NURS 6052 Discussion: Patient Preferences and Decision Making Essay

NURS 6052 Discussion: Patient Preferences and Decision Making Essay

NURS 6052 Discussion: Patient Preferences and Decision Making Essay

Patient preferences and values encompass patient beliefs, perspectives, expectations, and goals for their health and wellbeing. Most clinical and treatment decisions are patient preference-sensitive since patients can always choose to have no intervention (Seidman et al., 2019). In my current organization, a patient with a history of Bipolar presented to the clinic with manic symptoms. The patient was previously on lithium but was not compliant with treatment and took the drugs on and off. She states that she did not like the medication because it made her fat. After the assessment, the clinician went further and prescribed lithium without considering the patient’s preferences and informed her that it was the best shot at alleviating the manic symptoms. After eight weeks, the patient presented with no improvement in manic symptoms. The lack of improvement was due to treatment non-compliance, as the patient reported that she could not tolerate the drugs due to weight gain and sedation. The clinician had to change the treatment plan to Latuda with a lower risk of weight gain. The patient’s symptoms improved after changing treatment, and she was compliant with the medication since her preferences and expectations with treatment were met.

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Bipolar II Decision Aid was developed for individuals recently diagnosed with Bipolar II who are in partial or full remission from depression or hypomania and considering treatment from a clinician (Ottawa Hospital Research Institute, 2019). Options in the treatment decision aid include Lithium, Lamotrigine, Quetiapine, and Adjunctive psychological treatment, including Cognitive Behavioral Therapy and Group Psychoeducation. The decision aid can contribute to effective decision-making by guiding clinicians on the treatment approaches for bipolar patients with depression or hypomania (Fisher et al., 2020). The tool could have guided the clinician in determining the best treatment option for the patient apart from lithium. I can use the Bipolar II Decision Aid to make treatment plans for patients diagnosed with Bipolar II and determine if they will benefit from pharmacological treatment of psychotherapy.


Fisher, A., Keast, R., Costa, D., Sharpe, L., Manicavasagar, V., Anderson, J., & Juraskova, I. (2020). Improving treatment decision-making in bipolar II disorder: a phase II randomised controlled trial of an online patient decision-aid. BMC psychiatry20(1), 1-17.

Ottawa Hospital Research Institute. (2019, June 26). A to Z summary results. Patient Decision Aids – Ottawa Hospital Research Institute.

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Seidman, J., Masi, D., & Gomez-Rexrode, A. E. (2019). Personalizing value in cancer care: The case for incorporating patient preferences into routine clinical decision making. Journal of Participatory Medicine11(3), e13800.

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Module 6: Changing the World Through Evidence-Based Practice (Weeks 10-11)
Walden University, LLC. (Producer). (2018). Evidence-based Practice and Outcomes [Video file]. Baltimore, MD: Author.
Accessible player
Due By Assignment
Week 10, Days 1-3
Read the Learning Resources.
Begin to compose your assignment.
Week 10, Days 4-6
Continue to compose your Assignment.
Week 10, Day 7 Deadline to submit your Assignment.
Week 11, Days 1-2 Read the Learning Resources.
Compose your initial Discussion post.
Week 11, Day 3        Post your initial Discussion post.
Week 11, Days 4-5 Review your Discussion posts.
Compose your peer Discussion responses.
Week 11, Day 6 Post two peer Discussion responses.
Week 11, Day 7 Wrap up Discussion
Learning Objectives
Students will:
• Analyze opportunities for change within healthcare organizations
• Recommend evidence-based organizational changes using an evidence-based practice approach to decision making
• Identify measurable outcomes addressed by evidence-based changes
• Justify dissemination strategies
• Analyze the impact of patient preferences on clinical decision making
• Analyze decision aids
Learning Resources
Required Readings
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
• Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

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

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

Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from

Optional Resources

Review these instructions for guidance on how to create a narrated PowerPoint presentation.

Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change (9 SLIDES, 10 SOURECES)
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
• Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
• Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
• Consider the best method of disseminating the results of your presentation to an audience.
The Assignment: (Evidence-Based Project)
Part 4: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:
• Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
• Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
• Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
• Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
• Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
• Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
• Add a lessons learned section that includes the following:
o A summary of the critical appraisal of the peer-reviewed articles you previously submitted
o An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
By Day 7 of Week 10
Submit Part 4 of your Evidence-Based Project.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
• Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
• Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:
Week 10 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment Draft for Authenticity
Submit your Week 10 Assignment Draft and review the originality report

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:
Week 10 Assignment

Discussion: Discussion: Patient Preferences and Decision Making (1 PAGE, 4 REFERENCES)
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
o 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 11
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 11
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 11 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 11

To participate in this Discussion:
Week 11 Discussion

Congratulations! After you have finished all of the assignments for this Module, you have completed the course. Please submit your Course Evaluation by Day 7.

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