Running head patient preferences and decision making 1

1. Running head: PATIENT PREFERENCES AND DECISION
MAKING 1
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DISCUSION 1
COLLAPSE
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Patient Preferences and Decision Making
Incorporating patient preferences was a key principle in my
healthcare organization in administering care procedures to
patients. An outstanding situation that offered an insight into
the importance of incorporating the patient’s preferences was a
patient who preferredAngiotensin II receptor blockers instead of
Angiotensin-converting enzyme (ACE) inhibitors. Indeed, they

2. worked well for the patient as she could not tolerate ACE
inhibitors. According to HIPAA, the caregiver is obliged to
explain the benefits and the side effects of a healthcare
procedure for a patient to either accept or reject the treatment
intervention(Hoffman, Montori, & Del Mar, 2014).
Incorporating patient preferences in intervention decisions is
linked to benefits such a better outcomes and ease in changing
the reimbursement structure(Heath, 2016). The treatment plan
for heart failure is a long-term and in most cases, lifelong. The
use of the patent’s preference in treating the underlying causes
of heart failure, which positively impacted the trajectory of the
treatment plan.
Effective patient preferences such as the one described in the
above situation was a wake-up call for my professional career
and a takeaway skill on how to approach patient condition
before administering any medication. Generally, it implied the
need to thoroughly survey patients regarding their needs and the
most appropriate interventions for them. Remarkably, a
patient’s medical history can also be a crucial tool for making
decisions(Hoffman, Montori, & Del Mar, 2014). Further, the
lesson I derived from the scenario was the essence of making
treatment interventions patient-centered other than a case where
the care provider makes more decisions, making a provider -
centered care program. Meeting the patient’s preferences also
makes the healthcare facility a preferred destination for health
solutions.
References
Heath, S. (2016). “Ways to Incorporate Patient Preferences into
Healthcare.” https://patientengagementhit.com/news/3-ways-to-
incorporate-patient-preferences-into-healthcare
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

3. Bottom of Form
DISCUSSION 2
Main Post
The situation that I experienced when a patient’s preferences
were not considered for their treatment plan is
when a deaf patient needed to have bypass surgery. The
patient had lost his wife in the past and he said it was because
of her bypass surgery, therefore he was
extremely scared about having the heart
catheterization procedure. The patient was sedated for the
procedure and it was found that he had three vessel disease and
would either need surgery or many stents placed which is also a
high-risk procedure. The cardiologist was unable to wake the
patient to ask him whether he wanted stents or bypass and for
some reason felt as though the decision needed to be made right
then and there. Therefore, the daughter was called, and
she made the decision for him to have stents because he
“absolutely did not want to have bypass because of the
experience with his wife.” The cardiologist proceeded to place
multiple stents in that one procedure and when the procedure
was finished the patient coded and died.
I often wonder if the cardiologist would have stopped to let the
patient go back to his room to sleep off the sedation
and then talk about what he wanted to do with his daughter
things would have went differently. The patient could express
his concerns with having bypass surgery but there would be an
opportunity to speak to him about risks and benefits of each
procedure. According to Kon et al. (2016) if the patients and
family are not included in the treatment plan, the doctor may
not be aware of the beliefs or intentions of the care that
the patient and family may have. Melnyk and Fineout-Overholt
(2018) found that evidence-based decision-making puts the
patient in the center and all decisions are based on what they
want, this is the best way for treatment plans to go (Melnyk &

4. Fineout-Overholt, 2018).
The Ottawa Hospital Research Institue’s Decision Aid that I
would use is; Coronary Artery Disease: Should I have bypass
surgery? The decision aid is a very helpful tool that can be
implemented when educating the patient about the options they
have and what they can expect before and after their decision
(Healthwise, 2020). According to Healthwise (2020) the
information should not be given directly to the patient but is
available for healthcare providers to use as a reference, and it
may also educate some healthcare providers involved in the care
of the patient if they are not familiar with the procedures.
References
Healthwise. (2020, August 31). Coronary artery disease: Should
I have bypass
surgery? https://www.healthwise.net/ohridecisionaid/Content/St
dDocument.aspx?DOCHWID=av2037
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
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based
practice in nursing & healthcare: A guide to best practice (4th
ed.). Philadelphia, PA: Wolters Kluwer.
Running
head:
PATIENT PREFERENCES AND DECISION MAKING
1

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