Patient Preferences and Decision Making.

Learning Resources
Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.Patient Preferences and Decision Making.
Required Readings

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Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
• Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)
Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186
Note: You will access this article from the Walden Library databases.
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201.Patient Preferences and Decision Making. doi:10.1097/CCM.0000000000001396
Note: You will access this article from the Walden Library databases.
Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483
Note: You will access this article from the Walden Library databases.
Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x
Note: You will access this article from the Walden Library databases.

The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/

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Discussion: Patient Preferences and Decision Making
Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
What has your experience been with patient involvement in treatment or healthcare decisions?Patient Preferences and Decision Making.
In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
To Prepare:
• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
o Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.Patient Preferences and Decision Making.
By Day 3 of Week 8
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.Patient Preferences and Decision Making.

Involving Patients in the Decision Making About Their Care (Autonomy) and the Impact of that on the Treatment Plan

The bioethical principle of autonomy is one of the most important ethical considerations that healthcare workers must always consider when taking care of patients. It simply means planning the patient’s care according to what they wish. When this is respected, the patient is involved fully in the planning the course of their care as they would wish (Haswell, 2019). Not respecting autonomy may later lead to unwanted outcomes such as patient dissatisfaction and longer hospital stays (Entwistle, 2019). Patient Preferences and Decision Making.

A situation I experienced with regard to the concept of autonomy was when patient who was admitted to the ER with internal bleeding (but who was still concious) was transfused with allogeneic blood without being told. Unknown to the interprofessional team taking care of the African American male who had driven themselves alone to the ER; he had a history of reacting to allogenic blood transfusion. After 10 minutes of rapid transfusion, the patent developed a severe acute allergic reaction and had to be taken to the ICU due to anaphylaxis. The patient ended up being intubated in the ICU before undergoing emergency laparoscopic surgery. The hospital stay and healthcare costs ended up being higher due to the allergic reaction to transfusion. By just including the patient’s preferences and values in the treatment plan, the treatment team would have learnt of the risk of allergic reaction and used colloids instead to boost the intravascular volume and prevent hypovolemic shock. The patient would have spent less time in hospital and spent less on healthcare costs.Patient Preferences and Decision Making.

The patient decision aid on blood transfusion from the Ottawa Hospital Research Institute (OHRI) website would have contributed to decision making in the above case by making the care team ask the patient about the relevance of administering him with allogeneic blood (OHRI, 2019; Healthwise, 2019). I might use this decision aid in my professional practice by applying it to all transfusion cases, and in my personal life in case I end up needing transfusion in hospital (I would ask if I would be transfused).Patient Preferences and Decision Making.