Chapter 13: Person-Centered Care in Nursing

Chapter 13: Blended Competencies, Clinical Reasoning, and Processes of Person-Centered Care

• Focuses on blended competencies, clinical reasoning, and person-centered care
• Covers ANA definitions of nursing, Thoughtful Person-Centered Practice, Components of Thoughtful Practice, 10 Guiding Principles of Person-Centered Care, The Professional Nurse, Blended Competencies, QSEN Competencies, Clinical Judgment Concepts, Critical Thinking, Clinical Reasoning & Decision Making, Problem-Solving and the Nursing Process, Clinical Judgment Models, Five Steps of the Nursing Process, Steps in Concept Mapping, and Reflective Practice

ANA Definitions of Nursing

• Definition #1: Providing a caring relationship to facilitate health and healing, considering the range of human experiences and responses to health and illness within the patient's environment. This involves the integration of assessment data with the patient's subjective experience and applying scientific knowledge to diagnosis and treatment using critical thinking and judgment.
• Definition #2: Advancement of professional nursing knowledge through scholarly inquiry; influence on social and public policy to promote social justice; assurance of safe, quality, and evidence-based practice.

Thoughtful Person-Centered Practice

• Emphasizes the importance of the person, the professional nurse, reflective practice, clinical reasoning, decision-making, and the nurse's action in response to individual clinical needs.

Components of Thoughtful Person-Centered Practice

• Includes reflective practice for personal learning
• Focuses on the nurse's personal attributes, knowledge base, clinical experience, blended competencies, and QSEN competencies
• Incorporates patient-centered nursing processes for assessing, diagnosing, planning, implementing, and evaluating

Guiding Principles of Person-Centered Care

• Principle #1: All team members are caregivers; care is continuous, customized, and reflects patient needs, values, and choices; knowledge and information are shared; care is provided in a healing environment.
• Principle #2: Families and friends are part of the care team; patient safety is prioritized; transparency is essential; caregivers cooperate to support patient best interests; patients control their care.

The Professional Nurse

• Possesses personal attributes: open-mindedness, valuing individuals, self-awareness, responsibility, motivation, leadership skills, and bravery to question the system
• Shows a knowledge-base with the ability to draw upon nursing knowledge and evidence

Blended Competencies

• Blended Competencies #1: Cognitive competencies for critical thinking, purpose of thinking, adequacy of knowledge, potential problems, helpful resources, and critique of judgment/decision
• Blended Competencies #2: Developing technical competencies, interpersonal competencies (promoting human dignity, establishing caring relationships, enjoying mutual exchange), and ethical/legal competencies (understanding legal boundaries, scope of practice, personal strengths/weaknesses)

QSEN Competencies

• Includes patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

Clinical Judgment Concepts

• Includes critical thinking, clinical reasoning, clinical judgment, and situational awareness

Clinical Reasoning & Decision Making

• Processes used to address patient problems in clinical settings
• Leads to clinical judgment (outcomes) of critical thinking
• Uses purposeful, informed, outcome-focused thinking
• Driven by standards, policies, ethics, patient, family, and community needs

Problem-Solving and the Nursing Process

• Includes trial-and-error and scientific methods (seven-step process)
• Incorporates intuitive processes for direct understanding
• Encourages creative thinking in problem-solving

Clinical Judgment Models

• Tanner Model: Noticing, interpreting, responding, and reflecting in action or in the situation
• Nursing Process: Systematically collecting patient data (assessing), identifying patient strengths/problems (diagnosing), creating individualized care plans (planning), executing care plans (implementing), evaluating care plan effectiveness (evaluating)

Five Steps of the Nursing Process

• Assessing: Collecting, validating, and communicating patient data.
• Diagnosing: Analyzing data to identify patient strengths and problems.
• Planning: Specifying patient outcomes and related nursing interventions.
• Implementing: Carrying out the care plan.
• Evaluating: Measuring extent of patient outcome achievement.

Steps in Concept Mapping

• Collect patient problems/concerns.
• Connect and analyze relationships.
• Create a diagram.
• Keep key concepts in mind (nursing process, holism, safety, advocacy)

Reflective Practice

• Reflection in action: Thinking on your feet within an activity.
• Reflection on action: Thinking about an activity after it occurred
• Reflection for action: How present and future actions may change as a result of the reflection

PICMONIC ADPIE Video

• A video resource for the ADPIE nursing process.

This quiz focuses on blended competencies, clinical reasoning, and processes essential for person-centered care in nursing. Explore various guiding principles, definitions, and models that define thoughtful practice and enhance patient outcomes. Test your understanding of the core components in delivering effective nursing care.