Domain 2: Person-Centered Care

Domain 2: Person-Centered Care

 Descriptor: Person-centered care focuses on the individual within multiple complicated contexts, including family and/or important others. Person-centered care is holistic, individualized, just, respectful, compassionate, coordinated, evidence-based, and developmentally appropriate. Person-centered care builds on a scientific body of knowledge that guides nursing practice regardless of specialty or functional area. 

Contextual Statement: Person-centered care is the core purpose of nursing as a discipline. This purpose intertwines with any functional area of nursing practice, from the point of care where the hands of those that give and receive care meet, to the point of systems-level nursing leadership. Foundational to person-centered care is respect for diversity, differences, preferences, values, needs, resources, and the determinants of health unique to the individual. The person is a full partner and the source of control in team-based care. Person-centered care requires the intentional presence of the nurse seeking to know the totality of the individual’s lived experiences and connections to others (family, important others, community). As a scientific and practice discipline, nurses employ a relational lens that fosters mutuality, active participation, and individual empowerment. This focus is foundational to educational preparation from entry to advanced levels irrespective of practice areas. 

With an emphasis on diversity, equity, and inclusion, person-centered care is based on best evidence and clinical judgment in the planning and delivery of care across time, spheres of care, and developmental levels. Contributing to or making diagnoses is one essential aspect of nursing practice and critical to an informed plan of care and improving outcomes of care (Olson et al., 2019). Diagnoses at the system-level are equally as relevant, affecting operations that impact care for individuals. Person-centered care results in shared meaning with the healthcare team, recipient of care, and the healthcare system, thus creating humanization of wellness and healing from birth to death. 

2.1 Engage with the individual in establishing a caring relationship.

2.1d Promote caring relationships to effect positive outcomes.

2.1e Foster caring relationships.

2.2 Communicate effectively with individuals.

2.2g Demonstrate advanced communication skills and techniques using a variety of modalities with diverse audiences.

2.2h Design evidence-based, person-centered engagement materials.

2.2i Apply individualized information, such as gentic/genomic, pharmacogenetic, and environmental exposure information in the delivery of personalized health care.

2.2j Facilitate difficult conversations and disclosure of sensitive information.

2.3 Integrate assessment skills in practice.

2.3h Demonstrate that one's practice is informed by a comprehensive assessment appropriate to the functional area of advanced nursing practice.

2.4 Diagnose actual or potential health problems and needs.

2.4f Employ context driven, advanced reasoning to the diagnostic and decision-making process.

2.4g Integrate advanced scientific knowledge to guide decision making.

2.5 Develop a plan of care.

2.5h Lead and collaborate with an interprofessional team to develop a comprehensive plan of care.

2.5i Prioritize risk mitigation strategies to prevent or reduce adverse outcomes.

2.5j Develop evidence-based interventions to improve outcomes and safety.

2.5k Incorporate innovations into practice when evidence is not available.

2.5 Demonstrate accountability for care delivery.

2.6e Model best care practices to the team.

2.6f Monitor aggregate metrics to assure accountability for care outcomes.

2.6g Promote delivery of care that supports practice at the full scope of education.

2.6h Contribute to the development of policies and processes that promote transparency and accountability.

2.6i Apply current and emerging evidence to the development of care guidelines/tools.

2.6j Ensure accountability throughout transitions of care across the health continuum.

2.7 Evaluate outcomes of care.

2.7d Analyze data to identify gaps and inequities in care and monitor trends in outcomes.

2.7e Monitor epidemiological and system-level aggregate data to determine healthcare outcomes and trends.

2.7f Synthesize outcome data to inform evidence-based practice, guidelines, and policies.

2.8 Promote self-care management.

2.8f Develop strategies that promote self-care management.

2.8g Incorporate the use of current and emerging technologies to support self-care management.

2.8h Employ counseling techniques, including motivational interviewing, to advance wellness and self-care management.

2.8i Evaluate adequacy of resources available to support self-care management.

2.8j Foster partnerships with community organizations to support self-care management.

2.9 Provide care coordination.

2.9f Evaluate communication pathways among providers and others across settings, systems, and communities.

2.9g Develop strategies to optimize care coordination and transitions of care.

2.9h Guide the coordination of care across health systems.

2.9i Analyze system-level and public policy influence on care coordination.

2.9j Participate in system-level change to improve care coordination across settings.

(American Association of Colleges of Nursing, 2021, pp. 29-32)

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing.   https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Related Evidence

For the NURS 72133, Quality Outcomes Management course, I worked in a group with two other students for my Doctor of Nursing Practice (DNP) project. Our group performed a microsystem evaluation of a mental health organization in Arkansas to assess opportunities for improvement. Our group identified five opportunities for improvement. We then decided to focus our project on addressing the high number of complaints the clinic received from patients stating their calls were not answered and/or returned.

Once we completed the microsystem assessment, we presented clinic administrators with a quality improvement (QI) project proposal. The goal of this QI project was to enhance patient satisfaction with the phone-tree services of the behavioral health organization by implementing staff education on communication processes. We began by presenting our findings from the microsystem assessment. We then shared four specific project aims to address patient satisfaction with the phone-tree services, our proposed interventions with a timeline, our data analysis and evaluation plan, and the resources that would be utilized during the project.

Reflection

Both the microsystem analysis and QI project proposal presentation were excellent learning experiences. This was my first experience in the field of quality improvement, and I felt quite out of my depth with this project, which is one of many reasons I found the help of my teammates invaluable over the course of this project. The microsystem evaluation and the QI project proposal both enabled me to address multiple elements of Domain 2: Person-Centered Care of the Essentials: Core Competencies for Professional Nursing Education. Specifically, item 2.2g: “Demonstrate advanced communication skills and techniques using a variety of modalities with diverse audiences,” item 2.5h: “Lead and collaborate with an interprofessional team to develop a comprehensive plan of care,” item 2.6f: “Monitor aggregate metrics to assure accountability for care outcomes,” item 2.6h: “Contribute to the development of policies and processes that promote transparency and accountability,” and item 2.7d: “Analyze data to identify gaps and inequities in care and monitor trends in outcomes” (American Association of Colleges of Nursing, 2021, pp. 29-32).

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing.   https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf