NURS 6052 Patient Preferences and Decision Making

NURS 6052 Patient Preferences and Decision Making

Sample Answer for NURS 6052 Patient Preferences and Decision Making Included After Question

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. 

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/.  
  • 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. 

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. 

By Day 6 of Week 8 

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. 

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

A Sample Answer For the Assignment: NURS 6052 Patient Preferences and Decision Making

Title: NURS 6052 Patient Preferences and Decision Making

As a labor and delivery (L&D) nurse you are involved in and witness a lot of patients and their families making tough decisions. One situation that comes to mind is a 22-year-old female, pregnant with her first child and the fetus was diagnosed with a neural tube defect. She did not have prenatal testing during her pregnancy. This defect caused her baby’s brain not to fully develop. The parents did not understand the diagnosis and wanted more information about the defect.

They were provided the information but were also told that the baby would not survive long after delivery and other options were discussed. Ultimately, the team and the family were all on the same page, and made the best decision for the patient and her wishes. It was a beautiful process.

As her nurse, it was my responsibility to get in touch with the genetic counselor to make sure the parents were provided the information and the support needed to make an informed decision. Since I have been a nurse, it is imperative for me to involve the patients and their families. Autonomy or self-determination is at the core of all medical decision-making in the United States. (Congress.gov, 1990).  It means that patients have the right and ability to make their own choices and decisions about medical care and treatment they receive.

When we include the patient’s preferences and values, the trajectory of the situation might change in a way

NURS 6052 Patient Preferences and Decision Making
NURS 6052 Patient Preferences and Decision Making

that the medical providers do not anticipate. Sometimes the outcomes are surprising, but often, it is what the physicians said it would be.  As caregivers, we must respect the patients wants and needs, and if that means going in another direction because that is what the patients want, then that is what we are going to do. (Davoodvand, et al, 2016). The physicians do get upset, but we as nurses must speak up for and at times speak for the patient. I know some nurse’s personalities are stronger than others, but we must advocate for our patients.

The patient decision aid I selected was “Pregnancy: Should I Have Screening Tests for Birth Defects?” According to the Ottawa Hospital’s Research Institute, (2022) Testing for birth defects means that you may find out that your baby has a serious problem Would this information about that your baby having a birth defect change your plans? What I have seen in my practice as an L&D nurse is, we can never tell who will and will not continue with the pregnancy. We need to make sure that the proper information is given and that the parents understand what is being told to them.  Often, they do not comprehend and we as providers do not see that they don’t. it is important to use tools that the patients and their families understand and use to better understand their situation and or diagnosis.

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I would use this visual aid; it is very clear and straight to the point about what the screening is. It goes through six steps in detail. Get the facts, compare options, your feelings, your decision, quiz yourself, and your summary. This aid helps your say in this decision, this information will help you understand what your choices are so that you can talk to your doctor about them.

References

Congress.Gov.(1990). H.R.4449 – Patient Self Determination Act of 1990.

https://www.congress.gov/bill/101st-congress/house-bill/4449

Links to an external site.

Davoodvand S, Abbaszadeh A, Ahmadi F. (2016). Patient advocacy from the clinical nurses‘ viewpoint: a qualitative study. J Med Ethics Hist Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/

The Ottawa Hospital’s Research Institute. (2022) Decision Aids Inventory. “Pregnancy: Should I Have Screening Tests for Birth Defects?” https://decisionaid.ohri.ca/Azsumm.php?ID=1179

That is great news to hear about your granddaughter. According to AAMC, 2023, screening results for some patients may lead to unnecessary anxiety or false reassurance and providers lack a complete understanding of the limitations of the test. There is a big difference between a screening and a diagnostic test. The screening is offered to detect potential disease and if the screen is positive, it is appropriate to consider a diagnostic test.

Making informed decisions are hard, but it is also what is best for the patient.  An informed decision is a choice that individuals make once they have all the information related to the decision topic. It involves analyzing potential outcomes, benefits and risks associated with each option, then deciding which choice is the best for them. (Healthy People 2030, 2020).

   References         

Association of American Medical Colleges. (2023). Prenatal screenings can lead to false positives, heightened anxiety. https://www.aamc.org/news-insights/prenatal-screenings-can-lead-false-positives-heightened-anxiety

Links to an external site.

Healthy People 2030. (2020). Informed Decision Making. https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/informed-decision-making

Thank you for sharing about your experience as a nurse and how you protected your patients values and preferences throughout their care. This is so important in nursing and should always be considered when caring for patients. I have experienced situations even seeing my primary care doctor where it didn’t feel as though my values and preferences were being respected, which is never a good feeling as a patient.

One of the best ways that we can ensure that our patients values and preferences are being met is by educating patients before they have to make any decisions about their medical care. This can sometimes be difficult in time sensitive situations, but I believe as nurses it is always our responsibility to ensure that our patients are educated and that their voice is heard and respected in care decisions. Even something as simple as ensuring that care is clustered can allow a patient to feel respected and valued when receiving care.

This technique is called shared decision making and it is when a clinician provides their patient with information about diagnostic or treatment options including all of the benefits and risks (Supporting Patients’ Roles in Their Healthcare Decisions, 2022). From here the patient is prompted to explain their preferences about the potential outcomes, any concerns they may have, and any other issues of importance to them (Supporting Patients’ Roles in Their Healthcare Decisions, 2022). After this the clinician and patient discuss which treatment option makes the most sense given the patient’s preferences (Supporting Patients’ Roles in Their Healthcare Decisions, 2022). Unfortunately, it seems that clinicians do not always have the time to do this but I am sure that patients would feel much more heard and confident in their care if this could be done in every situation. Patient centered care revolves around the patient and involves ensuring that the way of caring for patients is meaningful and valuable to the patient (O’Neill, 2022).

References

O’Neill, N. (2022, April 18). The Eight Principles of Patient-Centered Care. Oneview Healthcare. https://www.oneviewhealthcare.com/blog/the-eight-principles-of-patient-centered-care/

Supporting Patients’ Roles in Their Healthcare Decisions. (2022, July 11). Supporting Patients’ Roles in Their Healthcare Decisions | PCORI. https://www.pcori.org/blog/supporting-patients-roles-their-healthcare-decisions

Your post was beautiful written and hits very close to home as I recently dealt with a very similar situation in my personal life. Through the process, the providers truly let me down. It was the nurses and genetic counselor that truly held my hand and carried me through. Having access to decision aids and resources helped me to make an informed decision independently. Thank you for being such a wonderful advocate to your patient to assure that they were provided with support and the information needed to make an informed decision.

In the beginning of a pregnancy, the mother may be first asked if they want to complete genetic testing. She will likely also be asked if she would change her birth or parenting plans if it was discovered that her fetus had a serious problem (The Ottawa Hospitals Research Institute, 2022). I would guess that most parents would say that they would not terminate the pregnancy regardless of the outcome before knowing potentially negative results from testing. Once a birth defect is identified, the mother may want to change her mind. In this situation, the mother has every right to change her mind. A decision aid would help a mother to be informed to make a decision that is best for her and her family.

In this situation, a decision aid would absolutely be helpful as it gives concrete data that can be used for making an informed decision. I am a witness that even without a family history, your fetus can have neural tube defects. Even as a health care professional, this was a scenario that I never even considered since my husband and I are both healthy, with no family history of any disease, defects, or health concerns. On the contrary, these tests can bring forth a large amount of anxiety that can come with the unknown, false negatives, and false positives. Ultimately, the patient being able to make their own informed decision is most important and the decision aid can largely help.

 

References

The Ottawa Hospital Research Institute. (2022). Decision Aid Summary. Pregnancy: Should I Have Screening Tests for Birth Defects? https://decisionaid.ohri.ca/Azsumm.php?ID=1179