Family Centred
Care
Carol Hilliard
NPDC
2007
Overview of lecture
Definition of ‘Family’
 Role of the family
 Identify the members of a family

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Family centred care (FCC)
Carol Hilliard 2007
What is a ‘family’?
Carol Hilliard 2007
What is a ‘family’?
Carol Hilliard 2007
What is a family?

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Several interpretations of a ‘family’
Our interpretation often depends on our own
experience of family
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In today’s world we must be open to the many
types of families we meet.
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Ultimately the family is defined by itself
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Therefore as nurses, we need to establish who
is in the child’s family
Carol Hilliard 2007
The Child in Hospital

Hospital can be new and frightening for children
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Often, their families are the only familiar aspect
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Hospital should not diminish the family’s role in
children’s care.

FCC recognises that nursing care is most
effective if done in conjunction with the parents
Carol Hilliard 2007
Family-centred care (FCC)
Broadly defined as promoting a partnership
between the parents and healthcare
professionals in the care of the child
(Smith et al. 2002)
Carol Hilliard 2007
The family
Assess the family relationships:

Are both parents involved?
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How many siblings in the family?
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Are the grandparents etc. involved in the child’s care?
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Any other important people?
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Will someone stay with the child in hospital?
Carol Hilliard 2007
Carol Hilliard 2007
The role of the nurse
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Introduce yourself to the child & parents
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Show the child & parents around the ward:
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tell them about the hospital facilities
Ask parents if they:

slept well,
had breakfast, etc.
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Explain the care the child will receive that day / night

Explain what you are going to do, for example, measure blood
pressure, dressing change
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Ask parents what they would like to do
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Ask them if they have any questions
Carol Hilliard 2007
Parents have a right to make decisions about
their child
Therefore:
Parents need to have information about
their child’s condition, treatment and nursing care
Carol Hilliard 2007
Answering questions

Do not be afraid to say “I do not know”
when a child / parent asks a question
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Tell child / parents “I do not know but I will
get that information for you”
Carol Hilliard 2007
Negotiation

Helping parents to be involved in their children’s care is
an important part of FCC

Nurses and parents need to decide who will perform the
care the child will need, for example:
- Showering the child
- Changing a wound dressing
- Feeding the child

How does the nurses’ routine suit the parents’ routine?
Carol Hilliard 2007
Family-Centered Care (FCC)

Remember: Parents do not know that they can
be involved in their child’s care

Therefore, nurses must explain to them

But nurses should not expect parents to be
involved

Therefore, negotiate with the parents what they
can do and what they want to do
Carol Hilliard 2007

A common myth is that family centred care
involves the parents staying with their child in
hospital.
This is not true

Family centred care means that we support the
parents to be involved as much as possible in
the child’s care
Carol Hilliard 2007
Reasons parents may not stay with
their child in hospital

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Other children
Expense
Their job
Personal reasons
Others ………
Remember: it is not our job to judge parents
Carol Hilliard 2007
The cost of staying with
a child in hospital
Food
 Parents’ accommodation
 Transport
 Possibly loss of earnings
 Child-minders for other siblings
 Telephone bills
 Toys & treats for the sick child
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Carol Hilliard 2007
Important Points
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Parents are not extra or unpaid nurses and should never
be expected to replace nursing shortages
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Parents should not be expected to be involved in their
children’s care - Parents can decide if they want to be
involved or not
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Never assume that a parent will do something
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Never judge parents because of your own personal
opinions
Carol Hilliard 2007
References

Battrick C. and Glasper E.A. (2002) The views of children and their families on being
in hospital, British Journal of Nursing 13(6), 328-336.

Callery P. (1997) Paying to participate: financial, social and personal costs to parents
of involvement in their children’s care in hospital, Journal of Advanced Nursing 25(4),
746-752.
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Casey A. (1995) Partnership nursing: influences on involvement of informal carers,
Journal of Advanced Nursing 22(6), 1058-1062.

Children in Hospital Ireland (2002) The EACH Charter for children in hospital &
annotations, Children in Hospital Ireland, Dublin.

Coyne I.T. (1995) Partnership in care: parents' views of participation in their
hospitalised child's care, Journal of Clinical Nursing 4(2), 71-79.
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Dudley S.K. and Carr J.M. (2004) Vigilance: the experience of parents staying at the
bedside of hospitalised children, Journal of Pediatric Nursing 19(4), 267-275.
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Espezel H.J.E. and Canam C.J. (2003) Parent–nurse interactions: care of
hospitalized children, Journal of Advanced Nursing 44(1), 34-41.
Carol Hilliard 2007
References

Friedman M (1998) Family nursing: theory and practice, 4th edition. Appleton-CenturyCrofts, Norwalk, CT, USA.
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Lindsay B. (2001) Visitors and children’s hospitals, 1852-1948: a re-appraisal,
Paediatric Nursing 13(4), 20-24.
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Lupton D. and Fenwick J. (2001) ‘They’ve forgotten that I’m the mum’: constructing
and practising motherhood in special care nurseries, Social Science & Medicine 53,
1011–1021.
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Shields L. and Tanner A. (2004) Costs of meals and parking for parents of
hospitalised children in Australia, Paediatric Nursing 16(6), 14-18.
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Smith L., Coleman V. and Bradshaw M. (eds) (2002) Family-centred care: concept,
theory and practice, Palgrave, Basingstoke, Hampshire.
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Valentine F. (1998) Empowerment: family-centred care, Paediatric Nursing 10(1), 247.
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Wang K.W.K. and Barnard A. (2004) Technology-dependent children and their
families: a review, Journal of Advanced Nursing 45(1), 36-46.
Carol Hilliard 2007