Topic 1

The Acute Care Experience for the Adult and Child

Student Learning Objectives:

1. Define and describe the following terms.

• Collaborative problems: potential or actual complications of disease or treatment that nurses

treat with other health care providers, most frequently physicians.
• Evidence-based practice: the use of evidence (results from research) to improve quality and
outcomes of health care. EBP uses the best scientific evidence from research to obtain the best
outcomes for clients and families. “the conscientious, explicit, and judicious use of current best
evidence in making decisions about the care of patients”
• Client-centred care: An approach in which clients are viewed as whole persons; it is not merely
about delivering services where the client is located. Client centred care involves advocacy,
empowerment, and respecting the client’s autonomy, voice, self-determination, and participation
in decision-making.
• Family centred care: Generally indicates an approach to care in which the family is viewed as
the unit of care, rather than just the identified patient. This approach is consistent with a client
centred approach when each individual’s meaning of “family” is respected and families are
viewed as an integral whole
The philosophy of family centred care recognizes the family as the one constant in a child’s life.
The 3 components are respect, collaboration and support. Families are supported in their care
giving and decision making when HCP build on their unique strengths and acknowledge their
expertise in caring for their child both within and outside the hospital setting. Needs of all family
members not just the patients are promoted. Family centered care acknowledges diversity among
family structures and backgrounds, family goals, dreams, strategies, and actions, and family
support, service, and information needs. Two basic concepts of family centered care are enabling
and empowerment. Professionals enable families by creating opportunities for all family
members to display their current abilities and competencies and to acquire new ones that are
necessary to meet the needs of the child and family. Empowerment describes the interaction of
professionals with families in such a way that families maintain or acquire a sense of control
over their lives and makes positive changes that result from helping behaviours that foster their
own strengths, abilities and actions.
• Cultural competence: involves the complex integration of knowledge, attitudes, and skills that
enable the nurse to provide culturally appropriate healthcare. Developing cultural competence
requires cultural awareness, cultural knowledge, cultural skills, and cultural encounter.
• Interprofessional collaboration: health care professionals representing expertise from various
health care disciplines collaborate (work together) to provide care.
• Situational Background Assessment Recommendations (SBAR): The SBAR (Situation-
Background-Assessment-Recommendation) technique provides a framework for communication
between members of the health care team about a patient's condition. SBAR is an easy-to-
remember, concrete mechanism useful for framing any conversation, especially critical ones,
requiring a clinician’s immediate attention and action. It allows for an easy and focused way to
set expectations for what will be communicated and how between members of the team, which is
essential for developing teamwork and fostering a culture of patient safety.

2. Review the principles of client centered care.

NRS, 322 Acute Health Challenges Winter 2010
The client is the one who decides if and who will participate in his/her care. The term client, is inclusive of
individuals, families/significant others, groups, communities, and populations. The agency should choose which
meaning of client is most suitable for its population.
The following are the values and beliefs that were identified as foundational to client centred care:
Respect: Respect clients’ wishes, concerns, values, priorities, perspectives, and strengths.
Human Dignity: Care for clients as whole and unique human beings, not as problems or diagnoses.
Clients Are Experts for Their Own Lives: Clients know themselves the best.
Clients as Leaders: Follow the lead of clients with respect to information giving, decision making, care in
general and involvement of others.
Clients ‘Goals Coordinate Care of the Health Care Team: Clients define the goals that coordinate the practices
of the health care team. All members of the team work toward facilitating the achievement of these goals.
Continuity and Consistency of Care and Caregiver: Continuity and consistency of care and caregiver provides a
foundation for client centred care.
Timeliness: The needs of clients and communities deserve a prompt response.
Responsiveness & Universal Access: Care that is offered to clients is universally accessible and responsive to
their wishes, values, priorities, perspectives, and concerns.

3. 19Discuss the importance of interprofessional collaboration.

-the range and complexity of factors that influence health and well being, as well as disease and illness, require
health professionals from diverse health professions to work together in a comprehensive manner. Working
together, the combined knowledge and skills of health professionals become a powerful mechanism to enhance
the health of the population served.

4. Review the critical thinking process.

-critical thinking is an active, organized, cognitive process used to carefully examine one’s thinking and the
thinking of others. It involves forming conclusions, making decisions, drawing inferences, and reflecting. A
critical thinker identifies and challenges assumptions, considers key aspects of a situation, imagines and
explores alternatives, considers ethical principles, applies reason and logic, and thus makes informed decisions.
-good problem solving
-commitment to look for the best way, based on the most current research and practice findings.
-identify and challenge assumptions , use an organized approach to assessment, check for accuracy, use an
organized approach to assessment, check for accuracy and reliability of information, distinguish relevant from
irrelevant , normal from abnormal and recognize inconsistencies, cluster related information, identify patterns
and missing information and draw valid conclusions based on evidence, identify different concurrent
conclusions and underlying causes, set priorities, and evaluate and correct thinking.

Acutely Ill Child/Adult

5. Discuss the impact of illness on the child, adult, and family.

6. Identify nursing actions that promote effective coping for both the patient and family with an acute
illness.

7. Discuss the roles of the nurse in an acute care setting.

NRS, 322 Acute Health Challenges Winter 2010