Republic of the Philippines

Wesleyan University – Philippines

Cabanatuan City, Nueva Ecija
Graduate School

Final Requirement
THEORETICAL FRAMEWORK IN NURSING PRACTICE

Prepared for
Adahlia T. Basco, EdD, RN

By
Julie Ann C. Visaya, DOH-RN, PH-RN
20-1960-683

MAY 2021
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School

Individualized Patient-Tailored Care (IPCT) Model

Quality of nursing care should be considered specifically for each patient. I chose to create
this model because I believe that the key to effective quality care is through an individualized,
tailored and patient-centered approach. Many times, I have witnessed a patient who were not
satisfied with the care they receive and complains that healthcare provider (HCP) just does what
they have to do. Some resort to healthcare hopping and acquire second, third, fourth opinions
because their needs weren’t addressed properly. HCP do not care enough to dig deeper and explore
all the aspect of the patient’s history and life to be able to give the holistic care they need. This
model will aide to assess regarding the patient experience about the care they received, whether
they felt that it was actually individualized according to their own needs and preferences. In
addition, Individual differences among patients, in terms of their health, illness and needs
emphasize the necessity of individualized nursing care. Individualized nursing care changes all
standardized nursing procedures and activities and adopts nursing activities with unique peculiarity
of each patient condition (Suhonen et al, 2010).
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School

The core concept of the individualized patient-tailored care is that we are looking at the
whole person, not just the chief complains. We must remain flexible when considering the needs
of the individual patient, remembering that we are all different, with different underlying problems
and care needs. To perceive individualized nursing care, nurses should tailor nursing interventions
for each patient to understand the model created, definition of terms and the nursing
metaparadigms in the context of IPTC is necessary:

Person/Human: A unique human being with a unique characteristics, situations, reactions

and responses to their health concerns, and physical and socio- environmental
characteristics of the health care context. They are someone who needs nursing care not
limited to illness care
Nursing: an art through which there is provision of care that is respectful of, and responsive
to, individual patient preferences, needs and values, in ways that are meaningful and
valuable to the individual patient and ensuring that patient values guide all clinical
decisions. It includes listening to, informing and involving patients in their care.
Health: the state in which there is balance in all realms of human life. In this context, a
person is healthy when all needs will be met not just physiologically. The person will
achieve the highest level of wellness by fulfilling first the physiological need before next
level (safety), and so on up the pyramid to transcendence. This is not same for everyone so
health then is defined according to the persons perception of health and his needs.
Environment: Maintaining a supportive environment is essential in the IPTC approach.
Confirming what setting the patient will receive care can help you to understand which
patient needs must be met first. When considering this, the patient will be more comfortable
in discussing the concerns. It can also include the physical, social, structural features,
family culture and community. In addition, technology could be used to improve
communication between patient and staff, using a smartphone or an app for example to
improve patient access to information, reducing the need for frequent clinic visits and
saving patient and staff time. Social media could be used to reach out to patients,
facilitating understanding.
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School

Maslow’s hierarchy of Needs: For the person to feel satisfied, cared for and cooperate,
their needs must be met individually. In this model, it is in the center. The level of care
required for the patient should be identified, not just the chief complain should be the only
thing that should be resolved but also, other needs should be explored, look upon and
addressed.

Surrounding the Person and the Hierarchy of Needs are the 4 C’s of Patient Centered Care
with my own definition of how it’s been related to the concept:
Care: this is providing what is necessary in the promotion, improvement and maintenance
of health of a person. The interventions that take into account the individuality of a person
and that suits individual condition, characteristics, needs and preferences.
Communication: this will involve a two-way communication between the person and the
healthcare professional. Effective communication will elicit the patient’s agenda. Prior to
that, trusting relationship should be established. In asking questions, it should be open-
ended, actively listen to the patient without interruption. According to Robert M. Arnold,
MD, Distinguished Service Professor of Medicine,
“Effectively communicating with patients in an empathic way isn't just fundamental to
providing good patient-centered care and reducing patients' feelings of anxiety and
depression, it is also essential in building a meaningful relationship with patients” (Cavallo,
2017).
Collaboration: Collaboration is the link between adaptive and proactive behaviors and
perceptions of team-level patient-centeredness (Durand & Fleury, 2021). In this context,
this will refer to the partnership between patients and professionals, in which patients are
encouraged to be equal partners, among practitioners, patients and their families (when
appropriate) to ensure that decisions respect patients' wants, needs and preferences and
solicit patients' input on the education and support they need.
Culture: Culture, beliefs, and traditions should be considered when carrying out an
individualized care. According to the National Institute of Health, cultural respect is critical
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School

to reducing health disparities and helps improve access to high-quality health care that is
respectful of and responsive to the needs of diverse patients.

Goals: the aim / desired result /expected outcome when individualized patient-tailored care
has been met. In this context these are: increase patient satisfaction, improve quality
outcomes, positive experience of care that strengthens individual well-being.

IPTC Goals, Role & Function addressing Quality Improvement

Quality improvement (QI) consists of systematic and continuous actions that lead to
measurable improvement in health care services and the health status of targeted patient groups.
The Institute of Medicine (IOM), which is a recognized leader and advisor on improving the
Nation’s health care, defines quality in health care as a direct correlation between the level of
improved health services and the desired health outcomes of individuals and populations.

The Individualized Patient-Tailored Care addresses quality improvement in a way that

when all the unique perceived needs of an individual will be met by incorporating the different
concepts in the model, the expected goal will be achieved and that includes quality and improved
care outcomes through: Identifying the core needs of an person through effective communication
and acting as a patient advocate and promoting patient empowerment that they can be heard and
be involved in their care plan; considering where the person comes from, his belief, values and
traditions that enhance patient centeredness and improve quality for all patients; treating them as
a partner in collaborating health care needs; lending ears to patients in the treatment process that
builds trust and lessens patient anxiety. IPCT digs on the issues and worries of the patients, aside
from the sickness they are battling. Knowing these challenges surrounding a person helps the
healthcare facility to determine the best course of treatment and medication to employ given the
situation of the patient. The overarching goal is for the patient to live as independently as possible
as an effect of this approach.
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School

Quality‐improvement (QI) intervention using individualized patient-tailored care plans in

summary can reduce unnecessary healthcare service utilization and hospital costs, identify areas
of waste and inefficiency and how to make services better, increase patient satisfaction, greater
awareness about health and illness, increases autonomy and health- related quality of life.

References
Cavallo, J. (2017, November 10). How Effective Communication Is Integral to Patient-Centered
Care: A Conversation With Robert M. Arnold, MD. The ASCO Post.
https://ascopost.com/issues/november-10-2017/how-effective-communication-is-integral-
to-patient-centered-care/
Durand, F. & Fleury, M. (2021). A multilevel study of patient-centered care perceptions in mental
health teams. BMC Health Serv Res 21, 44. https://doi.org/10.1186/s12913-020-06054-z
National Institutes of Health. (n.d.). Cultural Respect. https://www.nih.gov/institutes-nih/nih-
office-director/office-communications-public-liaison/clear-communication/cultural-
respect#:~:text=Cultural%20respect%20is%20critical%20to,the%20needs%20of%20dive
rse%20patients.
Suhonen, R., Gustafsson, M., Katajisto, J., Välimäki, M & Leino-Kilpi, H. (2010). Nurses'
perceptions of individualized care. J Adv Nurs; 6(5):1035-46.
 Republic of the Philippines
Wesleyan University – Philippines
Cabanatuan City, Nueva Ecija
Graduate School