ABSTRACT
Behavioral flow sheets are tools that can be used outside the domain of mental health. For the knowledgeable health care provider in any setting, they render a cost-effective, noninvasive mechanism for diagnosis and management of a variety of patient problems of organic as well as behavioral natures. Though there exists an assortment of standardized formats, flow-sheet design can be tailored to address the unique circumstances of each patient. They provide an avenue for actively involving patients and families in problem assessment as well as in the planning and evaluation of treatment regimens. In addition, flow sheets provide a feedback mechanism that can enhance patient/family self-esteem and increase the likelihood of adherence to treatment recommendations. There is both an art and a science to their design and use, but the skills involved are readily acquired by any interested practitioner. The conscientious professional will become acquainted with the potential pitfalls and thus avoid irresponsible or unethical application. The authors provide guidelines for developing and implementing flow sheets and illustrate their value through the sharing of several clinical vignettes.
Subject(s)
Behavior , Health Behavior , Nursing Records , Behavior Therapy , Data Collection , Humans , Medical Records , Primary NursingABSTRACT
The giving and receiving of gifts, funeral attendance, post-discharge babysitting, usurping of parental roles, indiscriminate sharing of personal information, and other issues prompted a pediatric tertiary care facility in the Midwest to examine intricacies involved in the promotion and maintenance of therapeutic relationships. A multidisciplinary group developed a therapeutic relations decision-making framework to (a) foster a proactive process of conscious deliberation regarding nurse/patient interactions, and (b) afford a nonthreatening mechanism for retrospective review of apparently non-therapeutic relationships. The framework, based upon an "act utilitarian" approach to moral reasoning, promotes the clarification of personal philosophy and values. The framework provides a basis for deliberate, consistent, and confident nursing care delivery and the impetus for developing of new patient and family care initiatives.
Subject(s)
Decision Making , Models, Nursing , Nurse-Patient Relations , Pediatric Nursing , Child , Ethical Theory , Ethics, Nursing , Fund Raising , Gift Giving , Humans , Professional-Family Relations , Social ValuesABSTRACT
Waiting is inevitable for patients and families seeking health care services. Anxiety, frustration, and stress are exacerbated. A pager program, where pagers are loaned free of charge to families, uses a family-centered approach to counteract the aggravation of waiting. Patients and families can leave the hospital room or clinic setting and then be paged to return as needed. In any clinical setting, having choices and control will enhance coping and satisfaction for both patients and families.
Subject(s)
Child, Hospitalized , Family/psychology , Hospital Communication Systems , Waiting Lists , Adaptation, Psychological , Adult , Child , Humans , Patient Satisfaction , Patient-Centered Care/organization & administration , Pilot ProjectsABSTRACT
Using a hierarchical approach to orientation is a means to address the needs of both the orientee and the institution. The Hierarchical Orientation Model, described in this article, focuses on the development of skills in patient assessment and management and on organization sensitivity and integration. The model is based on adult learning principles that include building on previous knowledge and self-paced learning. Although developed for a tertiary pediatric hospital, the Hierarchical Orientation Model can be applied to other settings.
