Family centered care

Family Centered Care:Family Centered Care:
Strategies for SuccessStrategies for Success
Jocelyn Farrar RN, MS, CCRN CRNPJocelyn Farrar RN, MS, CCRN CRNP
Doctoral Student, University of MarylandDoctoral Student, University of Maryland
School of NursingSchool of Nursing
Baltimore, MarylandBaltimore, Maryland
Robyn Schaffer MARobyn Schaffer MA
Carine McLaughlin LCSWCarine McLaughlin LCSW
Lara Klick BALara Klick BA
Sinai Hospital of BaltimoreSinai Hospital of Baltimore
Baltimore, MarylandBaltimore, Maryland

Why Design This Course?Why Design This Course?
• Adoption of a culture of Family Centered CareAdoption of a culture of Family Centered Care
• Nursing SurveyNursing Survey
– Strong desire to adopt Family Centered Care conceptsStrong desire to adopt Family Centered Care concepts
– Little to no Family Centered Care content in SchoolsLittle to no Family Centered Care content in Schools
of Nursingof Nursing
– Learning needsLearning needs
• Impact of hospitalization of family membersImpact of hospitalization of family members
• Communication strategiesCommunication strategies
• Developing partnerships with familiesDeveloping partnerships with families
• Caring for challenging familiesCaring for challenging families
• Dealing with out of control situationsDealing with out of control situations
• Recommendations from literatureRecommendations from literature
• Recommendations from familiesRecommendations from families

No one ever told me grief felt so much like fear.
-- C. S. Lewis (1898-1963)
www.6seconds.org/hwc/online/grief.html

Course Planning CommitteeCourse Planning Committee
• PatientsPatients
• Family membersFamily members
• Direct Care RNDirect Care RN
• Chairperson of the Family Centered CareChairperson of the Family Centered Care
Advisory CouncilAdvisory Council
• Director of Social WorkDirector of Social Work
• Director of Nursing EducationDirector of Nursing Education
• Organization Effectiveness DevelopmentOrganization Effectiveness Development
SpecialistSpecialist
• Safety and SecuritySafety and Security

Course ObjectiveCourse Objective
• To provide the participant with theTo provide the participant with the
knowledge and skills to enhance theknowledge and skills to enhance the
development of clear communication anddevelopment of clear communication and
positive partnerships with patientspositive partnerships with patients
and familiesand families

Participant Learning ObjectivesParticipant Learning Objectives
• Articulate the conceptsArticulate the concepts of Family Centered Careof Family Centered Care
• Discuss the impactDiscuss the impact of hospitalization on family membersof hospitalization on family members
• Identify interventionsIdentify interventions to optimize culturally sensitiveto optimize culturally sensitive
family care and facilitate positive partnering with patientsfamily care and facilitate positive partnering with patients
• Utilize the knowledgeUtilize the knowledge of differing temperaments toof differing temperaments to
provide optimal interventions for family membersprovide optimal interventions for family members
• Analyze personal biases and beliefs that influenceAnalyze personal biases and beliefs that influence
interpersonal relationshipsinterpersonal relationships
• Demonstrate effective communicationDemonstrate effective communication techniques whentechniques when
interacting with family membersinteracting with family members
• Implement appropriate interventionsImplement appropriate interventions for familiesfor families
exhibiting anger, aggression, and crisisexhibiting anger, aggression, and crisis
• Identify resourcesIdentify resources to assist in difficult or out of controlto assist in difficult or out of control
situationssituations

Family Centered Care: StrategiesFamily Centered Care: Strategies
for Successfor Success
Course OverviewCourse Overview
• Flexible, adapt to various educationFlexible, adapt to various education
venuesvenues
• 4 Modules4 Modules
– One computer-based learning moduleOne computer-based learning module
– Three interactive education modulesThree interactive education modules

Module 1: Computer – BasedModule 1: Computer – Based
Learning ModuleLearning Module
• Introduction to the Philosophy of FamilyIntroduction to the Philosophy of Family
Centered CareCentered Care
– Set the stage for the journeySet the stage for the journey
– What to expectWhat to expect
– ImpactImpact
• Prerequisite to other modulesPrerequisite to other modules
• 30 minutes to complete30 minutes to complete
• CEUs providedCEUs provided

Modules 2, 3, 4:Modules 2, 3, 4:
Interactive Education ModulesInteractive Education Modules
• Use as single modules or as a 4 – hour courseUse as single modules or as a 4 – hour course
– Module 2: Families in Crisis – 1 hourModule 2: Families in Crisis – 1 hour
– Module 3: “It’s All About Me” – 45 minutesModule 3: “It’s All About Me” – 45 minutes
– Module 4: Working with Families in Crisis – 1 hour 30Module 4: Working with Families in Crisis – 1 hour 30
minutesminutes
• Teaching strategiesTeaching strategies
– LectureLecture
– Interactive discussionInteractive discussion
– Role playingRole playing
– Group activitiesGroup activities
– Case study analysisCase study analysis
– CEUs providedCEUs provided

Pre Course EvaluationPre Course Evaluation
• I can clearly discuss theI can clearly discuss the
impact of hospitalization onimpact of hospitalization on
the patient’s familythe patient’s family
• I can identify the personalI can identify the personal
beliefs and biases thatbeliefs and biases that
influence my interpersonalinfluence my interpersonal
relationshipsrelationships
• I can apply my knowledgeI can apply my knowledge
of the impact of differentof the impact of different
temperaments to providetemperaments to provide
optimal interventions foroptimal interventions for
family membersfamily members
• I can develop effectiveI can develop effective
partnerships when caringpartnerships when caring
for familiesfor families
• I am able to demonstrateI am able to demonstrate
proactive negotiation andproactive negotiation and
contracting skillscontracting skills
ScoringScoring
• 4 = highly agree4 = highly agree
• 3 = agree3 = agree
• 2 = disagree2 = disagree
• 1 = highly1 = highly
disagreedisagree

Module 1: Computer – basedModule 1: Computer – based
Learning ModuleLearning Module

Family Centered CareFamily Centered Care
InitiativeInitiative
…………………………………………………………
…………
Advancing the Practice of FamilyAdvancing the Practice of Family
Centered Care. . .Centered Care. . .
Making Families Partners in CareMaking Families Partners in Care

What is Family CenteredWhat is Family Centered
Care?Care?
• AA philosophy and approach to healthphilosophy and approach to health care that placescare that places
the patient and family at the center of the institutionalthe patient and family at the center of the institutional
and professional purposesand professional purposes
• Patients and families arePatients and families are involvedinvolved in all aspects ofin all aspects of
planning, implementation and evaluation of healthplanning, implementation and evaluation of health
servicesservices
• It involves patients and families inIt involves patients and families in polices,polices, programs,programs,
facility design, and staff day-to-day interactions.facility design, and staff day-to-day interactions.
• Family Centered Care facilitatesFamily Centered Care facilitates collaborativecollaborative
relationships between and among consumers andrelationships between and among consumers and
health providers.health providers.

Family Centered Care is aFamily Centered Care is a paradigm shiftparadigm shift
and a profound change in culture for many health careand a profound change in culture for many health care
organizationsorganizations
• Family Centered CareFamily Centered Care challenges the traditionalchallenges the traditional
approachesapproaches that:that:
– Focus on patient and familyFocus on patient and family deficitsdeficits
– DisempowerDisempower patients and familiespatients and families
– Rely heavily onRely heavily on technologytechnology and biomedicaland biomedical
sciencescience
– UndervalueUndervalue the importance of humanthe importance of human
interactions in the health care experienceinteractions in the health care experience
– Are driven by theAre driven by the needs of the healthcareneeds of the healthcare
professionalsprofessionals and the systemand the system

Family Centered Care helps usFamily Centered Care helps us
clearly understand that. . .clearly understand that. . .

With that being said, we realize this concept
may bring a multitude of emotions….

But….for the sake of perspective…..just imagine ifBut….for the sake of perspective…..just imagine if
your loved one was now “the patient”….your loved one was now “the patient”….
How would you like him/her to be
treated? As the family member, how
would youyou like to be treated?

Regulatory and Specialty CareRegulatory and Specialty Care
Organizations That Support FamilyOrganizations That Support Family
• JCAHOJCAHO
• Healthcare AdvisoryHealthcare Advisory
BoardBoard
• Institute forInstitute for
HealthcareHealthcare
ImprovementImprovement
• Society of CriticalSociety of Critical
Care MedicineCare Medicine
• American HospitalAmerican Hospital
AssociationAssociation
• American AssociationAmerican Association
of Critical Careof Critical Care
NursesNurses
• Institute of MedicineInstitute of Medicine
• Institute for FamilyInstitute for Family

Why Is Family Centered CareWhy Is Family Centered Care
Important to Sinai Hospital?Important to Sinai Hospital?
• PATIENT SAFETY IS ENHANCED WHEN PATIENTSPATIENT SAFETY IS ENHANCED WHEN PATIENTS
AND FAMILIES PARTNER WITH THE HEALTH CAREAND FAMILIES PARTNER WITH THE HEALTH CARE
TEAMTEAM
• Patients and families are becoming more aware of theirPatients and families are becoming more aware of their
rights and arerights and are advocatingadvocating more vigorously for increasedmore vigorously for increased
accessaccess
• JCAHOJCAHO and others are looking for increased patient andand others are looking for increased patient and
family involvement in the development andfamily involvement in the development and
implementation of the plan of careimplementation of the plan of care
• ComplaintsComplaints have been received from patients and theirhave been received from patients and their
familiesfamilies
• ConfrontationsConfrontations have occurred between visitors and staffhave occurred between visitors and staff

Patient and family satisfactionPatient and family satisfaction
surveys give a measure ofsurveys give a measure of
where we are now:where we are now:
Overall Assessment ofOverall Assessment of
HospitalHospital

Patient Personal IssuesPatient Personal Issues

Visitor and Family IssuesVisitor and Family Issues

Where we want to be for the future!

TheThe Core ConceptsCore Concepts of Family Centeredof Family Centered
Care give us a vision of where we want toCare give us a vision of where we want to
bebe
• Mutual respectMutual respect
• Patient and familyPatient and family
choicechoice
• Focus on strengthsFocus on strengths
• Flexibility in healthFlexibility in health
care deliverycare delivery
• Information sharingInformation sharing
supportsupport
• Mutual collaborationMutual collaboration
empowermentempowerment

According to experts, the key phrase weAccording to experts, the key phrase we
like to work around is:like to work around is:
Families are not visiting,Families are not visiting,
they arethey are
“Family-ing”“Family-ing”

We will work to overcome issues that haveWe will work to overcome issues that have
historically beenhistorically been barriersbarriers to Family Centeredto Family Centered
CareCare
• Lack of geographicLack of geographic spacespace
• Incorrectly perceivedIncorrectly perceived negative impactnegative impact onon
recovery and healingrecovery and healing
• Staff convenienceStaff convenience
• Fear of “Fear of “being watchedbeing watched””
• Lack ofLack of timetime
• Nursing shortageNursing shortage
• ““It’sIt’s not my job”not my job”

MAGNETMAGNET
RECOGNITIONRECOGNITION
STUDERSTUDER
PRINCIPLESPRINCIPLES
PRESS GANEYPRESS GANEY
BASICS
SERVICESERVICE
EXCELLENCEEXCELLENCE
FAMILYFAMILY
CENTEREDCENTERED
CARECARE
Family Centered Care facilitates collaboration between the
patient, family and health
care team at all levels.

Family Centered CareFamily Centered Care outcomesoutcomes fromfrom
three major health care organizationsthree major health care organizations
across the country include:across the country include:
• Improved nursingImproved nursing staff satisfactionstaff satisfaction scoresscores
• ImprovedImproved patient and family satisfactionpatient and family satisfaction scores andscores and
reduced complaintsreduced complaints
• Contributed toContributed to successful Magnet certificationsuccessful Magnet certification
• Contributed to successfulContributed to successful JCAHO surveyJCAHO survey

PotentialPotential BenefitsBenefits to Sinaito Sinai
• ImprovedImproved safety and quality outcomessafety and quality outcomes
• ImprovedImproved medical & developmental outcomesmedical & developmental outcomes
• IncreasedIncreased organization responsivenessorganization responsiveness to patient andto patient and

PotentialPotential BenefitsBenefits to Sinaito Sinai
• EnhancedEnhanced patient and family satisfactionpatient and family satisfaction as well as staffas well as staff
and faculty satisfactionand faculty satisfaction
• Positions the hospital or clinic more effectively in thePositions the hospital or clinic more effectively in the
marketplacemarketplace
• Builds a cadre of families able toBuilds a cadre of families able to advocate for qualityadvocate for quality inin
health care and the resources to support quality in healthhealth care and the resources to support quality in health
carecare
• EnhancesEnhances employee prideemployee pride in the hospitalin the hospital

Organizational changesOrganizational changes that will helpthat will help
us reach our goal include:us reach our goal include:
• Mission, Vision and Philosophy of Care StatementsMission, Vision and Philosophy of Care Statements willwill
address family centered care and set the organizationaladdress family centered care and set the organizational
tonetone
• The leadership group and staff will adopt aThe leadership group and staff will adopt a change inchange in
cultureculture to one of patient and family centered careto one of patient and family centered care
• Patients and families will participatePatients and families will participate in hospital-wide andin hospital-wide and
unit based committeesunit based committees
• Patients and families will be givenPatients and families will be given choiceschoices in carein care
• Patients and families willPatients and families will collaboratecollaborate with the health carewith the health care
team in the planning, implementation and evaluation ofteam in the planning, implementation and evaluation of
carecare

OtherOther goal enhancinggoal enhancing organizationalorganizational
changeschanges include:include:
• Policies and performance evaluationsPolicies and performance evaluations will include awill include a
patient and family focuspatient and family focus
• Patient and familyPatient and family resourcesresources will be made availablewill be made available
• SignageSignage will be patient and family friendlywill be patient and family friendly
• ClinicalClinical documentationdocumentation will reflect the philosophy ofwill reflect the philosophy of

The followingThe following challengeschallenges
to Family Centered Care are beingto Family Centered Care are being
addressed as we move forward:addressed as we move forward:
• Safety and securitySafety and security
issuesissues
• ParkingParking
• Facility designFacility design
• Attitudes - patient,Attitudes - patient,
family, stafffamily, staff
• Staff knowledge andStaff knowledge and
skillsskills
• Family supportFamily support
resourcesresources
• ConfidentialityConfidentiality
• Resuscitations andResuscitations and
other complex clinicalother complex clinical
eventsevents
• Presence of childrenPresence of children

What IsWhat Is YourYour
RoleRole??
• EducateEducate yourself on theyourself on the
philosophy ofphilosophy of
• TalkTalk to your peers and leadersto your peers and leaders
• BecomeBecome involvedinvolved on a Family Centered Care unit-basedon a Family Centered Care unit-based
committeecommittee
• AttendAttend educationeducation offeringsofferings
• Incorporate the core conceptsIncorporate the core concepts of Familyof Family
Centered Care into your daily practiceCentered Care into your daily practice

Family Centered Care:Family Centered Care:
What have you learned?What have you learned?

1) In the Family Centered Care model, visiting is1) In the Family Centered Care model, visiting is
driven by the PATIENT'S choices and requests.driven by the PATIENT'S choices and requests.
True or FalseTrue or False

2) In understanding the concept of Family2) In understanding the concept of Family
Centered Care, staff are defined as “visitors”.Centered Care, staff are defined as “visitors”.

3) With Family Centered Care, patients and families3) With Family Centered Care, patients and families
are involved in planning and implementing, butare involved in planning and implementing, but
not evaluating health services.not evaluating health services.
Evaluation is the sole responsibility of theEvaluation is the sole responsibility of the
healthcare professional.healthcare professional.

4) Family should not be allowed to be present at4) Family should not be allowed to be present at
the bedside or participate in rounding due to thethe bedside or participate in rounding due to the
time constraints of the physician team and thetime constraints of the physician team and the
numbers of questions the patient or family willnumbers of questions the patient or family will
have.have.

5) Through the Family Centered Care initiative,5) Through the Family Centered Care initiative,
patient or family advocates will serve on unit-patient or family advocates will serve on unit-
based committees, bringing their expertise asbased committees, bringing their expertise as
patients and families to the table.patients and families to the table.

You have successfully completed theYou have successfully completed the
introductory course ofintroductory course of
Family Centered Care!Family Centered Care!

Module 2:Module 2:
Families In CrisisFamilies In Crisis
• Case studyCase study analysis andanalysis and applicationapplication ofof
conceptsconcepts
• InteractiveInteractive lecture and group discussionlecture and group discussion
• One hour moduleOne hour module

Module 2Module 2
Families In Crisis - ObjectivesFamilies In Crisis - Objectives
• DefineDefine crisiscrisis
• Discuss a family’s initialDiscuss a family’s initial responseresponse to crisisto crisis
• Describe three areas to include in a familyDescribe three areas to include in a family
systemsystem assessmentassessment
• Outline theOutline the top ten needstop ten needs of familiesof families
• ImplementImplement strategiesstrategies to appropriately careto appropriately care
for a family in crisisfor a family in crisis

Module 2: ContentModule 2: Content
• Crisis Case StudiesCrisis Case Studies
– DefinitionDefinition of crisisof crisis
– GoalsGoals of interventionof intervention
– Families initialFamilies initial reactionsreactions
– TopTop needsneeds of families in crisisof families in crisis
– Factors thatFactors that affect the responseaffect the response to crisisto crisis
– AssessmentAssessment of the family in an acute care settingof the family in an acute care setting
– What is a “What is a “challengingchallenging” family” family
– EffectiveEffective staff copingstaff coping skillsskills
– WhatWhat to doto do in a crisisin a crisis
– WhatWhat not to donot to do in a crisisin a crisis

Module 3Module 3
“It’s All About Me”“It’s All About Me”
• Lecture andLecture and interactiveinteractive discussiondiscussion
• Case studyCase study analysisanalysis

Module 3: ObjectivesModule 3: Objectives
• IdentifyIdentify personal biasespersonal biases that affect relationshipsthat affect relationships
with familieswith families
• DiscussDiscuss personal triggers/buttonspersonal triggers/buttons that preventthat prevent
effective partnering with patients and familieseffective partnering with patients and families
• AnalyzeAnalyze preferences and temperamentspreferences and temperaments thatthat
impact the development of partnershipsimpact the development of partnerships
• AnalyzeAnalyze behaviorsbehaviors that contribute to respect forthat contribute to respect for
differences and diversitydifferences and diversity

Module 3: ContentModule 3: Content
• Beliefs and biasesBeliefs and biases
– Ladder of InferenceLadder of Inference
– PersonalPersonal communication filterscommunication filters
– Triggers and buttonsTriggers and buttons
• EffectiveEffective listening skillslistening skills in difficult timesin difficult times
• PersonalPersonal preferences and temperamentspreferences and temperaments
– Absorb new informationAbsorb new information
– Make decisionsMake decisions
• Respecting differences and diversityRespecting differences and diversity

Module 4:Module 4:
Working With Families in CrisisWorking With Families in Crisis
• Lecture andLecture and interactiveinteractive discussiondiscussion
• Group workGroup work
• Role playRole play
• ScriptingScripting

Module 4: ObjectivesModule 4: Objectives
• RecognizeRecognize proactive techniquesproactive techniques to establishto establish
collaborative guidelines for partnershipscollaborative guidelines for partnerships
• DemonstrateDemonstrate proactive contracting and negotiatingproactive contracting and negotiating skillsskills
• IdentifyIdentify key wordskey words for communicating a caring responsefor communicating a caring response
to patients and familiesto patients and families
• Identify behaviors indicatingIdentify behaviors indicating escalating dissatisfactionescalating dissatisfaction inin
patients and familiespatients and families
• DemonstrateDemonstrate proactive positive de-escalation techniquesproactive positive de-escalation techniques
for working with angry patients and familiesfor working with angry patients and families
• IdentifyIdentify resourcesresources available to assist in out of controlavailable to assist in out of control
situations, when to access them and how to access themsituations, when to access them and how to access them

Module 4 - ContentModule 4 - Content
• Proactive patient preference discussionProactive patient preference discussion
– Establishing patient focused guidelines for careEstablishing patient focused guidelines for care
• Establishing partnersEstablishing partners in carein care
– TheThe responsibilityresponsibility of the patient, family and health care providerof the patient, family and health care provider
• ContractingContracting
– Ensuring thatEnsuring that “rules” are not a mystery“rules” are not a mystery
– NegotiatingNegotiating
– Red, Yellow and Green light rulesRed, Yellow and Green light rules
• Disagreements: Defining the Real IssuesDisagreements: Defining the Real Issues
– When is the issue not the issue?When is the issue not the issue?
– Addressing theAddressing the real issuereal issue
– What does it sound like (What does it sound like (scriptingscripting))
– When do you need helpWhen do you need help
• Anger and aggressionAnger and aggression
– De-escalationDe-escalation techniquestechniques
– DangerDanger signssigns
– Getting helpGetting help

The Tipping PointThe Tipping Point
• BehaviorBehavior of staff on the unitof staff on the unit
– Integrating concepts into careIntegrating concepts into care
– Questioning the status quoQuestioning the status quo
– Refusing to accept “non-family centered behaviorsRefusing to accept “non-family centered behaviors
• Managers appreciate theManagers appreciate the
valuevalue of the courseof the course
– Enhanced patient safetyEnhanced patient safety
– Nurse retention = $$$ savedNurse retention = $$$ saved
– Less problems = Time savingsLess problems = Time savings
– Patient and Family satisfaction =Patient and Family satisfaction =
• Better patient outcomesBetter patient outcomes
• Congruent with mission and visionCongruent with mission and vision
• Hospital of choiceHospital of choice
• Positive financial impactPositive financial impact

Post Course EvaluationPost Course Evaluation
• I can clearly discuss the impactI can clearly discuss the impact
of hospitalization on theof hospitalization on the
patient’s familypatient’s family
• I can identify the personalI can identify the personal
beliefs and biases that influencebeliefs and biases that influence
my interpersonal relationshipsmy interpersonal relationships
• I can apply my knowledge of theI can apply my knowledge of the
impact of differentimpact of different
temperaments to providetemperaments to provide
optimal interventions for familyoptimal interventions for family
membersmembers
• I can develop effectiveI can develop effective
partnerships when caring forpartnerships when caring for
familiesfamilies
• I am able to demonstrateI am able to demonstrate
proactive negotiation andproactive negotiation and
contracting skillscontracting skills
ScoringScoring
• 4 = highly agree4 = highly agree
• 3 = agree3 = agree
• 2 = disagree2 = disagree
• 1 = highly1 = highly
disagreedisagree

Course EvaluationCourse Evaluation
• ““This is the best course I have ever taken”This is the best course I have ever taken”
• ““The physicians need to learn about this”The physicians need to learn about this”
• Improved Press Ganey Scores andImproved Press Ganey Scores and
positive patient and family commentspositive patient and family comments
• Absence of staff and family conflictAbsence of staff and family conflict
• Improved nurse satisfactionImproved nurse satisfaction
• Collaborative relationships with patientsCollaborative relationships with patients

Evidence of SuccessEvidence of Success
• The baptism in a bucketThe baptism in a bucket
• Family presence at a CodeFamily presence at a Code
• Removal of the “family presence prohibited” sign in theRemoval of the “family presence prohibited” sign in the
CCUCCU
• Patient centered visiting in almost all unitsPatient centered visiting in almost all units
• Unit – based family hospitality centersUnit – based family hospitality centers
• Staff training of staffStaff training of staff
• Collaboration with Child Life Specialists in the Adult ICUCollaboration with Child Life Specialists in the Adult ICU
• Nurse Managers deem the course to be mandatoryNurse Managers deem the course to be mandatory
training for stafftraining for staff
• Resident education coordinators integrate the courseResident education coordinators integrate the course
into resident traininginto resident training

Attendees to DateAttendees to Date
• Over 700 registered nursesOver 700 registered nurses
• Patient care techs and unit receptionistsPatient care techs and unit receptionists
• Radiology staffRadiology staff
• All Social Work staffAll Social Work staff
• All ClergyAll Clergy
• All Physical Therapy and Occupational TherapyAll Physical Therapy and Occupational Therapy
staff in the Rehabilitation Centerstaff in the Rehabilitation Center
• All Guest Relations staffAll Guest Relations staff
• University of Maryland senior nursing studentsUniversity of Maryland senior nursing students
• Sinai and Johns Hopkins medical residentsSinai and Johns Hopkins medical residents

Future of the CourseFuture of the Course
• Hearing the Voice of the Patient andHearing the Voice of the Patient and
FamilyFamily
– Development of a training video by patientsDevelopment of a training video by patients
and families for staffand families for staff
• Required education for all physicianRequired education for all physician
residentsresidents
• Incorporation into School of NursingIncorporation into School of Nursing
curriculumcurriculum
• Development of a course for ancillary staffDevelopment of a course for ancillary staff
– Transporters, dietary hostesses, security staffTransporters, dietary hostesses, security staff

Our views have increased the markOur views have increased the mark
of the 20,000of the 20,000
Thank you viewersThank you viewers
Looking forward to franchise,Looking forward to franchise,
collaboration, partners.collaboration, partners.

This platform has been started by ParveenThis platform has been started by Parveen
Kumar Chadha with the vision that nobodyKumar Chadha with the vision that nobody
should suffer the way he has suffered because ofshould suffer the way he has suffered because of
lack and improper healthcare facilities in India.lack and improper healthcare facilities in India.
We need lots of funds manpower etc. to makeWe need lots of funds manpower etc. to make
this vision a reality please contact us. Join us asthis vision a reality please contact us. Join us as
a member for a noble cause.a member for a noble cause.

Contact us:- 011-25464531, 9818569476
E-mail:- nursingnursing@yahoo.in

Family centered care

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Family centered care

Similar to Family centered care (20)

More from Nursing Hi Nursing

More from Nursing Hi Nursing (20)

Recently uploaded

Recently uploaded (20)

Family centered care