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Fundamentals · chapter 6 · Promoting Individualized Care

Patient-Centered and Holistic Health Care

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. PCC patient empowerment

    Patient-centered care aims to empower patients to become active participants in their care, with the hope of giving them self-management in the process.

  2. Whole-patient nursing view

    The nurse looks at the whole patient, not just the diagnosis or complaint, to get a better understanding of the situation.

  3. Nurse liaison role

    The nurse can collaborate with the physician and act as a liaison between the physician and patient to improve care and outcomes.

  4. PCC implementation standards

    Patient-centered care models emerged as best practice standards in nursing and can be achieved through care coordination and integration of care.

  5. PCC patient outcomes

    Patients who receive patient-centered care report more satisfaction with care received, higher rates of patient engagement, and better healthcare outcomes.

  6. PCC system benefits

    The benefits can translate into faster recovery and lower emergency room visits or readmission rates, all of which affect the total cost of patient care.

  7. Care coordination purpose

    Care coordination is an important factor in providing effective, efficient, and safe patient-centered care.

  8. Integrated records benefit

    For example, when facilities utilize integrated electronic health records across specialties, it allows healthcare providers real-time access to accurate patient information such as screenings, laboratory tests, and prescriptions. With this integrated access, duplicating laboratory tests does not occur, which controls overall costs.

  9. Transparency and outcomes

    Transparency in health care promotes care coordination and the concept of high-quality, high-value care. As patients are more aware of the costs, able to make better choices for care, and participate in programs that promote care coordination, better health outcomes should occur.

  10. Interaction after care

    Increased interaction and improved communication, such as following up with patients after surgical procedures, with test results, or after new medications are started, has positive effects on patient satisfaction, length of stay, and adverse events (Wang et al., 2018).

  11. Shared decision-making outcomes

    Research suggests that patients who participate in decision-making not only have better healthcare outcomes, improved satisfaction with health care, and reduction of healthcare costs, but also can reduce their mortality from chronic disease (Paterick et al., 2017).

  12. Family decision support

    When families are involved in the decision-making process, patients are more prone to following through with the care plan because the family can provide additional resources for the patient.

  13. Self-management education

    Nurses should help patients realize they are in control of their own health; health care is not a passive process in which only the healthcare provider tells them what to do.

  14. Holistic intervention safety

    Nurses should attempt to incorporate holistic interventions into their patients’ care plans only after confirming with the rest of the clinical team that the treatments are safe and will not interfere with the medical plan.

Terms to know

patient-centered care (PCC)
The term patient-centered care (PCC) is a healthcare delivery model that aims to ensure the patient is an equal partner in their health care.
holistic care
Relatedly, holistic care is aimed at healing all parts of the body, mind, and spirit.
care coordination
The term care coordination is the specific coordination among team members to organize healthcare activities.
medical power of attorney
If a patient is under 18 years of age or is not capable of making decisions for themselves, then a family member is typically assigned as the medical power of attorney, or the person in charge of making medical decisions for the patient.
thoughtful practice
Practicing care in a way that reflects compassion and incorporates empathy for a patient’s unique situation is known as thoughtful practice.
self-knowledge
Increasing self-knowledge, the understanding of one’s own motives and character, is an important aspect of being a nurse.
aromatherapy
The use of essential oils via inhalation or diluted application to the skin is known as aromatherapy.
hydrotherapy
The use of water to reduce pain, swelling, and sore muscles is called hydrotherapy.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

The graded version needs JavaScript. Every question is below anyway, with the answer and why.

Every question here, with the answer

  1. A patient with a chronic condition says, “I will just do whatever the provider tells me. I do not need to be involved.” Which nursing response best reflects patient-centered care?

    1. “Your family should make most of the decisions so you do not feel overwhelmed.”
    2. “Let’s review your options and discuss how your daily choices affect your health.”
    3. “The provider’s diagnosis is the only information needed for your care plan.”
    4. “You should wait until your next visit before asking questions about your treatment plan.”

    Answer: “Let’s review your options and discuss how your daily choices affect your health.”

    Patient-centered care supports the patient as an active participant and key team member in the care plan. The other responses reduce the patient’s role, focus only on diagnosis, or delay communication instead of supporting self-management.

  2. The nurse is planning care coordination for a patient with multiple healthcare needs. Which actions demonstrate appropriate care coordination? Select all that apply.

    1. Using integrated electronic health records so providers can access accurate patient information
    2. Repeating laboratory tests across specialties to make sure each office has its own results
    3. Clarifying accountability and responsibilities among healthcare team members
    4. Linking the patient with community resources
    5. Arranging a timely referral for physical therapy

    Answer: Using integrated electronic health records so providers can access accurate patient information, Clarifying accountability and responsibilities among healthcare team members, Linking the patient with community resources, Arranging a timely referral for physical therapy

    Care coordination organizes healthcare activities among team members and supports effective, efficient, safe patient-centered care. Repeating laboratory tests unnecessarily is inconsistent with the section’s example that integrated access prevents duplication and controls costs.

  3. A patient asks why the provider ordered an MRI instead of a CT scan. Which nursing action best supports transparency in care?

    1. Encourage the patient to focus on insurance approval rather than the purpose of the test.
    2. Tell the patient to wait for the results before asking about the test.
    3. Explain that diagnostic choices are made by providers and do not need to be discussed.
    4. Review the reason the diagnostic test was ordered and how it relates to the patient’s care.

    Answer: Review the reason the diagnostic test was ordered and how it relates to the patient’s care.

    Transparency gives patients more control and helps build trust by explaining the reason for care decisions. Avoiding the discussion or delaying the explanation does not support transparent, patient-centered care.

  4. The nurse is considering holistic interventions for a patient’s care plan. Which nursing actions are appropriate? Select all that apply.

    1. Teach the patient not to consume essential oils when discussing aromatherapy
    2. Begin acupuncture at the bedside because it is a common holistic treatment
    3. Avoid massaging the lower extremities of a patient diagnosed with or expected to have deep vein thrombosis
    4. Use hydrotherapy for a patient who already has weeping skin on the lower extremities
    5. Confirm with the clinical team that the treatment is safe and will not interfere with the medical plan

    Answer: Teach the patient not to consume essential oils when discussing aromatherapy, Avoid massaging the lower extremities of a patient diagnosed with or expected to have deep vein thrombosis, Confirm with the clinical team that the treatment is safe and will not interfere with the medical plan

    The section states that nurses should confirm holistic interventions are safe and do not interfere with the medical plan, teach safe essential oil use, and avoid lower-extremity massage when DVT is diagnosed or expected. Acupuncture should only be performed by a certified acupuncturist, and a patient with weeping lower-extremity skin would not be a good candidate for hydrotherapy.

  5. A patient had a surgical procedure yesterday and has started a new medication. Which nursing action best reflects the increased interaction described in patient-centered care?

    1. Limit communication to the discharge paperwork to avoid overwhelming the patient.
    2. Ask the family to monitor the patient and contact the nurse only if there is a problem.
    3. Follow up with the patient about the procedure, test results, and response to the new medication.
    4. Wait for the patient to call before providing any follow-up information.

    Answer: Follow up with the patient about the procedure, test results, and response to the new medication.

    Increased interaction includes improved communication and follow-up after procedures, test results, or new medications. Waiting passively or relying only on paperwork or family communication does not reflect the nurse’s role in improving communication during changing conditions.

  6. A patient receiving palliative care reports physical discomfort, fear, and concern about spiritual needs. Which actions are consistent with holistic nursing care? Select all that apply.

    1. Collaborate with interdisciplinary holistic healthcare providers
    2. Include traditional treatments along with complementary and alternative treatments when appropriate
    3. Address the patient’s physical, psychological, and spiritual needs as part of the plan of care
    4. Focus only on the physical diagnosis because palliative care is not related to emotional needs
    5. Avoid discussing the patient’s concerns because holistic care is separate from nursing care

    Answer: Collaborate with interdisciplinary holistic healthcare providers, Include traditional treatments along with complementary and alternative treatments when appropriate, Address the patient’s physical, psychological, and spiritual needs as part of the plan of care

    Holistic care treats the mind, body, and spirit as one, and palliative care is given as an example of a situation requiring spiritual, psychological, and physical needs to be met. Ignoring emotional or spiritual concerns conflicts with holistic nursing care.

Where every quote comes from

Section 6.1 Patient-Centered and Holistic Health Care of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.