05 May Post?a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of healthLinks to an exte
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of healthLinks to an external site., and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, 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.
5/3/23, 9:56 PM Topic: Module 6: Discussion
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This is a graded discussion: 100 points possible due May 10 at 10:59pm
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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?
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.
DISCUSSION: PATIENT PREFERENCES AND DECISION MAKING
RESOURCES
5/3/23, 9:56 PM Topic: Module 6: Discussion
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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/ (https://decisionaid.ohri.ca/) .
Choose "For Specific Conditions," then Browse an alphabetical listing of decision aids by health topic. After you have chosen a topic (or condition) and a decision aid, consider if social determinants of health (https://academicguides.waldenu.edu/Library/sdoh) were considered in the treatment plan Social determinants of health can affect a patient's decision as these are conditions in the patient's environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context. 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.
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of health (https://academicguides.waldenu.edu/Library/sdoh) , and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, 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.
(Please Note: The underlined "social determinants of health" in the above content is meant to hotlink to the following Walden webpage and content:
Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.
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Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden (https://academicguides.waldenu.edu/Library/sdoh) University)
Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.
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(https:// Wemimo Ojetunde (https://waldenu.instructure.com/courses/53151/users/74061)
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Patient preferences and decision making
One of the hallmarks of high-quality healthcare is patient-centered care, which means tailoring treatment plans to each individual patient. The Institute of Medicine defines patient-centered care as one that is "respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions" (Institute of Medicine, 2001). Patient-centered treatment has been shown to enhance health outcomes. Patient participation in healthcare decision-making has been shown to enhance treatment results and patients' ability to do everyday activities (Vahdat et al., 2014). More satisfied patients are more likely to follow their doctors' orders, which in turn lowers healthcare expenditures (Epstein et al., 2010; Snyderman & Yoediono, 2010).
5/3/23, 9:56 PM Topic: Module 6: Discussion
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My time spent on a labor and delivery unit was on one instance in which I had to consider patients' values and preferences. A 32-year-old expecting mother was admitted to the hospital complaining of fatigue and difficulty breathing. The patient's Jehovah Witness status was noted on the admission history form. As a result of her religious convictions, she could not accept a blood transfusion. Hemoglobin levels in the patient's was 6.9 g/dl. Unbeknownst to him, the attending physician had already entered an order to transfuse a unit of PRBCs into the hospital's computerized electronic order system. I explained to the woman that her Hemoglobin was low and that doctors frequently prescribe blood transfusions in cases like hers. I informed the physician and proposed that she seek out an alternate treatment plan to accommodate her religious convictions. The physician explained the risk and benefits to the patient and she stated clearly that she was okay with an alternative treatment. However, the patient did report previously using ferric carboxymaltose to treat her anemia. Following hearing the patient's request, the doctor agreed on giving her two intravenous infusions of ferric carboxymaltose to treat her iron deficiency anemia.
Social determinants of health strongly influenced this patients' healthcare decisions. Since she was a Jehovah's Witness, her religious beliefs prevented her from receiving a blood transfusion. Because Jehovah's Witnesses believe blood transfusions are against the Bible, healthcare providers may struggle to meet her needs in this case. Financial and religious factors affect this patient's decision. Alternative treatments are expensive, making them unaffordable for many, particularly the poor and uninsured. Social and financial networks may also influence a patient's inclination to pursue complementary or alternative therapy. In this situation, the patient's prior experience with ferric carboxymaltose shows the necessity of considering a patient's past and preferences when formulating a treatment strategy. The doctor tailored the treatment to the patient's values, preferences, medical history, and religious views while following evidence-based practice.
Including patient preferences, social determinants of health, and values in the treatment plan can change a healthcare situation. These considerations enabled the Jehovah's Witness patient to obtain treatment that honored her beliefs and interests. Health care providers were able to meet the patient's demands while treating her medical condition by recognizing her religious affiliation and blood transfusion views. The patient's history with ferric carboxymaltose, the chosen medication, was examined. Social determinants of health and the patient's religion influenced the treatment strategy. Alternative therapy costs and transportation may have hindered the patient's care. However, healthcare providers addressed these variables to ensure the patient received the treatment she required. Finally, including the patient's values and preferences in the treatment plan ensured that the patient was heard and respected.
The Ottawa Patient Decision Aid I chose is helpful in various ways. First, the tool emphasizes patient values and preferences when making treatment decisions, which aligns with patient-centered care. The tool empowers patients to make educated choices that represent their beliefs and preferences by guiding and supporting patients and healthcare professionals through
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challenging decisions. The Ottawa Patient Decision Aid assisted to better understand her treatment options and their risks and benefits. The patient and healthcare team used the tool to analyze her ideas and values about blood transfusions and arrived at a more suitable treatment plan. The Ottawa Patient Decision Aid also stresses the relevance of socioeconomic determinants of health to reduce inequities and guarantee that all patients get high-quality treatment. Healthcare provider was able to secure this patient’s access to treatment regardless of her socioeconomic position.
As a nurse, I will use patient decision aids to educate patients and include them in decision-making. Nurses benefit from Ottawa Hospital decision aids. I can utilize decision aids to evaluate a patient's grasp of their health issue and provide treatment alternatives based on their preferences and beliefs. Decision aids improve collaborative decision-making and foster trust and open communication, letting patients know their values are honored (Hoffman et al., 2014).
In conclusion, when it comes to facilitating patient-centered care and sound decision making, patient decision tools like the Ottawa Patient Decision Aid are valuable resources. Patient decision aids improves the quality-of-care patients get by encouraging them to take an active role in their healthcare choices and by providing them with organized advice and assistance.
References
Epstein RM, Street RL Jr. The values and value of patient-centered care. Ann Fam Med. 2011;9(2):100-103. doi: 10.1370/afm.1239
Hoffmann, 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. https://doi.org/10.1001/jama.2014.10186
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press.
Snyderman, R., & Yoediono, Z. (2010). Perspective: Prospective health care and the role of academic medicine: Lead, follow, or get out of the way. Academic Medicine, 85(2), 214-226. doi: 10.1097/ACM.0b013e3181c87753
Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: A review. Iranian Red Crescent Medical Journal, 16(1), e12454. doi: 10.5812/ircmj.12454
5/3/23, 9:56 PM Topic: Module 6: Discussion
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Reply
(http Emily Keyes (She/Her) (https://waldenu.instructure.com/courses/53151/users/2872)
11:33am
Reply
Wemimo,
Great case to present, i.e., how you honored your JW patient and her wish to not receive RBC! I am glad that you and she found an alternative treatment that helped her, while also respecting her religious and personal beliefs! Good use of Ottawa Patient Decision Aid!
Thanks!
Dr. K.
,
RESOURCES
· 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 Links to an external site. . Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186
· 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 Links to an external site. . Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396
· Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice Links to an external site. . Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483
· 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 Links to an external site. . Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.xThe Ottawa Hospital Research Institute. (2019). Patient decision aids Links to an external site. . Retrieved from https://decisionaid.ohri.ca/
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