A patient centered care approach

BOX 27-7 CULTURAL ASPECTS OF CARE A Patient-Centered Care Approach Hospitalization places patients at risk for injury in an unfamiliar and confusing environment. The experience is usually at least minimally frightening. Normal life cues such as a bed without side rails and the direction one usually takes to the bathroom are absent. Thought processes and coping mechanisms are affected by illness and its accompanying emotions. Thus patients are more vulnerable to injury. This vulnerability is often intensified for patients of diverse backgrounds, It is a nurse's responsibility to diligently protect all patients, regardless of their socioeconomic status and cultural background. Most untoward events are related to failures of communication. This is espe- cially important during assessment. Ensure you use an approach that recog~ nizes a patient's cultural background so you ask appropriate questions to reveal health behaviors and risks, You also need to be aware of cultural beliefs about restraints when caring for patients who need restraints. Safety is enhanced when you consider patients in light ofthe whole person and value seeing each care situation through "the patient's eyes" and not just through your own perspective, Some specific patient-centered safety guidelines about the use of restraints follow. Implications for Practice 0 When restraints are needed, assess their meaning to the patient and the family. For example, some Asian families view the restraining of older adults as disrespectful. Similarly some survivors of war or persecution view restraints as imprisonment or punishment. Collaborate with family members in accommodating a patient's cultural perspectives about restraints. Removing the restraints when family members are present shows respect and caring for the patient. Define the protocol of the nursing unit on the use of restraints. Identify potential areas for negotiation with the patient's/family's preferences such as using a jacket versus arm restraints.