The induction of labor is medically indicated for many conditions in which delivering the baby outweighs the risk of continuing the pregnancy. Patients admitted for the induction of labor require adequate information to actively participate in decision making that affects their plan of care. The purpose of this quality improvement project was to improve the quality of healthcare delivery and promote patient engagement by providing consistent education using a teaching tool. The project question addressed the impact of a labor-induction teaching tool on improving patient education, participation, and overall satisfaction. The Plan-Do-Study-Act (PDSA) model was used to plan, implement, and evaluate the labor-induction teaching tool in a 9-room labor and delivery unit that averages approximately 1,500 births per year. The teaching tool content was obtained from existing patient education information from the organization's resource library. The nurses piloted the teaching tool for all patients admitted for the induction of labor for 3 weeks. Patient comments supported the use of the teaching tool to improve knowledge, increase participation in decision making, and enhance overall satisfaction. The nurses voluntarily completed an online survey that indicated the teaching tool was easy to use, positively impacted workflow, and supported informed choice. Patient charts were audited and showed a 94% compliance with documentation of education. The success of the teaching tool in improving patient education and decision-making capacity supports the development of other teaching tools, encourages patient and family-centered care, and improves the delivery of quality care.

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Advances in healthcare and shifts toward patient and family centered care have allowed healthcare professionals to focus on the entirety of a patient and what affects his/her health. In noting such changes, and in consideration of what affects quality of life, findings in the literature address the physiological and physiological differences between those who are caregivers versus those who are not caregivers. This study investigated the relaxation state of those who were considered informal caregivers of hospice and palliative patients in an acute hospitalized setting. A family centered music therapy session was conducted utilizing a music-­‐ assisted relaxation intervention incorporating a loving-­‐kindness meditation. A total of 29 participants, 15 males and 13 females, took part in the study and 28 participants were included in data analysis. Findings from the study suggest an increase in relaxation scores after taking part in the brief intervention. Participant survey responses indicated participants’ agreement with feeling more relaxed and supported as a caregiver after the intervention. Survey results also indicated participants’ willingness to try some relaxation techniques from the study intervention on their own.

Introdução: Partindo-se do pressuposto que o Cuidado Centrado no Paciente e na Família é o modo mais humanizado de prestar cuidado em saúde, faz-se necessário refletir sobre a aplicabilidade dessa abordagem em unidades de emergência pediátrica. Uma possibilidade é o favorecimento da presença da família no atendimento de emergência. O uso de protocolo e o treinamento de profissionais de saúde são ferramentas que fortalecem a prática. Objetivos: elaborar e aplicar na prática clínica um protocolo brasileiro que inclui a família no atendimento de emergência pediátrica. Método: estudo piloto do tipo descritivo observacional, realizado em três etapas: 1) elaboração do protocolo; 2) treinamento de profissionais para a aplicação do protocolo. O treinamento foi realizado com 26 profissionais de enfermagem atuantes em uma unidade de emergência pediátrica de um hospital de ensino, localizado na cidade de São Paulo e 3) análise da aplicação do protocolo na prática assistencial. Para essa análise, foi investigada a dinâmica do atendimento de emergência focando os aspectos relacionados à presença da família; as perspectivas de profissionais de saúde em relação ao conteúdo do protocolo e as anotações de enfermagem no que tange a aplicação do protocolo. Resultados: Foram analisados 65 atendimentos de emergência com a aplicação do protocolo. Em 65,6% dos atendimentos, foi designado um profissional de suporte; 93,4% das famílias aceitaram o convite para presenciar o atendimento e não ocorreu interrupção do atendimento ao paciente em consequência da presença desta. Ao avaliar o protocolo, 85,7% dos profissionais referiram confiança em aplicá-lo em sua prática profissional. As principais dificuldades percebidas pelos profissionais para aplicar o protocolo incluíram a falta de recursos humanos, a falta de treinamento de todos os profissionais e a falta de estrutura física para o acolhimento familiar. Em relação às facilidades, foram elencadas equipe sensibilizada à prática, suporte familiar, o CCPF como alicerce teórico e membros na equipe experientes sobre o tema. Em relação ao conteúdo, os profissionais consideraram o protocolo fácil e rápido de ser aplicado. Apenas em 50% das anotações de enfermagem foi registrado que a família estava presente no atendimento. Conclusões: As ações promotoras para a adoção institucional do protocolo incluem a sensibilização dos profissionais para acolher as famílias no atendimento de emergência e treinamento para a aplicação do protocolo na prática assistencial. Além disso, as ações que facilitam a implantação do protocolo na prática assistencial incluem respaldo teórico na abordagem do CCPF, profissionais que atuem como referência sobre o tema para os demais membros da equipe e designação de um profissional de suporte. / Introduction: Based on the assumption that Patient and Family Centered Care (PFCC) is the most humanized way of providing health care, it is necessary to reflect on the applicability of this approach in pediatric emergency units. One possibility is to favor the presence of the family in emergency care. The use of protocol and the training of health professionals are tools that strengthen the practice. Objectives: To elaborate and apply in clinical practice a Brazilian protocol that includes the family in pediatric emergency care. Method: pilot study of descriptive observational type, carried out in three stages: 1) elaboration of the protocol; 2) professional training for the application of the protocol. The training was performed with 26 nursing professionals working in a pediatric emergency unit of a teaching hospital, located in the city of São Paulo; and 3) analysis of the application of the protocol in the practice of care. For this analysis, it was investigated the dynamics of emergency care focusing on the aspects related to family presence; the perspectives of health professionals regarding the content of the protocol and the nursing notes regarding the application of the protocol. Results: A total of 65 emergencies were analyzed using the protocol. In 65.6% of the attendances a support professional was assigned; 93.4% of the families accepted the invitation to attend the service and there was no interruption of the patient care due to the presence of the family. When evaluating the protocol, 85.7% of the professionals reported confidence in applying it to their professional practice. The main difficulties perceived by professionals to apply the protocol included lack of human resources, lack of training of all professionals and lack of physical structure for the family. Regarding the facilities, the team was sensitized to practice, family support, the PFCC as a theoretical foundation and have experienced team members on the topic. Regarding content, professionals considered the protocol easy and quick to apply. Only 50% of the nursing notes recorded that the family was present in the care. Conclusions: The actions promoting the institutional adoption of the protocol include raising the awareness of professionals to receive families in emergency care and training for the application of the protocol in the practice of care. In addition, actions that facilitate the implementation of the protocol in the practice of care include theoretical support in the approach of the PFCC, professionals who serve as reference on the theme for the other members of the team and appointment of a support professional.