Discussion: Patient Preferences and Decision

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Discussion: Patient Preferences and Decision

Discussion: Patient Preferences and Decision Making
Discussion: Patient Preferences and Decision Making

Discussion: Patient Preferences and Decision

Question Description
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Discussion: Patient Preferences and Decision Making
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.

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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.

SUBMISSION AND GRADING INFORMATION
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 8
To participate in this Discussion:
Week 8 Discussion

RE: Discussion – Week 8

            Low back pain is a very common complaint patients have when coming to our clinic. More often than not, there is no precipitating factor for the pain, it just starts one day. In these cases, military medical personnel are required to follow a set procedure and more often than not the patient is not happy with the procedure. Almost every patient I had in this situation immediately complains about getting anti-inflammatories with physical therapy, they want imaging done. The amount of incorrect information floating around military units and bases makes having discussions like these with your patients even more difficult because they all know someone who had a “huge bulging disk that was ignored by doctors and told to just do physical therapy and now they are….” They are convinced the same thing is happening to them and they will end up kicked out of the army, or something worse. As a clinic we try to always have available the guidance that is given to our providers available for patients to review so they understand we are following guidelines put in place by the medical command teams, but it is always an uphill battle.

I looked at the Ottawa Hospital Research Institute’s Decision Aid for Low Back Pain: Should I have an MRI? and it looks like a great tool that outlines what an MRI is and what is can do, along with risks involved. This tool would be very helpful in our clinic for those that maybe do not want an MRI, want a better understanding of the risks involved and better understanding of what information an MRI can provide in regards to their diagnosis. This tool may not be very helpful for those patients who are insisting on an MRI that possibly do not need one or have not yet attempted anti-inflammatories or physical therapy as prescribed by their provider.

References

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

The Ottawa Hospital Research Institute. (n.d.). Low Back Pain: Should I have an MRI? Retrieved July 19, 2020, from https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=aa6410

RE: Discussion – Week 8

Emily,

Low back pain, and pain in general, are so hard to manage, especially when there are no known precipitating factors. No one likes to be uncomfortable, and patients are usually very persistent in gaining pain relief. Unfortunately, we live in a society that expects instant gratification. This can make it impossible to get patients to comply with interventions like anti-inflammatories and physical therapy. People with low back pain often express the need for clear and concise information on their condition, complete with a treatment plan consisting of treatment options, prognosis, and self-management strategies (Lim et al., 2019).

Two other options for managing low back pain that are often successful but require thinking outside of the box a bit are spinal manipulation and yoga. The Ottawa Research Institute also has a decision aid, “Should I Have Spinal Manipulation?”. This decision aid discusses spinal manipulation options with or without other treatments, like ice/heat therapy, massage, exercise, and acupuncture (The Ottawa Hospital Research Institute, 2019). In a systematic review of the by Lewis et al. (2019), it was determined that yoga is a safe and effective intervention for chronic low back pain when paired with other prescribed interventions.

ReferencesLewis, K., Metcalf, S., Pearon, T., & Whichello, R. (2019). Implementing yoga into the management of patients with refractory low back pain in an outpatient clinic setting. Journal of Holistic Nursing, 37(3), 237-247. doi:10.1177/0898010118797193

Lim, Y., Chou, L., Au, R., Seneviwickrama, K., Cicuttini, F., Briggs, A., . . . Wluka, A. (2019). People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: a systematic review. Journal of Physiotherapy, 65(3), 124-135. doi:10.1016/j.jphys.2019.05.010

The Ottawa Hospital Research Institute. (2019). Retrieved from Patient decision aids: https://decisionaid.ohri.ca/AZinvent.php

 

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6052_Module05_Week08_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6052_Module05_Week08_Discussion_Rubric

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