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.

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.

Scenario:
• Your 79, year old female patient suffered a stroke 6 months ago. She is cared for in her sister’s home. The patient is dependent for position changes. She is unable to communicate the need to be turned. She must be fed at all meals. She has a stage II pressure injury on her sacral area.

Questions:
• Develop a teaching plan for the family to ensure that the patient’s needs are met

 

Fluid, Electrolyte, and Acid-Base Balance
1. You are a nurse who frequently cares for post-surgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice. 
a. What conditions might lead to the development of hypovolemia?
b. How would the amount of patient fluid loss be determined?
c. Describe how hypovolemia and third-space fluid shifts correlate.
d. Outline the major difference between hypovolemia and third-space fluid shift.
e. Which conditions can result in third-space fluid shift?
2. You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction—much to her chagrin, as she loves ice cream. 
a. What within her history would indicate she was at risk for hypervolemia?
b. How would dill pickles and sauerkraut impact her fluid volume?

c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)?
d. Why would your patient be on a strict fluid restriction while hospitalized?
e. Outline nursing interventions used while a patient is on fluid restriction.

PLEASE follow the instructions. Answer each question in the order it appears and separately. This is the bibliography to guide you:

 1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404.  

 

1)  Minimum 15 slides with  speaker notes and 3 full pages

              Part 1: Minimum 15 slides with  speaker notes (All slides)

              Part 2: minimum 3 full pages

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 6 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: 

Suppose you are interviewing a person who works at The Palace at home in Miami, based on the questions in File 2 and supposes your interviewee’s answers. These answers should be evidenced in the PowerPoint

 

This assignment consists of both an interview and a PowerPoint (PPT) presentation.

Assessment/Interview

Select a community of interest in your region. Perform a physical assessment of the community.

Place: The palace at home

Location: Miami

Community: Elderly

Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.” (See File 1).

Interview a community health and public health provider regarding that person’s role and experiences within the community.

Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about

1) The role of the provider in the community and the health issues faced by the chosen community.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation (Power point).

____________________________________________________________________________-

PowerPoint Presentation

Create a PowerPoint presentation of 15 slides with notes (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

1) Description of community and community boundaries:

 A. The people and the geographic

B. Geopolitical, financial, educational level; ethnic 

C. Phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges

D. Including any identified social determinates of health.

2) Summary of community assessment:

(a) funding sources 

(b) partnerships.

3) Summary of interview with community health/public health provider (See the first instruction).

a) Identification of an issue that is lacking or an opportunity for health promotion (Elderly people).

4) A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.

Part 2: 

 

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website.

Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. 

Include the following information: 

(a) what population is affected, 

(b) at what level does it occur (local, state, or national), 

(c) evidence about the issues supported by resources.

2. Create a problem statement.

3. Provide suggestions for addressing the health issue caused by the current policy. 

(a) Describe what steps are required to initiate policy change. 

(b) Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

4. Discuss the impact on the health care delivery system.

 Models of Practice

 What is a model?

A model demonstrates the researcher’s interpretation of how concepts are related to one another and are developed based on qualitative research. Models often are precursors to theory development.

Three of the most prominent nursing models categorized as focusing on goals and functions include Florence Nightingale’s environmental model of nursing, Dorothy Johnson’s behavioral system model, and Nola J. Pender’s health promotion model.

Directions

In this assignment, you will locate a model of practice that you could apply to nursing. It does not need to be a nursing model. Models of practice can be found in leadership, business, education, and technology. You will explain why you have chosen the model and apply the model to your advanced practice role in the template provided.

In the first row, in the first column, write the name of your chosen model. An example has been provided in the first rows to guide you. Please remove the examples when entering your information

In the first column of the template table, list the characteristics of the model you have chosen with a source/s of support. In the second column, list an application to your advanced nursing practice role upon graduation with a source of support/s.

Assignment Details

For this Assignment, your paper must be 2 to 3 pages, not including the title and reference pages. 

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources. 

Assignment Requirements

Before finalizing your work, you should:

• Minimum requirement of at least five sources of support
• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

• follow the conventions of Standard English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 7th Edition