Walden University Changing the World Through Evidence Based Practice Essay
Description
Changing the World Through Evidence-Based Practice
Patient Preferences and Decision Making
Implementing evidence-based practice (EBP) within healthcare makes it an ever-changing environment (Pivec & Potocan, 2021). As clinicians, we often make implementing EBP a challenge along with other contributing factors. However, without successfully implementing EBP/evidence-based medicine, we cannot help our patients and surrogates in adequated shared decision-making as the two are co-dependent on each other(Hoffmann et al., 2014). For this discussion post, I will share a recent clinical experience explaining how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Also, I will explain the significance of patient decision aid and how it might contribute to effective decision-making.
Clinical Experience
A 40-year-old woman presents to the emergency department for shortness of breath, fever, and malaise. Symptoms lasted three days, but she became shorter of breath and decided to come to the hospital. She presents a history of extensive comorbidities, including asthma, end-stage renal disease (ESRD), and obesity. Also, she reported recent admission at another facility for asthma exacerbation a month prior and had to be mechanically ventilated. With admission to the intensive unit and an additional diagnosis of the COVID 19 virus, she shared her experience of being intubated and ventilated and wish not to experience said event. Her wishes were honored, and treatment commenced, and high flow oxygen utilizes in the daytime with continuous BiPAP at night along with prone therapy. However, as the days passed, her progress became worse, and intubation was now the only option she refused on countless tries when asked for consent. Days passed, and she got even worse and eventually gave permission. By this time, her lungs were already far gone, and she expired shortly after being intubated.
Base on this womans previous experience with being intubated and mechanically ventilated, she was traumatized by the experience. She didnt want to relive the situation even though her life was dependent on it, and she got educated on the subject regardless.
How does involving or not involving patients preference affect clinical outcome
According to Kon et al. (2016), Shared decision-making is a central component of patient-centered care in the intensive care unit (ICU). The shared decision-making concept, in my opinion, is first based on relationship building between patient and caregiver. As information is shared, an understanding bond is formed between the patient and caregiver, resulting in trust. Involving patients preferences and values into their care have everything about how the treatment plan will turn out. Decisions based on patients values facilitate engagement in the treatment plan and give them autonomy. Not involving them leaves them feeling powerless and may disturb the treatment regimen, lengthen hospital stays and increase the patient cost (Healthcare Value Hub, 2019).
Patient decision aid and its contribution to effective decision making
A patient decision aid designed to its best capacity provides complete information on the possible treatment options available, involving the risk, benefits, and even the burdens of the treatment plan. This better aids the patient in generating knowledge of their condition and understand the clinical evidence beyond their treatment (Healthcare Value Hub, 2019). The patient decision aid of choice for the scenario mentioned above is the Ottawa Personal Decision Guide. The Ottawa Personal Decision Guide depicts a replica of a well-designed decision aid, hence my choice. Also, the patient had multiple medical conditions; therefore, the A-Z option did not apply to the situation.
References
Healthcare Value Hub. (May 2019). The consumer benefits of patient shared decision
Making. Retrieved August 9, 2021, from https://www.healthcarevaluehub.org/advocate-
resources/publications/consumer-benefits-patient-shared-decision-making
Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. JAMA, 312(13), 1295. https://doi.org/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. executive summary of the american college of critical care medicine and american thoracic society policy statement. American Journal of Respiratory and Critical Care Medicine, 193(12), 13341336. https://doi.org/10.1164/rccm.201602-0269ed
Pivec, N., & Poto?an, V. (2021). Strength of Culture and Transfer of Knowledge in Organizations. Management: Journal of Contemporary Management
Issues, 26(1), 2135. https://doi-org.ezp.waldenulibrary.org/10.30924/mj
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