52/8 Discuss REPLY 1

 Write a 2 Paragraph response (with 2-3 sources) 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. I posted 4 sources you can use them or whatever is easier for you


REPLY TO THIS POST: 
Evidence-based practice is supported by clinical expertise which incorporates patient preferences and values as well as best evidence.  The combination of these components leads to the most optimal results (Laureate Education, 2018).  As healthcare providers, it is within our duties to include our patients in the process of their care, and providing them with the information to make the most informed decisions possible for themselves, not only based on evidence but also taking into consideration their own beliefs and values (Melnyk & Fineout-Overholt, 2018). 
            A particular situation that comes to mind was an instance when a woman in her late 30’s arrived at our Emergency Department following a call from the physician informed her that she may be experiencing an ectopic pregnancy.  At that point, she was a little over 2 months along.  Fairly far for an ectopic pregnancy.  The patient herself had already believed that she was possibly experiencing an ectopic pregnancy, however previous imaging was inconclusive.  With in-depth imaging, it was confirmed.  Her only option was to abort the pregnancy by either chemical or mechanical means.  After a complete and thorough discussion with the physician team, against the doctors’ better judgement, the patient decided to take the chemical route in order to salvage her reproductive organs in order to maintain the possibility of future conception.  While physicians felt that this was definitely the riskier of solutions, they respected the patient’s decision and treated the patient chemically, and then remotely monitored her over the next couple of weeks.  In the end, the procedure was a success.  In this situation based on her own thoughts and beliefs regarding her body, the patient was able to make an informed decision that thankfully turned out for the best in this case. 
            While there is not a decision aid summary that was specific to the situation I spoke of, I chose the decision summary pertaining to miscarriages.  This is type of situation is already difficult for individuals to take in, let alone make a decision on how they would like to proceed.  Providing a patient with a tool that breaks-down their options simply and clearly can not only help them to make an informed decision that is best for their situation, but can also give them time to review their options in their own time. 
            While many decisions in healthcare are difficult, and we want our patients to make the best decision for their care, they may not always choose the route that we feel is appropriate. It is important that we include patient-centeredness in our care plans.  Meaning that along with evidence-based practice that we are inclusive of our patient’s preference and values.  In order to achieve true evidence-based medicine, shared-decision making must occur (Hoffman, Montori, & Del Mar, 2019).