Instructions: Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids. ( 2 separate responses - 2 citations / references for each response provided ) Post 1  Patient Preferences and Decision Making.            Health care workers are encouraged to engage in Evidence-Based Practice with a focus on patient-centered care. Sometimes it could be challenging for health care workers trying to consider the patient's family members. It has been proven that engaged nurses have the background of acknowledging the social and cultural factors both in treatment and related social and cultural influence that could lead to more efficient and effective health outcomes. Clinicians must act in the patient's best interests and use evidence-based decision-making, including their judgment, to help patients make decisions (Melynk & Fineout-Overholt, 2018).              Whenever I plan for my patients, I always want to make their care plan all about them. Patients are more likely to be compliant and follow through when they are included in planning their care. Patients who participate in their decisions making report higher levels of satisfaction with their care; having increased knowledge about conditions, tests, and treatment leads to having more realistic expectations about benefits and harms. Hence, patients are more likely to adhere to screening, diagnostic, or treatment plans.  Having reduced decisional conflict and anxiety are less likely to receive tests or procedures which may be unnecessary and, in some cases, even have improved health outcomes (Krist, Tong, Aycock & Longo, 2017). Also, when completing my assessment, it is always very useful to include this question: "Are there any spiritual or cultural preferences that need to be met while in this facility."             Although these conversations are complicated and may be unproductive at first, it is critical to encourage patients to be open about their personal goals to inform how clinicians can best meet them. As a psych Nurse, I come across mentally ill patients who oftentimes do not understand the disease process. I have initially encountered a patient with Acute psychosis from Africa; he was brought into the psych Emergency, activated by the family members for bizarre behavior. When the patient started getting better at a point, he presented himself to the clinical team as somebody that must go back to his home country because according to the patient that "whatever he is going through now is a result of not performing the burial rites of his late parents" that was the reason they are tormenting him from the spiritual world and appearing to him in his dreams as well.             The clinical team was taken by surprise to what the patient was claiming as the cause of his ill health but at the same time, had an obligation to respect the pa ...

1. Instructions: Respond to at least two of your colleagues on two
different days and offer alternative views on the impact of
patient preferences on treatment plans or outcomes, or the
potential impact of patient decision aids. ( 2 separate
responses - 2 citations / references for each response provided )
Post 1
Patient Preferences and Decision Making.
Health care workers are encouraged to engage in
Evidence-Based Practice with a focus on patient-centered care.
Sometimes it could be challenging for health care workers
trying to consider the patient's family members. It has been
proven that engaged nurses have the background of
acknowledging the social and cultural factors both in treatment
and related social and cultural influence that could lead to more
efficient and effective health outcomes. Clinicians must act in
the patient's best interests and use evidence-based decision-
making, including their judgment, to help patients make
decisions (Melynk & Fineout-Overholt, 2018).
Whenever I plan for my patients, I always want to
make their care plan all about them. Patients are more likely to
be compliant and follow through when they are included in
planning their care. Patients who participate in their decisions
making report higher levels of satisfaction with their care;
having increased knowledge about conditions, tests, and
treatment leads to having more realistic expectations about
benefits and harms. Hence, patients are more likely to adhere to
screening, diagnostic, or treatment plans. Having reduced
decisional conflict and anxiety are less likely to receive tests or
procedures which may be unnecessary and, in some cases, even
have improved health outcomes (Krist, Tong, Aycock & Longo,
2017). Also, when completing my assessment, it is always very
useful to include this question: "Are there any spiritual or

2. cultural preferences that need to be met while in this facility."
Although these conversations are complicated and may
be unproductive at first, it is critical to encourage patients to be
open about their personal goals to inform how clinicians can
best meet them. As a psych Nurse, I come across mentally ill
patients who oftentimes do not understand the disease process. I
have initially encountered a patient with Acute psychosis from
Africa; he was brought into the psych Emergency, activated by
the family members for bizarre behavior. When the patient
started getting better at a point, he presented himself to the
clinical team as somebody that must go back to his home
country because according to the patient that "whatever he is
going through now is a result of not performing the burial rites
of his late parents" that was the reason they are tormenting him
from the spiritual world and appearing to him in his dreams as
well.
The clinical team was taken by surprise to what the
patient was claiming as the cause of his ill health but at the
same time, had an obligation to respect the patient's wish. In the
end, the patient was discharged from the hospital even though it
was uncertain if the patient going back to his country home to
perform some cultural ritual rite in order to calm the spirit of
his parents in order to help him recover from his mental illness.
It is also essential to respect the decision and preference of the
patient during his plan of care. Although these conversations
are difficult and maybe unproductive at first, it is critical to
encourage patients to be open about their personal goals that
will inform how clinicians can best meet them (Lindsey Lord,
n.d.). The treatment plan must be based on patient wants and
needs to be successful. Patient preferences and values will
impact the trajectory of the situation in a positive way if it is
based on their preferences and values. If a patient's preferences
and values are disregarded, they most likely will not follow
through or be compliant with the care plan because it has
nothing to do with their needs and goal.

3. Reference:
Krist, A.H., Tong, S.T, Aycock, R.A., & Longo, D.R. (2017).
Engaging patients in decision-making and behavior change to
promote
prevention. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC699
6004
Lord, L. (n.d.). The value of understanding patient preferences
in treatment plans and protocols. Retrieved
from, https://cipherhealth.com/blog/the-value-of-
understanding-patient-preferences-in-treatment-plans-and-
protocols/
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based
practice in nursing & healthcare: A guide to best practice (4th
ed.). Philadelphia, PA: Wolters Kluwer
Post 2
Patient Preference Experience
As a nurse that floats within my hospital’s
women/children service line, I have worked in labor and
delivery and have aided in the insertion/management of an
epidural in laboring patients. The choice to have natural labor
versus medicated labor has been a debate for years, with
benefits and drawbacks to each. Expecting mothers usually
always have a specific delivery plan; however, rarely do all of
the plans go perfectly according to that plan.
One patient experienced I have personally been involved in is a
woman who said she wished to not use any form of pain
medication as a part of her delivery plan. As it is a woman's
right to make this decision, this wish, of course, was granted if
the baby and mom remained safe throughout the delivery.
Sometimes in medicine, there is no “correct” option, and
delivering a baby naturally or medicated is one of those choices.
What we do know is that patient-centered care has a direct
correlation with evidence-based practice; without involving
patients and their loved ones in their medical decisions and
treatment plans, we are not providing good care at all. (Fineout-

4. Overholt, Long, & Gallagher-Ford, 2018). The expecting
mother, in my experience, valued her choice of natural birth,
and staff worked to try to provide every option of care to make
this happen; however, in some cases, patient safety trumps
patient preference.
Patient Preference Impact on Treatment Plan
Hours into pushing, the mother could not bear the pain of
completing the delivery. In response to this, the baby started to
have late and variable decelerations in heart rate. Sung &
Abramovitz (2021) and Pillarisetty & Bragg (2021) state
variable decelerations indicate that the umbilical cord is
compressed or prolapsed, and late decelerations indicate the
baby is not getting enough oxygen by either baby positioning or
cord entanglements. After minutes of seeing the baby decline,
doctors decided this form of delivery was not safe for the baby
and completed an emergency C-section that resulted in keeping
all involved from experiencing a bad medical outcome. The
baby had to spend a little time in the NICU after delivery but
was otherwise healthy. Had the baby's mother decided to
receive an epidural, outcomes might have been different in
either a better or potentially worse way.
Patient Decision Aid
The patient decision aid is a helpful tool to weigh
medical options that have benefits and downfalls to various
health topics; this tool gives individuals the information to
make the best choice for them and to include them in their
health options (The Ottawa Hospital Research Institute, 2019).
The health topic I chose to evaluate was 'Pregnancy: Should I
Have an Epidural During Childbirth?' because I provide care to
women who deliver regularly, and this is also a question that I
still have yet to answer for myself if I decide to have babies in
the future.
This tool gives women the pros and cons of having an epidural,
such as pain relief if receiving it versus avoiding the adverse
effects of not receiving one (severe headache, to numb to push
effectively or drop in blood pressure) (The Ottawa Hospital

5. Research Institute, 2021). Maybe if the mother in my personal
experience used the ‘Your Feelings’, ‘Your Decision’, and
‘Quiz Yourself’ sections present within the patient decision aid,
she could then evaluate the summary of her answers and realize
from those results that may be intense pain is not manageable
for her and that receiving an epidural would outweigh the pros
of a natural birth (The Ottawa Hospital Research Institute,
2021).
References
E. Fineout-Overholt, L. E. Long, & L. Gallagher-Ford. (2018).
Making the case for evidence-based practice and cultivating a
spirit of inquiry. In Melnyk, B. M., & Fineout-
Overholt (Eds.), Evidence-based practice in nursing &
healthcare: A guide to best practice (4th ed., pp. 7–32). Wolters
Kluwer.
Pillarisetty, L.S., & Bragg, B.N. (2021, July 19). Late
decelerations. StatPearls. https://www.ncbi.nlm.nih.gov/books/
NBK539820/
Sung, S., & Abramovitz, A. (2021, August 11). Variable
decelerations. StatPearls. https://www.ncbi.nlm.nih.gov/books/
NBK546627/
The Ottawa Hospital Research Institute. (2019). Patient decision
aids. https://decisionaid.ohri.ca/
The Ottawa Hospital Research Institute. (2021). Pregnancy:
Should I have an epidural during
childbirth? https://www.healthwise.net/ohridecisionaid/Content/
StdDocument.aspx?DOCHWID=tn9762