Patient-Centered and Person-Centered Care

There has been a growing focus over patient-centered and person-focused care in nursing. Brought on by the nursing shortage and push for quality patient care, patient-centered care became prevalent in the late 1990's (Ben Natan & Hochman, XXXXXXXXXXPatient-centered care focuses on the patient within the context of disease management. Person-focused care focuses on life-long experiences in wellness and illness. They are different but share the commonality of connectedness and increase of quality of care (Cardiff, 2016).

Leaders monitor patient-centered care and patient satisfaction survey results for variance. They can also speak with their nurses, facilitate conversations on their ability to perform their tasks, and provide good centered care. This information can be relayed to their managers (Marquis & Huston, 2017).

Managers initiate changes to patient-centered care and organize the work activities. They ensure that staff have the required tools to provide such care. The manager can also explore the need for using case managers, nurse navigators, and advanced practice nurses to improve efficiency across the care settings (Marquis & Huston, 2017).

In addition to patient-centered care, person-centeredness has also been identified as a feature of quality workplace cultures (Cardiff, XXXXXXXXXXJust like in patient-centered care, where nurses include patients in decision making and cares, person-centered leadership involves including staff in decision making and balancing the needs of everyone involved.

According to Cardiff (2016), there are six attributes that enable a leader or manager to be connected with their staff. The media below looks at these attributes and how they may differ depending on the role.

(Cardiff, 2016)

AACN CNL

Clinical Nurse LeaderSMor CNL® was developed by the American Association of Colleges of Nursing in collaboration with leaders from healthcare practice and education to improve the quality of patient outcomes (American Association of Colleges of Nursing, 2020).

According to the American Association of Colleges of Nursing (2020), a CNL® is a master's educated nurse focused on

• Care Coordination
• Outcomes Measurement
• Transitions of Care
• Interprofessional Communication & Team Leadership
• Risk Assessment
• Implementation of Best Practices Based on Evidence
• Quality Improvement

Some healthcare facilities have started using the CNL® to help manage healthcare delivery for the patients. They may be involved in the planning, implementation, delegating, and coordination of care. The addition of this person would help leaders and managers manage staffing and patient care. They may be utilized in general healthcare delivery areas, or in special units like ICU, Oncology, etc. This certification process validates the nurse's qualifications based on pre-defined standards. This is an area of professional development that requires extensive training (American Association of Colleges of Nursing, 2020).

Question :

Week 5 Discussion: Reflection on Knowledge of Competencies (Graded)

Purpose

The purpose of this reflection is for learners to learn about legal and ethical competencies in the workplace.

Course Outcome

This reflection enables the student to meet the following course outcome:

• CO 5: Summarize legal, ethical, and professional competencies utilized by nursing leadership. (PO 6)

Due Date

• Answer post due by Wednesday 11:59 p.m. MT in Week 5.
• Two replies to classmates and/or instructor due by Sunday 11:59 p.m. MT at the end of Week 5.

Points Possible

50 points

Directions

• Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed.
• Use the rubric on this page as you compose your answers.
• Scholarly sources areNOT requiredfor this reflection.

Week 5 Lesson: Legal and Ethical Competencies

Legal and Ethical Competencies

An effective health system requires a collaborative network of different agencies that provide competencies, standards, and requirements. These agencies can be found at every level - federal, tribal, state, and local. In this lesson, legal and ethical competencies will be explained and how they influence leaders and managers.

The Joint Commission

The Joint Commission is "an independent, not-for-profit organization" (The Joint Commission, 2020, para. 2). Their role is to set standards and accredit many different types of healthcare facilities. The standards focus on patient care and organizational functions that are vital for providing quality care. Facilities can voluntarily choose to pursue accreditation which requires an on-site visit and evaluation of standards compliance. Being accredited by the Joint Commission indicates a higher level of quality care and safety efforts which may attract more patients and staff. They also offer certification of clinical programs and services.

Transcript

Learn

1. Facility Management contacts The Joint Commission to learn about accreditation process.
2. Management requests access to The Joint Commission Standards Manuals.

Prepare

3. Management communicates standards to leaders. Leaders communicate standards to staff and compare current performance with the standards. Leaders will identify standards that are not being met. Management will create a plan for success.
4. Management identifies when facility will be ready for an on-site visit and completes an accreditation application.

Sustain

5. The Joint Commission surveys the site by collecting data from facility, management, leaders, and staff.
6. Accreditation may or may not be granted depending on whether standards are met. The Joint Commission will make recommendations for improvement.

Nurse Practice Acts and Boards of Nursing

The United States Constitution does not address regulating healthcare thus the responsibility falls to the state level. Each state has their own practice act but the specifics of each act varies. In some states, Nurse Practice Acts have alternate titles or may be combined with regulation of other professions.

What is included in a Nurse Practice Act?

(Russell, 2017)

All Nurse Practice Acts include:

⦁ Definitions

⦁ Authority, power, and composition of a Board of Nursing

⦁ Educational program standards

⦁ Standards and scope of nursing practice

⦁ Types of titles and licenses

⦁ Protection of titles

⦁ Requirements for licensure

⦁ Grounds for disciplinary action, other violations, and possible remedies

The legislation is not enough to monitor and guide the field of nursing, so each state also has a board of nursing. Nurse leaders may use resources provided by the Board of Nursing for continuing education requirements and other nursing educational offerings. Nurse managers may use the board of nursing website for license verification and reporting of nursing infractions. Current regulatory information is also available.

American Nurses Association Code of Ethics

Ethical decision making has become part of nurse's daily duties. As a leader or manager, role modeling moral behavior as defined in the Code of Ethics is essential. According to Weiss et al. (2019, p. 64), "leaders who do not exhibit these [ethical] characteristics cannot expect them of their followers."

Ethical Leadership Behaviors

• Engages in continuing ethics education
• Demonstrates that ethics is a priority
• Role models and communicates expectations for ethical practice
• Develops/utilizes ethics resources
• Engages in ethical decision-making

Transactional Leadership

• Works within existing organizational culture
• Focuses on identified goals; clarifies expectations
• Maintenance/management of daily functions

Transformational Leadership

• Promotes organizational culture change
• Stimulates/Inspires through charisma
• Focuses on a higher purpose
• Encourages collaboration

Servant Leadership

• Creates caring organizational culture
• Encourages through empathy and honesty
• Focuses on relationships and trust

(Robinchaux, 2017)

Leaders and managers are charged with creating healthy work environment of caring and connectedness which can be complex. Becoming an ethical leader requires additional knowledge above and beyond a basic ethics course. That knowledge is the foundation for the ability to recognize an ethical situation and apply ethical conflict resolution skills.