PDFlib PLOP: PDF Linearization, Optimization, Protection

Page inserted by evaluation versionwww.pdflib.com – sales@pdflib.com

Family-centered care (FCC) evolved, in part, as aneffort to humanize health care settings. FCC hasbeen so widely used to describe a broad range ofhealth care services and providers—especially servic-es to women, children, and their families—that themeaning of the term has become diluted. Liberalhospital visitation, incorporating patients and fami-ly members on hospital advisory councils, or usingthe term family-centered care in hospital or unitpolicies are important components of FCC, but inisolation, they simply do not go far enough.

According to the nonprofit Institute for Family-Centered Care (2004), “Family-centered care is anapproach to the planning, delivery, and evaluation ofhealth care that is governed by mutually beneficialpartnerships between health care professionals,patients, and families.” This definition establishes highstandards for professional collaboration with fami-lies from the conceptualization and design of healthcare services through their delivery and evaluation.

FCC has been supported by the establishment ofTitle V agencies and programs, inclusion in publichealth goals set by the U.S. Department of Healthand Human Services in Healthy People 2010, andthe endorsement by many professional nursingorganizations such as AWHONN. However, tworesearch reports recently published in JOGNN vivid-ly illustrate the disconnection between the theoryand practice of FCC in neonatal intensive care unitsettings. In the first report, Hurst (2004) presented amother’s experience in a neonatal intensive care unit.This woman’s needs and the concerns of her familywere seemingly overshadowed by the unit’s pressingneeds for a bilingual interpreter and transportationfor non-English-speaking families. In the secondarticle, Petersen and colleagues (2004) presented astudy of FCC in three in-patient units within thesame hospital: the neonatal intensive care unit, pedi-atrics, and the pediatric intensive care unit. Theyfound that neonatal intensive care nurses were lesslikely to value and implement the tenets of family-centered care compared to pediatric and pediatricintensive care nurses.

Between 1992 and 2003, the preterm birth raterose from 10.7 to 12.3% and the low-birth-weightrate increased from 7.1 to 7.9%. More families thanever before are using high-risk neonatal, perinatal,and obstetric services. Therefore, obstetric andneonatal nurses are compelled to practice FCCbecause it is in those settings that many familiesbegin. Although our current health care environ-ment may present significant barriers to family-cen-tered care, these barriers could be overcome if allnurses were fully committed to family-centered nurs-ing care. By collaborating with families, we can helpthem create and achieve healthy lives and familyrelationships. Nurses across settings—practice, edu-cation, administration, and research—must embracefamily-centered care as the way to practice, teach,and study nursing. To do this, we must collaboratewith families not only in direct patient care but alsoin designing curricula for nursing educational pro-grams, creating and planning supportive institution-al environments, and setting national research prior-ities that reflect the vital role of families in ourpatients’ lives and our commitment to a truly col-laborative partnership. It is time to move beyond therhetoric.

Kristin F. LutzPostdoctoral FellowOregon Health & Science University

REFERENCES

Hurst, I. (2004). I. Imposed burdens: A Mexican Ameri-can mother’s experience of family resources in anewborn intensive-care unit. Journal of Obstetric,Gynecologic, and Neonatal Nursing, 33, 156-163.

Institute for Family-Centered Care. (2004). What is fami-ly-centered care? Retrieved December 15, 2004,from http://www.familycenteredcare.org/about-us-frame.html

Petersen, M. F., Cohen, J., & Parsons, V. (2004).Family-centered care: Do we practice what wepreach? Journal of Obstetric, Gynecologic, andNeonatal Nursing, 33, 421-427.

Address for correspondence: Kristin F. Lutz, PhD, RN,Oregon Health & Science University, School of Nursing,Mail Code SN-5S, 3455 SW US Veterans Hospital Road,Portland, OR 97239. E-mail: lutzk@ohsu.edu.

March/April 2005 JOGNN 149

EDITORIAL

Moving Beyond the Rhetoric of Family-Centered Care