This assignment will define the meaning of person-centred care and my understanding of the definition. The selected areas of Person-centred care that will be discussed and emphasised in the essay, will be Confidentiality, Accuracy of Information and Working in Partnership and how it can be provided by the student nurse.
The RCN together with Department of Health and Midwifery Council developed eight Principles, to provide the level of knowledge and how the person-centred care should be delivered across all medical disciplines. Principle A explains a nurse's duty to treat people with dignity and compassion and Principle D promote person-centred care. (RCN 2012)
Examples will be given to explain and to underpin the concepts that will be discussed in depth within the essay.
(Ponte et al, 2003) suggests that the Person Centred Care (PCC) is the consideration of the patient's point of view and takes into account their decisions to meet their health goals (Ponte et al, 2003).
Person centred care is in operation when the Health Care Professions put the patient at the centre of the whole process. They give the opportunity for the patient to have the best treatment for their illness and circumstances. Patients are given the choice of whether to receive the treatments or not and their decision are respected. Surrounding all of these principles there is a need to keep all the information about the patient confidential.
A nurse and student nurse must always be able to justify the nurse patient trust and never forget what a privilege it is to care for someone (Goldsmith J. 2011).
Confidentiality has been defined as a fundamental part of professional practice that protects human rights. NMC (2008).
Confidentiality means privacy, means maintaining dignity and respecting important aspects of our personal life. When a patient is admitted to hospital the staff take on this responsibility and treat very seriously this element of care. (NMC 2008).
It is expected that all information will be held in confidence by all medical staff that are legally bound and obliged to follow the rules and legislation put into place by the Data Protection Act (1998) and the Computer Misuse Act (1990), (NMC 1998).
A review of patient confidentiality issues was commissioned and its findings published as the
Caldicott Report in December 1997. It made 16 recommendations and formulated six principals. The role and responsibility of Caldicott guardians has grown significantly into what is now known as information governance. These principles in brief are Formal justification of purpose; Information transferred only when absolutely necessary; Only the minimum reqired; Need to access controls; all to understand their responsibility; Comply with and understand the law.
Since the Caldicott Report in 1997 the following acts have became law. Data Protection Act 1998, Human Rights Act 1998, Public Interest Disclosure Act 1998, Audit Commission Act 1998, Terrorism Act 2000, section 60 of the Health and Social Care Act 2001 and Regulation of Investigatory Powers Act 2000 and in 2005 The Freedom of Information Act 2000.
Information can to be shared with other health care professionals to provide the best solution for their treatment with the patients consent. (NMC 2003), (Doh 2003).
There are exceptions to these rules in that it is allowed or even legally obligatory to violate a patient's confidentiality without their consent if they are involved in criminal activities such as terrorism or that a patient can be at risk of harm. Police and Criminal Evidence act (1984).
It is the duty of the Nurse and student nurse to adhere to the principles of confidentiality.
To keep the patient's information confidential is quite challenging for a student nurse and the medical staff, it is very much influenced by the ward arrangement and available writing space. In particular when a discussion takes place behind the curtains or at the bedside, this may result in breaches of confidentiality. We all are aware of where to discuss patient information and that it is not in the full hearing of all or leaving notes in full view of passersby.
The key priority is guarding the dignity and the confidentiality of the patient one simple way of ensuring this is by using coded curtain pegs or signs which warn others that information is being shared. (Woogara, 2005).
The second area with a significant importance for PCC is accuracy of information, because without it, the patient cannot receive the accurate care and correct treatment such as medication.
In relation to one of the eight principles, Record-keeping has been defined as an integral part of Nursing. The Nursing and Midwifery Council has put in place a set of regulations to safe guard the health and wellbeing of the public, called The Code (NMC 2008). The student nurse and the nursing team have to operate by these rules to maintain the high level of competency for record keeping. The governance guide states that to keep the accuracy of the information, notes have to be readable and understandable. Records will contain what kind of medication has been given and how effective it has been. The records have to be written as soon as an event occurred and be dated and signed.
As a student nurse it is very important to learn how to write clearly and keep written records in order and accurately updated.
To keep the patient and records safe, the NHS's system assigns a unique number to the patients name together with a date of birth, to identify each person correctly, making sure that the right patients get the correct medication and the medical records are recorded and tracked correctly. (NMC 2009).
Every person that comes to hospital has to be assessed by the professional staff, to ensure that the best quality care is given to the patient. During the patient's stay the student nurse and the nursing staff compile documents such as a Care plan and Risk Assessment booklet.
The Care Plan is a document used to record and prove every single action and assistance that is given to a patient. It is used to record and monitor different aspects of the patients information. It is also used on the patients' admission to the ward. It has to be filled in correctly with the entire patients' medical and social history to ensure the best care for the individual patient.
There are keys principals that must be followed to keep the records clear and effective. These are produced by the Royal College of Nursing (RCN 2012).
For example, if these principles are not adhered to and information has been omitted in the patient's notes, regarding the administration of medication and other medical staff give further medication, this will result in overdosing the patient. The consequences would be to worsen the patient's condition and breach the duty of care. (NMC 2009).
The Care Plan is completed together with the Risk Assessment booklet and covers elements such as patient falls and pressure sores to ensure patient wellbeing. (Bird, A., et al.), (RCN 2012), (NMC 2009).
The clinical records also contain X-rays, photographs and anything can be use to support treatment. These are to be kept accurate, secure and confidential. It is a good practice states the NMC (Nursing Midwifery Council 2008) to keep valuable data, which maintains high standards of clinical care and good communications. Clinical records also highlight any changes in the patient's condition.
When all this information is correlated, accurately and continually updated, it can be said that the delivery of quality care is effective and safe.
As a student nurse we are part of a wider health care team that includes: assistant practitioners, health care assistants and nurses, we are all accountable for good record keeping. The use of simple terminology (for the patient to understand), with no abbreviations should be used, with the records being signed, timed, and dated if they are handwritten to provide support in communication and decision making (NMC 2009).
The principles of good record keeping should reflect the core values of individuality and partnership working. (NMC 2009).
To deliver person-centred care all the elements mentioned above need to be combined together and working in partnerships, the third element of this assignment, is one of them.
Lyotard (1992) argues that since the new national partnership scheme has been created, the social problems such as poor housing and poverty have increased rather than diminished.
Health care professionals and Social Services have been pushed to involve patients in their decision making regarding their services rather than the patients passively receiving them.
The current policy highlights a three-way partnership between health, social care providers and services users, which determine the combination of services that must be provided and by whom. Working successfully in partnerships is the key to improve Person centred-care treatments. Families, friends, doctors and health care professionals are called together to put in place an optimum plan in the best interest of the patient. Involving the patient's families contributes to expand the knowledge about that specific patient, adding a more human element, resulting in knowing more about their routine and their personality.
(Joint Improvement Team 2009) defined that working in partnership consists of two or more independent professionals, working together to accomplish more successful results, than they could by working independently with the willingness to share their achievements and failures. A Multidisciplinary Team is formed by several different qualified professionals and not qualified members, who are involved in diverse areas of expertise, that are able to coordinate and response to patients needs.
Working in partnership means planning a method to support individuals, allowing them to take charge and meet their goals, also to guide them to have a better quality of life in every aspect from good mental health to overcoming physical disabilities.
For example: if we have a good relationship with a patient there will be a possibility that he/she will open himself to you and tell you about the abuse received from the family or from within the Home they are living in. In any of these cases we have a duty to report the abuse to the ward manager or person in charge and the relevant profession team will be called in to intervene and put a plan together to protect the patient.
The practice of nursing is a dynamic and evolving profession. Engaging and negotiating with the patient has shown to be effective in achieving cooperation and results and more participation of the patient in their therapy to accomplish specific goals. These helped to break down barriers and result in being more responsive to the results. (Community Care 2011).
In conclusion, there are several elements to person-centred care that benefit both patients and health profession.
Person-Centred care is carried out when the Health profession put the patient at the centre of all decision making tailed to their needs.
Both nurse and student nurse must always be able to uphold the nurse patient trust and never forget what a privilege it is to care for someone (Goldsmith J. 2011).
It is the responsibility of the Nurse and student nurse to adhere to the principles of confidentiality. Also everyone is accountable for a good record keeping and to do so there is a guide line put in place by the NMC (NMC 2009).
Information can be shared with other health care professional with the patients' consent and by following law and regulation put in place by Data Protection Act (1998) and the Computer Misuse Act (1990), NMC (1998), to offer the best solution for their treatment. (NMC 2003), Doh (2003).
Beech, M. (2007). Confidentiality in health care: Conflicting legal and ethical issues. Nursing Standard, 21 (21) 42-46.
Bird, A., Robertson G. (2012). Documentation and record keeping. Retrieved from http://www.rcn.org.uk/__data/assets/pdf_file/0006/292227/Recordkeeping.pdf 24-2-13
Community Care. (2011). Overcoming barriers to person-centred care. Community Care. 1881 26-27.
Care Quality Commission. (2011). Consent to treatment. Retrieved 23-2-13 http://www.cqc.org.uk/public/reports-surveys-and-reviews/reports/mental-health-act-annual-report-2010/11/consent-treatment.
Carnwell , R. , Carson A. (2005). Chapter 1 The concepts of partnership and collaboration. (First ed.).
Glasgow: Bell and Bain.
Childs, L. L., Cole L., Marjoram B. (2009). Essential skills cluster for nurses theory for practice. Oxford UK: Wiley-Blackwell
DH/IPU/Patient Confidentiality. Department of Health, (2003). NHS Confidentiality Code of Practice. London: DH Publications Orderline. www.doh.gov.uk/
Doh (2003) Confidentiality NHS Code of Practice Retrieved 23-2-13 from
Drinkwater, M. (2010). For everyone in social care working in a team and joint working.
Journal Community care
Goldsmith , J. (2011). The NMC code: conduct, performance and ethics. Nursing Practice, 107(37), 12-14. Retrieved 22-2-13
Edwards, M. (2009). Patient confidentiality and data protection. Practice Nursing, 20 (8), 411-413.
Legislation.gov.uk editorial team. (1990). Computer misuse act 1990.
Retrieved from 23-2-13 http://www.legislation.gov.uk/ukpga/1990/18/contents
Legislation.gov.uk. (1984). Police and Criminal Evidence Act (1984). Retrieved 23 February 2013 from http://www.legislation.gov.uk/ukpga/1984/60/contents.
Manley, K., Hills, V. & Marriot, S. (2011). Person-centred care: Principles of Nursing Practice D. Nursing Standard. 25 (31) 35-37.
Mcferrant, T. (2008). Oxford dictionary of nursing. (Fifth ed.). Oxford UK: Market House
NMC. (2012). Confidentiality. Retrieved 22-2-2013
NMC. (1998) Data Protection Policy Retrieved 23-2-13 from
NMC (2009) Record Keeping - Guidance for Nurses and Midwives. Nursing and
Midwifery Council, Retrieved from Nursing Midwifery Council
website: www.nmc-uk.org 23-2-13
NMC. (2009). Record keeping guidance for nurses and midwives. Retrieved from Nursing Midwifery Council website: www.nmc-uk.org 27-11-12
(Ponte et al, 2003). Time to learn: understanding patient-centred care. British Journal of Nursing, 19(14), 912-917.
RCN. (2012). Time launches new record keeping resource to learn: understanding. This is Nursing, www.nmc-uk.org
Richards, A., Edward S. (2008). A nurse's survival guide to the ward. London: Elsevier.
Roch-Berry, D. C. (2003). What is a Caldicott guardian? Postgraduate Medical Journal, 79 (935), 516-518. Retrieved from 23 February 2013 http://pmj.bmj.com/content/79/935/516.full
(2007). Successful partnership working partnerships have been described as 'the indefinable in pursuit of the unachievable'. Nursing Times,
Woogara, J. (2005). Human rights and patients' privacy in uk hospitals. Nursing Ethics, 8 (45), 273-286. Retrieved from http://www.seeph.pro.mcg.pl/files/Resources Articles/Health Ethics and Law/ethics-law-2.pdf 23 February 2013