NURS 6052 Discussion: Patient Preferences and Decision Making
NURS 6052 Discussion: Patient Preferences and Decision Making
Patient Preferences And Decision Making Experience
Case: High Blood Pressure
A 60-year-old male patient had been diagnosed with high blood pressure. He had two options, to immediately start taking medicine or try lifestyle modification. Since his blood pressure was so high at 173/120 he decided to immediately start taking medicine for he needed to lower his blood pressure quickly. Though the diagnosis was shocking to him, participating in decision making helped to make him less anxious.
He also had a better understanding of his condition. He was compliant with his medication which brought about an improved health outcome. The patient was also more open to cost-effective drugs that helped in managing his blood pressure (Stacey et al., 2017). Lifestyle modification can be an option when blood pressure is not higher than 160/100 when there are no comorbidities or organ failure. If lifestyle modifications do not bring down blood pressure to the desired level, then pills are recommended (Burke et al., 2018).
Impact Of Patient Involvement
Positive impact: Patient participation enhances trust and reduces a patient’s anxiety. He gains a better understanding of what is needed of him which improves his quality of life. It ensures the delivery of more appropriate and cost-effective services without much resistance. The patient will actively participate in his healthcare process and more carefully monitor their care.
Negative impact: Robs the doctor autonomy and confidence as the patient will keep checking if what is being done is in line with what he had decided. It is time-consuming as it involves a lot of consultation. The patient may opt for a treatment modality that the doctor is not well conversant with. Does not give the doctor room for exploration (Ankolekar, et al., 2018).
NURS 6052 Discussion: Patient Preferences and Decision Making References
Ankolekar, A., Dekker, A., Fijten, R., & Berlanga, A. (2018). The benefits and challenges of using patient decision aids to support shared decision making in health care. JCO Clinical Cancer Informatics, 2, 1-10. https://doi.org/10.1200/CCI.18.00013
Burke, R. E., Jones, J., Lawrence, E., Ladebue, A., Ayele, R., Leonard, C., … & Cumbler, E. (2018). Evaluating the quality of patient decision-making regarding post-acute care. Journal of General Internal Medicine, 33(5), 678-684. https://link.springer.com/journal/11606
Stacey, D., Légaré, F., & Lewis, K. B. (2017). Patient decision aids to engage adults in treatment or screening decisions. JAMA, 318(7), 657-658. https://doi.org/10.1001/jama.2017.10289
NURS 6052 Week 1 Assignment – Evidence-Based Practice and the Quadruple Aim
Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
To Prepare:
Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
To Complete:
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:
Patient experience
Population health
Costs
Work life of healthcare providers
Evidence-Based Practice and the Quadruple Aim
The Connection between Evidence-Based Practice and the Quadruple Aim
Healthcare organizations have adopted the Quadruple Aim framework as a means to enhance healthcare delivery. The Quadruple Aim emphasizes four key measures: patient experience, population health, costs, and the work-life of healthcare providers. Evidence-Based Practice (EBP) plays a crucial role in supporting and advancing the Quadruple Aim by promoting the use of the best available evidence in decision-making and driving improvements in these four areas. This paper explores the connection between EBP and the Quadruple Aim, discussing how EBP can facilitate progress in each measure.
Patient Experience
EBP significantly improves patient experience by promoting the delivery of high-quality, patient-centered care. Integrating research evidence, clinical expertise, and patient preferences, EBP ensures that healthcare interventions align with the best available evidence of effectiveness, safety, and patient preferences (Bowles et al., 2019). This approach enhances patient outcomes, reduces variations in care, and fosters shared decision-making. EBP interventions, such as standardized care protocols and clinical practice guidelines, improve patient satisfaction, increase engagement, and enhance communication between patients and healthcare providers (Iglesia et al., 2020).
Population Health
EBP advances population health by enabling healthcare organizations to implement evidence-based interventions and strategies that promote the health and well-being of entire communities. Synthesizing research evidence on preventive measures, health promotion initiatives, and disease management strategies, EBP informs population-level interventions addressing social determinants of health and reducing health disparities.
According to Iglesias et al. (2020), EBP guides the development of public health programs targeting specific populations or interventions aimed at reducing the burden of chronic diseases. By incorporating EBP into population health management, healthcare systems improve health outcomes, reduce healthcare utilization, and enhance community well-being.
Costs
EBP positively impacts healthcare costs by guiding resource allocation toward interventions that demonstrate effectiveness and cost-efficiency. Adopting evidence-based interventions allows healthcare organizations to avoid unnecessary or ineffective treatments, reduce medical errors, and optimize resource utilization.
Bowles et al. (2019) reiterate that EBP informs decisions regarding the adoption of new technologies, drugs, or medical devices by considering their clinical effectiveness and cost-effectiveness. Additionally, EBP identifies strategies for optimizing care delivery processes, improving care coordination, and reducing waste. Integrating EBP into healthcare decision-making allows organizations to achieve better outcomes while managing costs more efficiently (Nundy et al., 2022).
Work-Life of Healthcare Providers
EBP enhances the work life of healthcare providers by promoting a culture of continuous learning, professional development and reducing practice variability. Basing clinical decisions on sound evidence increases healthcare providers’ confidence, leading to improved job satisfaction and reduced burnout.
EBP supports the use of standardized care protocols and clinical guidelines, which reduces the cognitive load on healthcare professionals and streamlines care processes (Bachynsky, 2020). Moreover, EBP fosters a collaborative approach to decision-making, promoting interdisciplinary teamwork and communication. These factors contribute to a positive work environment, improved provider well-being, and ultimately, better patient care.
Conclusion
Evidence-Based Practice plays a vital role in achieving the Quadruple Aim by improving patient experience, population health, cost-effectiveness, and the work life of healthcare providers. Integrating research evidence into decision-making processes allows healthcare organizations to deliver high-quality, patient-centered care, promote population health, optimize resource utilization, and enhance the well-being of healthcare professionals. Embracing EBP as a core component of healthcare delivery is essential for realizing the Quadruple Aim and driving meaningful improvements across these four measures.
References
Bachynsky, N. (2020). Implications for policy: The triple aim, quadruple aim, and interprofessional collaboration. In Nursing forum 55(1), 54-64. https://doi.org/10.1111/nuf.12382
Bowles, J. R., Batcheller, J., Adams, J. M., Zimmermann, D., & Pappas, S. (2019). Nursing’s leadership role in advancing professional practice/work environments as part of the quadruple aim. Nursing Administration Quarterly, 43(2), 157-163. https://doi.org/10.1097/NAQ.0000000000000342
Iglesia, E. G., Greenhawt, M., & Shaker, M. S. (2020). Achieving the Quadruple Aim to deliver value-based allergy care in an ever-evolving health care system. Annals of Allergy, Asthma & Immunology, 125(2), 126-136. https://doi.org/10.1016/j.anai.2020.04.007
Nundy, S., Cooper, L. A., & Mate, K. S. (2022). The quintuple aim for health care improvement: a new imperative to advance health equity. JAMA, 327(6), 521-522. https://doi.org/10.1001/jama.2021.25181
NURS 6052 Week 2 & 3 Assignment Evidence-Based Project
Is there a difference between common practice and best practice?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,†you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: An Introduction to Clinical Inquiry
Create a 4- to 5-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you used keywords to search on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four peer-reviewed articles you selected.
Part 2: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
The full citation of each peer-reviewed article in APA format.
A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.
NURS 6052 Week 5 Assignment – Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews
Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
To Prepare:
Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest for the Assignment.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
The Assignment (Evidence-Based Project)
Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four peer-reviewed articles you selected.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
NURS 6052 Week 7 Assignment Evidence-Based Project, Part 4: Critical Appraisal of Research
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use appraisal tools to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
Review the Resources and consider the importance of critically appraising research evidence.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tools document provided in the Resources.
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include:
An evaluation table
A levels of evidence table
An outcomes synthesis table
Part 4B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
NURS 6052 Week 9 Assignment Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change
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.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
The Assignment: (Evidence-Based Project)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide 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.
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:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the evaluation table (1 slide)
An explanation about what you learned from completing the levels of evidence table (1 slide)
An explanation about what you learned from completing the outcomes synthesis table (1 slide)
NURS 6052 Week 11 Assignment Evidence-Based Capstone Project, Part 6: Disseminating Results
The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.
To Prepare:
Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
Consider the best method of disseminating the results of your presentation to an audience.
To Complete:
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.
Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
