M. M.

COLLEGE OF NURSING
MULLANA, AMBALA
INSERVICE EDUCATION

TOPIC: FAMILY CENTRED CARE

SUBMITTED TO: SUBMITTED BY:

Dr. (Mrs) Jyoti Sarin Ms.
Janet Chaudhary
Director, Principal M. Sc
Nursing 1st year
1909719
 IDENTIFICATION DATA: -

Name of the student teacher : Ms. Balwinder Kaur, Ms. Janet Chaudhary, Mrs. Jasdeep Kaur, Mrs. P. J. Subhashini,
Ms. Sandeep Kaur, Ms. Kiran Khasa.

Class : M. Sc Nursing 1st Year

Name of the Subject : Nursing Education

Name of the Topic : Family Centred care

Group of the students : Staff Nurses of Kalawati Saran Children Hospital

Size of the Group : 30

Date and Time : 25/01/2010 ; 09:45 am- 12:30 pm

Duration of teaching : 2 hour

Method of Teaching : Lecture cum Discussion

A.V. Aids : PowerPoint Slides and charts

General Objectives : At the end of the topic the nursing personnel will be able to exhibit increase in the knowledge
Regarding family - centred care and will be able to inculcate family centred care into their practice.
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OBJECTIVES OBJECTIVES

5 min To introduce the INTRODUCTION OF THE SELF:

topic. Today we the students of M. M.
College of Nursing, Mullana,
ambala are conductiong an
inservice education programme on
the topic family centred care at
Kalawati Saran Children Hospital,
New Delhi.

10 min At the end of the INTRODUCTION OF THE TOPIC:

lecture the
participants will The illness of a child can have a
be able to traumatic effect on both family and
explain the a child. Paediatric care has
meaning of adopted the philosophy of a family
family centred centred care approach in order to
care. maximize the wellbeing of
paediatric patient. Parents are
experts in the child’s care and
know more about their child then
we can learn through assessments
and charts.

Family-centred care is an
approach to children’s health care
that respects the central role of the
family in a child’s life. It upholds
the importance of the family as a
partner on the health care team.
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3 min At the end of the HISTORY OF FAMILY CENTRED CARE: Family centred
lecture the ■ Family-Centred care was first defined in 1987 as part The student – teacher will explain care was first
students will be of former Surgeon General Koop’s initiative for family- the history of family centred care defined in the
able to centred, community-based, coordinated care for with the help of PowerPoint slides. year?
understand the children with special health care needs and their
history of family families. The Key Elements of Family-Centred Care
centred care. were further refined in 1994 by the ACCH (Association
for the Care of Children’s Health). These key elements
are widely accepted by families and professionals alike
as they embody both the spirit and heart of Family-
Centred Care. Family Centered Care challenges the
traditional approaches that:
† Focus on patient and family deficits
† Disempowering patients and families
† Rely heavily on technology and biomedical science
† Undervalue the importance of human interactions in
the health care experience
† Are driven by the needs of the healthcare
professionals and the system

PHILOSPHY OF FAMILY CENTRED CARE:

12 min
At the end of the According to Wong and Hockenbery, the philosophy of The student – teacher will explain Explain the
lecture the family centred care recognizes the family as the constant the philosophy of family centred philosophy of the
students will be in a child’s life, health care professionals enable and care with the help of PowerPoint family centred
able to explain empower families to continue their care giving role. slides. care.
the philosophy Families are supported in their natural care giving and
of family centred decision making roles by building on their unique
care. strengths as individuals and families.
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OBJECTIVES OBJECTIVES

This philosophy also acknowledges diversity among

At the end of the family structures and backgrounds, family goals, dreams,
lecture the strategies for coping and actions to deal with problems
students will be and family support such as relatives and friends, family-
able to explain centred care is built on partnerships between families and The student – teacher will explain
the philosophy professionals. ‘Family-centred care was first intended for the philosophy of family centred
of family centred children with special needs, it can also be relevant in all care with the help of PowerPoint
care. settings and can be applied to persons of all ages.’ slides.

Family-centred professionals acknowledge and respect

family diversity Family-centred care is an approach to
health care that shapes health care policies, programs,
facility design, and day-to-day interactions among
patients, families, physicians, and other health care
professionals. Health care professionals who practice
family-centred care recognize the vital role that families
play in ensuring the health and well-being of children and
family members of all ages. These practitioners
acknowledge that emotional, social, and developmental
support is integral components of health care. They
respect each child and family’s innate strengths and view
the health care experience as an opportunity to build on
these strengths and support families in their care giving
and decision-making roles.

Family-centred approaches lead to better health

outcomes and wiser allocation of resources as well as
greater patient and family satisfaction. Family-centred
care in paediatrics is based on the understanding that the
family is the child’s primary source of strength and support
and that the child’s and family’s perspectives and
information are important in clinical decision making.
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Family-centred practitioners are keenly aware that health The student – teacher will explain
care experiences can enhance parents’ confidence in the philosophy of family centred
their roles and, over time, increase the competence of care with the help of PowerPoint
children and young adults to take responsibility for their slides.
own health care, particularly in anticipation of the
transition to adult service systems.

CORE CONCEPTS OF FAMILY CENTRED CARE:

Family-centred care core concepts include:

10 min At the end of the FAMILY STRENGTHS:

lecture the The family is the constant in the child's life. Support and The student – teacher will explain Explain in detail
students will be empower family members as partners and decision- the core concept of family centred the core concepts
able to explain makers in their child's care and help them cope more care with the help of PowerPoint of family centred
the core confidently with their child's illness. slides. care?
concepts of
family centred RESPECT:
care. Family-centred care requires trust and respect, including
respect for each family's values, beliefs, and religious and
cultural background.  Value families' knowledge of their
children, acknowledging their authority as decision-
makers and respect their choices.

CHOICE:
Provide the information families need to make educated
choices about treatment and support the choices they
make.  When families understand their options, they feel
less powerless about their child's hospital experience.
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INFORMATION SHARING:
At the end of the Professional staff provides medical information to families The student – teacher will explain Explain in detail
lecture the and values the personal information families provide the core concept of family centred the core concepts
students will be about their children.  This information exchange builds care with the help of PowerPoint of family centred
able to explain trust and contributes to the partnership between families slides. care?
the core and caregivers.
concepts of
family centred SUPPORT:
care. Support families by respecting their decisions; offering
comfort as they cope with the child's illness; meeting the
social, developmental and emotional needs of the child;
and fostering family members' confidence in their ability to
care for their child.

FLEXIBILITY:
Families bring different personalities, life experiences,
values, beliefs, education, and religious and cultural
backgrounds to the hospital setting.  Family-centred care
emphasizes that caregivers must be flexible so they can
meet the needs and preferences of all families.

COLLABORATION:
As partners in care, professional staff and family
members work together as collaborators in the best
interest of the child.

EMPOWERMENT:
Families have the right and the authority to care for their
children.  The core concepts of family-centred care
empower families in the care of their children.
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OBJECTIVES OBJECTIVES

10 min At the end of the ELEMENTS OF FAMILY-CENTRED CARE:

lecture the The student – teacher will explain Enumerate the
students will be ■ Recognize that the family is the constant in the child's the elements of family centred care elements of family
able to explain life, while the service systems and personnel within with the help of PowerPoint slides centred care.
the elements of those systems fluctuate. and chart.
family centred
care. ■ Share complete and unbiased information with
parents about their child's condition on an ongoing
basis. Do so in an appropriate and supportive manner.

■ Recognize family strengths and individuality.

Respect different methods of coping.

■ Encourage and make referrals to parent-to-parent

support.

■ Facilitate parent/professional collaboration at all

levels of health care -- care of an individual child,
program development, implementation, and evaluation
policy formation.

■ Assure that the design of health care delivery

systems is flexible, accessible and responsive to
families.

■ Implement appropriate policies and programs that

provide emotional and financial support to families.

■ Understand and incorporate the developmental

needs of children and families into health care delivery
systems.
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OBJECTIVES OBJECTIVES

At the end of the ■ Recognizing that the family is the constant in a child's
lecture the life, while the service systems and personnel within The student – teacher will explain Enumerate the
students will be those systems fluctuate. the elements of family centred care elements of family
able to explain with the help of PowerPoint slides centred care.
the elements of ■ Facilitating child/family/professional collaboration at all and chart.
family centred levels of service.
care.
■ Sharing with the family, on a continuing basis and in a
supportive manner, the best information regarding their
child's health care.

■ Understanding and incorporating the developmental

needs of infants, children, adolescents, and their
families in health care delivery.

■ Recognizing family strengths and individuality and

respecting different methods of coping.

■ Recognizing and honouring diversity, strengths and

individuality within and across all families, including
racial, spiritual, social, economic, educational and
geographical diversity.

■ Encouraging and facilitating family-to-family support

and networking.

■ Implementing comprehensive policies and programs

that provide support to meet the diverse health care
needs of families.

■ Designing accessible service systems that are flexible,

sensitive, and responsive to family-identified health
care needs
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BENEFITS OF FAMILY CENTRED CARE:

10 min At the end of the ■ A stronger alliance with the family helps in The student – teacher will explain Explain the
lecture the promoting each child’s health and development the benefits of family centred care benefits of family
students will be ■ Improved clinical decision making on the basis of with the help of PowerPoint slides. centred care.
able to explain better information and collaborative processes
the benefits of ■ Improved follow-through when the plan of care is
family centred developed collaboratively with families
care. ■ Greater understanding of the family’s strengths and
care giving capacities
■ More efficient and effective use of professional time
and health care resources (e.g. more care managed at
home, decrease in unnecessary hospitalizations and
emergency department visits, more effective use of
preventive care)
■ Improved communication among members of the
health care team
■ A more competitive position in the health care
marketplace
■ A practice environment that enhances professional
satisfaction
■ Greater child and family satisfaction with their
health care
■ Family-Centered Care improves and enhances
clinical outcomes for children with special needs and
provides more support for their families as they deal
with the challenges and joys of raising a child with
special needs Greater child and family satisfaction with
their health care
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OBJECTIVES OBJECTIVES
BARRIERS TO PARENT PARTICIPATION IN FAMILY-
CENTRED CARE

10 min At the end of the ROLE STRESS:

lecture the All roles that a person adopts are subject to role stress The student – teacher will explain Enumerate the
students will be during certain periods of his or her life. Role stress is a the barriers to parent participation barriers in parent
able to explain "subjective experience that is associated with lack of role in family centred care with the help participation?
the barriers to clarity, role overload, role conflict, or temporary role of PowerPoint slides.
parent pressures" . It can affect the communication process by
participation in causing the person to focus solely on the source of the
family centred stress rather than on the underlying issues. Parenting
care. roles can be subjected to role stress from an ill child as
well as from the different and greater demands placed on
the parent as a result of the child's illness. During both
hospitalization and home care, the parent's role changes
from parenting the healthy child to parenting an acutely ill
child. With such a shift in relations, stress will occur
naturally.

NEGOTIATION FAILURE: Negotiation "implies

discussion resulting in mutual agreement" Negotiation in
family-centered care involves an open relationship
between the nurse, child, and parents whereby caring
roles are established. Positive negotiation between the
parents and nurse result in reaching an agreement with
the parents concerning their roles in providing care
without imposing any of their own erroneous expectations
on one another Failed negotiations in care arrangements
and poor nurse-family relationships can interfere with the
health care experiences for the child and parents, as well
as the parents' desire to care for their ill child.
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NURSES’S RESPONSIBILITIES IN PROVIDING

FAMILY CENTERD CARE:

10 min At the end of the Nurses play very important role in providing family The student – teacher will explain Explain the
lecture the centered care. As nurses act as collaborator between the the nurse’s responsibilities in responsibilities of
students will be physician and family so she plays a leading role in providing family centred care with the nurse’s in
able to explain providing family centered care to children the help of PowerPoint slides. providing family
the ■ The nurse recognize the family as an essential centred care.
responsibilities part of the child's care and illness experience but also
of the nurse in acknowledges and respects the expertise of the family
family centred in caring for the child both within and outside of the
care. hospital environment.
■ The nurse may suggest parenting classes to
increase their knowledge base and promote
empowerment
■ In the absence of the child's family during
hospitalization, the nurse should attempt to maintain
routines established by the family
■ The nurse involves encouraging family-to-family
support and networking
■ The nurse can also facilitate change and alleviate
role stress effectively by aiding the family in realizing
their own strengths, coping strategies, and support
networks.
TIME SPECIFIC CONTENT TEACHING – LEARNING EVALUATION
OBJECTIVES OBJECTIVES

■ The acronym LEARN dictates the following directives

for nurses:
L - Listen empathetically and with understanding to the
family's perception of the situation.
E - Explain your perception of the situation.
A - Acknowledge and discuss the similarities as well as
differences between the two perceptions.
R - Recommend interventions.
N - Negotiate an agreement on the interventions.

■ The pediatric nurse involves helping the parents

develop advocacy skills for their child to further
empower their role during hospitalization and home
care visits.

RESEARCH EVIDENCES RELATED TO FAMILY

CENTERED CARE

■ A short-term longitudinal descriptive evaluation of

current levels of parents' participation in the care of a
child hospitalized with leukaemia was conducted to
identify varying levels of parent participation and their
relationship to the child's behaviour during
hospitalization. A positive relationship between the
number of activities a parent participates in and the
child's behaviour during hospitalization was
revealed( Dolores C Jones)
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■ Family-centered care (FCC) has been implemented in

many NICUs throughout the U.S. It is valuable in
helping families whose infants require hospitalization
cope with the stress, fear, and altered parenting roles
that may accompany their child's condition and
hospitalization. To employ such a significant philosophy
of care, nurses must understand what the FCC concept
signifies. A concept analysis can often aid
understanding of abstract ideas such as FCC. This
article utilizes a 1995 framework for concept analysis to
clarify the meaning of FCC for the neonatal nurse.
Incorporating FCC into daily professional practice can
enable nurses to improve the emotional and physical
well- being of each family they encounter.( Maluski K
Sheila)
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CONCLUSION:
5 min To conclude the
topic Family is a fundamental social
group in society. Families are big,
small, extended, nuclear and multi
– generational, with one parent,
two parents and grandparents. A
family can be as temporary as a
few weeks, as permanent as
forever. Parents are experts in the
child’s care and know more about
their child then we can learn
through assessments and charts.
The family is also the child’s main
source of support providing
stability in what can be an
otherwise traumatic period in
child’s life.

To summarize SUMMARIZATION:
5 min the topic Today we discussed about:
■ History of family centred care
■ Philosophy.
■ Core concepts.
■ Elements.
■ Benefits.
■ Barriers.
■ Nursing responsibilities in
providing family centred care.
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■ Hockenberry,Wilson .Wong’s nursing care of infants and children. 2 nd ed.New delhi: elsiever India PVT ltd; 2007.p. 17 -18

■ Ball Jane, Bindle Buth. Pediatric nursing. 2nd edition . Connecticut; Appleton and lange publishers;1995.p. 14

■ Ahmann, E. (1994). Family-centered care: Shifting orientation. Pediatric Nursing, 20(2), 113-117.

■ Arnold, E., & Boggs, K. (1995). Interpersonal relationships (2nd ed.). Toronto: W.B. Saunders Company.
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Article_ID=930266

■ Berlin, E.A., & Fowkes, W.C. (1983). A teaching framework for cross-cultural health care. The Western Journal of Medicine, 139(6),
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Availablefrom:URL:http//www.nursingcenter.com/library/journal/article.asp?Article_ID=93160

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Health Care, 19, 28-36. [ serial online] 2005 Aug[cited 2010 jan19]; 35(8):57-59. Available from: URL:http//www.ncbi.nlm.nih.gov

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