%0 Journal Article
%T Patients' Participation as It Appears in the Nursing Documentation, When Care Is Ruled by Standardized Care Plans
%A Christina Andreae
%A Mirjam Ekstedt
%A Ingrid Snellman
%J ISRN Nursing
%D 2011
%R 10.5402/2011/707601
%X This study aimed to describe inpatients with myocardial infarction and their participation in care as documented in the nursing records when standardized care plans are used in care. The use of standardized care plans not only has increased the quality of medical treatment but has also overlooked patients' opportunities to participate in their own care. There is a lack of knowledge about how standardized care plans influence patients' participation in nursing care. Data were collected from thirteen patients' records with diagnoses of myocardial infarction. Participation in the decision-making process and participation associated with ¡°sharing with others¡± were searched for in the analysis. The analytical process was guided by content analysis. The findings were grouped into two categories: patients' intermediary participation and patients' active participation. The main results indicated that patients' intermediary participation depended on healthcare professionals' power to rule the nursing care situation. 1. Introduction Standardized care plans have been in place since the middle of the 1980s and are used in several countries with the objective of achieving a quality-assured standard of care [1¨C3]. Standardized care plans make it possible to give good care to everyone regardless of who is caring, and standardized care plans are particularly important for quality of care [4]. Standardized care plans are both health and cost effective [5, 6] although there are few studies that show how standardized care plans affect patients¡¯ participation and their influence on health care. Which conditions are required of the patients in order to participate in nursing care and treatment, if care is already planned before the patient¡¯s admission to hospital? This study presents the findings of patients with myocardial infarction and their participation in care, as it appears in the nursing documentation. When standardized care plans are used in nursing care, the care plans are designed in advance for a specific patient group. The standard care plan lists the treatment steps to be performed as well as the times [4, 7¨C10]. The effect of standardized care plans on different outcomes is wide and has been used in care of patients with different diagnoses. For example, patients with heart failure who received medical care with guidance of a standardized care plan showed a decrease in mortality from 14% to 7% [11]; for patients with pneumonia, mortality decreased from 10% to 5% [12]. Another outcome using standardized care plans is that fewer postoperative complications
%U http://www.hindawi.com/journals/isrn.nursing/2011/707601/