Family Centered Care

How is cultural humility presented in healthcare?

- Requires providers to engage in self-reflection and self-critique - Views patient and family as full members of health care team - Evolving aspect of healthcare -an ongoing process that promotes deeper thinking and knowledge of oneself, others, and the world

What is cultural humility?

- a commitment and active engagement in a lifelong process that individuals enter into for an ongoing basis with patients, communities, colleagues and themselves

How can one provide family centered care?

- enable families, empower families so they maintain a sense of control, and develop a partnership between the parent and professionals - identify a family's strengths and help them expand upon their strengths - assist with emotional support of child and family - decrease anxiety

What are the AAP's three discipline strategies?

1. Maintain positive support, nurture care-giver child relationship. 2. Use positive reinforcements to increase good behavior. 3. Remove positive reinforcements to help eliminate or reduce bad behavior.

Define culture...

A particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another

A mother brings her three children to the clinic for their annual physical examinations. The children are 13 months and 2 and 5 years of age. The two younger children are cared for at the local day care, and the 5-year-old attends kindergarten. The grandmother cares for the children for 2 hours in the early evening until the mother finishes work. The grandmother lives in a two-story house on a busy road located in the city. The mother reports a recent divorce, and the children have no contact with their father. The 5-year-old recently started kindergarten, and the mother reports that the teacher has concerns because he is quiet and withdrawn but has become aggressive with peers. Which of the following is not appropriate to discuss with the mother? A. Marital factors in the home have an effect on children of all ages. B. Attention to the child's emotional and developmental needs is important. C. Aggression is a normal behavior that can be related to divorce. D. Positive outcomes of divorce rarely occur.

D Divorce has a profound effect on children, and marital factors in the home have an effect on children of all ages. Attention to the child's emotional and developmental needs is important. Aggression is a normal behavior that could be related to the divorce.

A mother brings her three children to the clinic for their annual physical examinations. The children are 13 months and 2 and 5 years of age. The two younger children are cared for at the local day care, and the 5-year-old attends kindergarten. The grandmother cares for the children for 2 hours in the early evening until the mother finishes work. The grandmother lives in a two-story house on a busy road located in the city. The mother reports a recent divorce, and the children have no contact with their father. The mother expresses concerns related to the children's safety. When providing anticipatory guidance to the mother, what do you say? A. Injuries cause no more deaths or disabilities in children than all types of diseases combined. B. Injuries cannot be prevented, even when safety measures are applied. C. Car restraints, bicycle helmets, and smoke detectors have not resulted in a significant decrease in fatalities. D. The developmental stage of the child helps determine the types of injuries that are most likely to occur at a specific age.

D The developmental stage of a child helps to determine the type of injuries most likely to occur at a specific age. As children grow older, the percentage of deaths from injuries increases. Injuries do cause more deaths and disabilities in children than all causes of disease combined. Injuries can be prevented when safety measures are applied. Prevention strategies such as car restraints, bicycle helmets, and smoke detectors have resulted in a significant decrease in fatalities for children ages 1 to 19.

How does the nurse assess the family structure?

Discussion and direct observation 1. Assess the family structure by discussion and direct observation. a. Determine who is considered to be family members. b. Identify the decision maker regarding the child's care. c. Identify the child's caregivers. d. Determine who is the primary caregiver. e. Determine what roles each family member plays. The concept of family varies among cultures. Family ties within some cultures or subcultures may be especially strong. Family groups rather than the parents may be decision makers, or responsibility for making decisions may be allocated to one or two specific family members, such as a grandfather or maternal uncle.

What influence does culture have in pediatrics?

Effects parenting styles and pace of acquisition of cognitive and motor skills as well as child's social and emotional development

Focusing on FCC can do what for the hospital stay?

FCC increases child calmness and therefore better pain management, recovery times are shorter, communication is better, costs decrease.

What are 3 types of discipline?

Positive reinforcement Extinction (ignore/time-out) Corporal punishment (not reccomended by AAP)

Family can be defined as...

Whatever the individual/patient considers it to be. Consanguineous family is related by blood. Affinal family is related by marriage. Family of origin means you were born into that family. Household family is related by living in one house together.

How does the nurse assess the healthcare practices of the family?

a. Determine what the family usually does about particular illnesses or problems. b. Ask family members how they usually maintain health.

How can a nurse use interventions to support the family?

• Ask family to help with meals, babysitting, laundry or transportation of siblings to school can help reduce burden on parents and make family feel needed • Clergy can be helpful to counsel • Nurse should anticipate influence of culture and help intervene therapeutically

How can a nurse support the parent?

• Encourage participation and assess each parents for their level of involvement/comfort • Encourage parents to leave for brief period • Arrange for sleeping quarters on unit outside of child's room for parent • Plan schedule for alternating visitors so parent can get rest

How can a nurse support the siblings?

• Prep sibling for hospital visit, assess their adjustment and provide intervention/referrals when needed • Trade off staying at hospital with parent at home with sibling • Offer info to sibling about child's condition • Encourage phone visits, mail, etc.