Make reply with 200 words in two answers to your peers with one reference. 

 Student’s name: Yaimi Quintana Marrero

Course: MSN 5270 Advanced Theoretical Perspectives for Nursing

Date: February. 7, 2023

Comfort Contract

The purpose of this comfort contract is to guarantee that the patient or their representative is aware of the anticipated level of post-operative comfort and that any lingering discomforts are being attended to. The agreement will help ensure that the patient or their representative is satisfied with the care level and that any persistent discomforts are managed. Studies have shown that when patients and healthcare providers agree about comfort expectations, patient satisfaction, and outcomes are improved (Gualandi et al., 2021). The contract will include a scale from 1 to 10 on which the patient can rate the extent of care comfort provided within the facility. The patients will be questioned to clarify if there are any ongoing discomforts or even at-home remedies and other interventions that they use for relief. This information will ensure that the patient or their proxy is satisfied with their care and that any chronic discomforts are being managed. According to studies by Abidova et al. (2020), having a clear agreement between patients and healthcare providers about comfort expectations improves patient satisfaction and outcomes. By signing this contract, the patient or their proxy agrees to provide feedback about their level of comfort and any persistent discomforts they are experiencing (van den Ende et al., 2022).   The contract will be reviewed regularly to ensure that the patient or their proxy is comfortable with the level of care they are receiving. 

Illustration of Comfort Contract 

Patient Name: ___________________________________________________________________

Surrogate Name (if applicable): _______________________________________________________

1 On a scale of 1 to 10, with 10 being the most comfortable, please rate your current level of comfort.

2. Are there any persistent discomforts that you are experiencing?

3. Are there any at-home treatments or interventions that bring you respite?

4. Are you satisfied with the care you are receiving?

5. Are there any areas in which your healthcare provider could improve?

6. Please rate your overall satisfaction with the treatment and care you are receiving on a scale of 1 to 10, with 10 being the maximum possible score.

7. Do you have any additional concerns or questions that need to be addressed?

Signatures: 

Patient or Proxy: ______________________________________ Date:   ___________

Provider: _____________________________________________ Date:  ____________ 

The care plan will consider the patient’s unique needs and be developed based on the specifics of the comfort contract. In accordance with the agreement, the nurse will discuss the care plan with the patient or their proxy to ensure that their needs are being met. According to Dees et al. (2022). The comfort contract is a beneficial tool to improve communication between the nurse and the patient in; the nurse practitioner should use it to help the patient as it ensures that individualized treatment plans are created, and all of the patient’s requirements are fulfilled. 

References

Abidova, A., Alcantara da Silva, P., & Moreira, S. (2020). Predictors of patient satisfaction and the perceived quality of healthcare in an emergency department in Portugal. 
WestJEM 21.2 March Issue, 
21(2), 391–403. 
https://doi.org/10.5811/westjem.2019.9.44667

Dees, M. L., Carpenter, J. S., & Longtin, K. (2022). Communication between registered nurses and family members of Intensive Care Unit Patients. 
Critical Care Nurse, 
42(6), 25–34. 
https://doi.org/10.4037/ccn2022913

Gualandi, R., Masella, C., Piredda, M., Ercoli, M., & Tartaglini, D. (2021). What does the patient have to say? valuing the patient experience to improve the patient journey. 
BMC Health Services Research, 
21(1). 
https://doi.org/10.1186/s12913-021-06341-3

van den Ende, E. S., Burger, P., Keesenberg, M., Merten, H., Gemke, R. J. B. J., & Nanayakkara, P. W. B. (2022). Patient-nurse agreement on inpatient sleep and sleep disturbing factors. 
Sleep Medicine: X, 
4, 100047. 
https://doi.org/10.1016/j.sleepx.2022.100047

 

Janelly Perez

MSN5270: Advanced Theoretical Perspectives for Nursing

January 24, 2023

Introduction 

Notably, meeting the patient’s expectations is significant in bettering their health improvement and recovery process. Several theories are significant in the formulation of a comfort contract in nursing. However, the theory to be used depends on the nature of the nursing intervention on the patients. Postsurgical, chronic discomforts and interventions adopt the specific theory of comfort that provides the general atmosphere of comfort for ease in recovery(Martins & Sousa et al., 2022). Thus, nurses are responsible for developing a comfort contract that specifies the expectations on the overall comfort level to be experienced after the surgery and addresses any discomfort encountered during recovery at home for relief. 

The comfort contract therein will adopt Kolcaba’s theory that focuses on three thematic areas: relief, ease, and transcendence (Kolcaba, 2015). For example, the contract will focus on meeting the patient’s needs during surgery by ensuring that the patient is free from complications and symptoms before transfer to the Post-Anesthesia Care Unit (PACU). Also, the contract outlines that the PACU should be located near the operating room for intervention in case of complication and must be free from congestion (Martins & Sousa et al., 2022). The PACU will be supplied with the necessary equipment, which includes the pulse oximeter, blood pressure monitor, suction, and airway manager. Additionally, a registered nurse will be in charge of a specific patient, and the length of the stay will depend on the patient’s specific case.  

The “comfort contract” is designed to ensure that the patient’s expectations are met, and to provide clarity on both sides as to what comfort level is expected. It identifies chronic discomforts that the patient typically experiences at home and any interventions they use for relief. It also outlines a plan of care for postsurgical overall comfort with specific strategies for the nurse and patient to work together. This plan of care can include pain management, sleep hygiene, relaxation techniques, physical activity and more. The goals are to provide a comfortable environment in which the patient can feel secure and safe throughout their recovery journey. The success of this contract relies on understanding the individual needs of each patient and providing personalized care and interventions. By providing detailed information about the patient’s expectations and needs, and setting clear expectations on both sides, the nurse can ensure that the contract is beneficial to everyone involved. The success of this comfort contract will depend on clearly articulated mutual goals between the nurse and patient. When developed with care, it can be a valuable tool in achieving a successful recovery and increased overall comfort. The nurse should be willing to listen to the patient’s requests, ask clarifying questions, provide education about potential interventions, and adjust their care plan as needed throughout the recovery process. This contract can also provide a great opportunity for both parties to discuss any spatial concerns or expectations for privacy that may arise during treatment.

Kolcab’s theory addresses four contexts that seek to ensure that the patient’s overall comfort is achieved. The four contexts include the psych-spiritual, physical, environmental, and socio-cultural, which creates a taxonomic matrix to ensure that the patient’s recovery process is wholly addressed. The physical and environmental context is the care in the PACU and at home. Some intervening variables at home are the emotional state, age, past experiences, finances, support system, and cultural background. Thus, the nurses should ensure that the patient understands the significance of such factors to ensure that they aid in the recovery process(Kolcaba, 2015). The Psych-spiritual and the physical environment should be aligned with the recovery process of the patient; that is, the patient’s emotional state and the support system in the hospital and home environment should be aligned with the recovery objectives. 

 

References

Kolcaba, K. A. T. H. A. R. I. N. E. (2015). Katharine Kolcaba’s comfort theory. Nursing theories and nursing practice, 381-392. 

Martins, A. G., Sousa, P. P., & Marques, R. M. (2022). COMFORT: THEORETICAL CONTRIBUTION TO NURSING. Cogitare Enfermagem, 27. 

https://www.scielo.br/j/cenf/a/ptVT6P54WZZL5FL94BxNypv/?format=pdf&lang=en