Respond to EACH POST 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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PATIENT PREFERENCES AND DECISION MAKING

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DISCUSION 1

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Patient Preferences and Decision Making

Incorporating patient preferences was a key principle in my healthcare organization in administering care procedures to patients. An outstanding situation that offered an insight into the importance of incorporating the patient’s preferences was a patient who preferredAngiotensin II receptor blockers instead of Angiotensin-converting enzyme (ACE) inhibitors. Indeed, they worked well for the patient as she could not tolerate ACE inhibitors. According to HIPAA, the caregiver is obliged to explain the benefits and the side effects of a healthcare procedure for a patient to either accept or reject the treatment intervention(Hoffman, Montori, & Del Mar, 2014). Incorporating patient preferences in intervention decisions is linked to benefits such a better outcomes and ease in changing the reimbursement structure(Heath, 2016). The treatment plan for heart failure is a long-term and in most cases, lifelong. The use of the patent’s preference in treating the underlying causes of heart failure, which positively impacted the trajectory of the treatment plan.

Effective patient preferences such as the one described in the above situation was a wake-up call for my professional career and a takeaway skill on how to approach patient condition before administering any medication. Generally, it implied the need to thoroughly survey patients regarding their needs and the most appropriate interventions for them. Remarkably, a patient’s medical history can also be a crucial tool for making decisions(Hoffman, Montori, & Del Mar, 2014). Further, the lesson I derived from the scenario was the essence of making treatment interventions patient-centered other than a case where the care provider makes more decisions, making a provider-centered care program. Meeting the patient’s preferences also makes the healthcare facility a preferred destination for health solutions.

References

Heath, S. (2016). “Ways to Incorporate Patient Preferences into Healthcare.” https://patientengagementhit.com/news/3-ways-to-incorporate-patient-preferences-into-healthcare

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

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DISCUSSION 2

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The situation that I experienced when a patient’s preferences were not considered for their treatment plan is when a deaf patient needed to have bypass surgery.  The patient had lost his wife in the past and he said it was because of her bypass surgery, therefore he was extremely scared about having the heart catheterization procedure.  The patient was sedated for the procedure and it was found that he had three vessel disease and would either need surgery or many stents placed which is also a high-risk procedure.  The cardiologist was unable to wake the patient to ask him whether he wanted stents or bypass and for some reason felt as though the decision needed to be made right then and there.  Therefore, the daughter was called, and she made the decision for him to have stents because he “absolutely did not want to have bypass because of the experience with his wife.”  The cardiologist proceeded to place multiple stents in that one procedure and when the procedure was finished the patient coded and died.  

I often wonder if the cardiologist would have stopped to let the patient go back to his room to sleep off the sedation and then talk about what he wanted to do with his daughter things would have went differently.  The patient could express his concerns with having bypass surgery but there would be an opportunity to speak to him about risks and benefits of each procedure.  According to Kon et al. (2016) if the patients and family are not included in the treatment plan, the doctor may not be aware of the beliefs or intentions of the care that the patient and family may have.  Melnyk and Fineout-Overholt (2018) found that evidence-based decision-making puts the patient in the center and all decisions are based on what they want, this is the best way for treatment plans to go (Melnyk & Fineout-Overholt, 2018).  

The Ottawa Hospital Research Institue’s Decision Aid that I would use is; Coronary Artery Disease: Should I have bypass surgery?  The decision aid is a very helpful tool that can be implemented when educating the patient about the options they have and what they can expect before and after their decision (Healthwise, 2020).  According to Healthwise (2020) the information should not be given directly to the patient but is available for healthcare providers to use as a reference, and it may also educate some healthcare providers involved in the care of the patient if they are not familiar with the procedures. 

References 

Healthwise. (2020, August 31). Coronary artery disease: Should I have bypass surgery? https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=av2037 

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. doi:10.1097/CCM.0000000000001396 

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. 

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