PATIENT PREFERENCES AND DECISION MAKING

Sample Solution

The Value of Shared Decision-Making: A Nurse's Perspective A Missed Opportunity: Early in my nursing career, I witnessed a situation where a patient's preferences weren't fully incorporated into their treatment plan. The patient, an elderly woman (Mrs. A) with congestive heart failure, was admitted for worsening shortness of breath. The cardiologist recommended an invasive surgery with potential long-term benefits but significant short-term risks. Mrs. A, while initially hesitant, seemed to reluctantly agree to the surgery. Missing Pieces: Looking back, I realized several factors might have influenced the decision-making process:

• Limited Exploration of Preferences: The discussion focused solely on the medical aspects of the surgery, with minimal exploration of Mrs. A's priorities. Did she prioritize longevity or quality of life? Did she have concerns about recovery or the impact on her independence?
• Social Determinants of Health: We didn't delve into Mrs. A's living situation. Did she have a support system to help her recover at home? Living alone with limited mobility could significantly impact her post-surgical well-being, potentially leading to complications.

A Different Path: Including Mrs. A's preferences and social context could have led to a different outcome:

• Shared Decision-Making: A more in-depth conversation about her values and goals could have revealed a preference for managing her condition through medication and lifestyle modifications, allowing her to spend her remaining time comfortably at home.
• Considering Social Determinants: Evaluating her social support network could have prompted exploring alternative care options, such as home healthcare services, to ensure a safe recovery at home.

The Power of Patient Decision Aids: The Ottawa Hospital Research Institute's Decision Aids Inventory offers valuable tools to empower patients like Mrs. A. For example, the decision aid for "Angioplasty or Bypass Surgery for Coronary Artery Disease" could have been used in this case. It provides balanced information about both procedures, allowing patients to weigh risks and benefits alongside their individual priorities. Impact and Future Use: This experience highlights the importance of shared decision-making. The Decision Aids Inventory can be a powerful resource in my nursing practice by:

• Facilitating Patient Education: These tools can provide patients with clear, evidence-based information about their treatment options.
• Empowering Choice: By understanding the risks and benefits, patients can participate actively in treatment decisions aligned with their values.
• Improving Communication: Decision aids can prompt deeper conversations about patient priorities and social determinants of health, fostering collaboration between patients and healthcare providers.

Beyond the Hospital: This inventory extends beyond my professional practice. I can share it with family members facing healthcare decisions, empowering them to advocate for their loved ones and participate actively in their care. By prioritizing shared decision-making and utilizing resources like the Decision Aids Inventory, we can ensure patients like Mrs. A feel empowered and heard, leading to treatment plans that align with their medical needs, values, and social circumstances.