his or her familyHonoring racial, ethnic, cultural, andsocioeconomic diversity and its effect on thefamily’s experience and perception of care

Recognizing and building on the strengths of each child and family, even in difficult andchallenging situationsSupporting and facilitating choice for the child

and family about approaches to care and supportEnsuring flexibility in organizational policies,procedures, and provider practices so servicescan be tailored to the needs, beliefs, andcultural values of each child and family

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Sharing honest and unbiased information withfamilies on an ongoing basis and in ways theyfind useful and affirmingProviding and/or ensuring formal and informal

support (eg, family-to-family support) for thechild and parent(s) during pregnancy, childbirth,infancy, childhood, adolescence, and youngadulthoodCollaborating with families at all levels of healthcare, in the care of the individual child and inprofessional education, policy making, and pro-gram developmentEmpowering each child and family

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The most important task of the nurse in fccis to provide support to the family.There are two key components of support,

these are enabling and empowerment.Enabling refers to providing opportunities for thefamily to display their current skills whilelearning and acquiring new skills.

Empowerment refers to the ability of thehealthcare team to allow families to acquire asense of control over their family’s lives

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Family presence during health careprocedures decreases anxiety for the childand the parents.

Recovered faster and discharged earlierCried less, less restless, and required lessmedicationEmotional distress, coping during procedures,and adjustment during hospitalization werecontrolled

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Parent-to-parent support can increasedparents’ confidence and problem -solvingcapacity.

Family-to-family support can have beneficialeffects on the mental health status

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A stronger alliance with the family inpromoting each child’s health anddevelopment

Improved clinical decision making on thebasis of better information and collaborativeprocessesImproved success when the plan of care is

developed collaboratively with familiesGreater understanding of the family’sstrengths and care giving capacities

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More efficient and effective use of professional time and health care resources(eg, more care man-aged at home, decreasein unnecessary hospitalizations andemergency department visits, more effectiveuse of preventive care)Improved communication among members of

the health care teamGreater child and family satisfaction withtheir health care

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Ensure that the core concepts of familycentered care are incorporated into allaspects of nursing practice.

Respect for parents’ unique insight into andunderstanding of their child’s behavior andneeds.Decisions on a patient’s plan of care should

be made only after such consultation withchild and family has been made.Working with families in decision making andinformation sharing in all practice settings

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Parents should be offered the option to bepresent with their child during medicalprocedures and offered support before,during, and after the procedure.Promote the active participation of allchildren in the management and direction of their own health careShare information with children and families

in ways that are useful and affirming.Ensure that there are systems in place thatfacilitate children and families’ access toconsumer health information and support.

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Encourage and facilitate family-to-familysupport and networking, particularly withfamilies of similar cultural and linguisticbackgrounds or families who have children withthe same type of medical condition.Health care institutions should design theirfacilities to promote the philosophy of family-centered care.

Pediatricians should advocate for opportunitiesfor children and families to participate in designplanning for renovation or construction of hospitals, clinics, and office-based practices.

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In the pediatric setting nurses have theadditional responsibility of establishing arelationship with the family. Children arespecial patients and require a uniquedelivery of care that includes treating thefamily as a whole.The family-centered care philosophy canenhance patient and family satisfaction,

build on their strengths, patient and familyoutcome, increase the nurse andhealthcare staff’s satisfaction, anddecrease healthcare costs.

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FCC is a process that is integral to providingquality care. It acknowledges the essentialrole of the patient and family as well as theimportance of a partnership between thepatient, family and health care providers.FCC allows patients and families to beinvolved in medical decision making, and it

allows family member presence duringprocedures and resuscitations, whenappropriate.

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Components for implementing FCC include:Developing a philosophy of FCC along withpolicies and procedures that incorporate patientand family input;Educating staff; andProviding a friendly environment for the patientand his or her family.