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Healthcare is a patient-oriented business and should always be centered around the patient and family members involved in their care. We, as health care professionals, do not fulfill our due diligence when leaving the patient uninformed of decisions that are to be made that may or may not be life altering. According to (Hoffmann et al., 2014), both shared decision making, and evidence-based practice cannot function without one another and are essential to each other existence. Luckily, I have not had to be a part of an incident involving leaving the patient out of the loop and not effectively communicating with them. Our hospital purposely enforces strict rounding that brings together the physician, nurse, charge nurse, pharmacist and the patient and family members. One example of a shared decision-making event was when a patient had come in for some mild chest pain and ended up having a significant blockage seen by a heart catheterization. After this occurred the entire healthcare team rounded on the patient and discussed the next few steps in his plan of care. The doctors discussed that it would be extremely beneficial to perform open heart surgery, all the while taking time for the patient to understand the risks and allowing them to decide based upon all the factual knowledge available.
Something as simple as this not only encourages evidence-based practice but also allows the patient to ask questions and feel like a part of this care plan. According to (Kon et al., 2016), health care professionals needs to include three imperative parts which are information discussion, careful consideration and making a decision. Our treatment team provided these three essentials when discussing the need for an open-heart surgery. This was even discussed when the patient was initially brought into the hospital prior to a heart catheterization. The health aid I chose that was most closely related to this patients chief complain was the coronary artery disease: Should I have an angioplasty for stable angina. This patient did have stable angina and had a heart cath performed, but there were too many occlusions to perform an angioplasty/stent. This decision aid would have been appropriate for this patient before the heart cath by showing the patient his options and the benefits/risks of the procedure. Through the utilization of this decision aid or others that were used in the process of shared decision making, the patient was found to have significant blockages that required an open-heart surgery. This knowledge would have never been made aware to the staff and the patient, thus potentially saving this patients life. I would utilize this aid in my life if anyone I personally know would need to make a decision about getting an angioplasty as it completely lays out in detail what occurs during the procedure, risks/benefits/ additional options, etc.
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), 1334–1336. https://doi.org/10.1164/rccm.201602-0269ed
The Ottawa Hospital Research Institute. (2019). Patient decision aids. https://decisionaid.ohri.ca/