Reference no: EM133220815
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.
In clinical practice, evidence-based (EBP) incorporates accurate research, clinical knowledge, patient preferences, and principles and integrates external evidence to inform decisions that guide the best clinical outcomes (Melnyk & Fineout-Overholt 2018). Today patient and their families are very knowledgeable about healthcare options. Healthcare professionals should begin with a viewpoint that integrates communication, reflection, and decision-making (Kon et al., 2016). Adjustments are made by patient cultural values, objectives, and principles. Shared decision-making is vital because such a collaborative approach achieves all the care objectives and subtle decisions. Patient-centeredness integrates patient preferences in evidenced-based care (Kon et al., 2016). Therefore, it is not a one clinician's process; it should be adopted by the whole system (Melnyk & Fineout-Overholt 2018).
One of my experiences was a case of a patient who was not cooperative with his care and was constantly admitted to our facility. The patient was living with his family. He had schizophrenia and was also a methamphetamine and cannabis abuser. He was not following up with care after discharge and was not consistently taking his medication. He was not listening to his mother's instructions who was taking care of him. Before that admission, he had been admitted nine times in 6 months.
The treatment team came up with the option of conserving the patient by his family member or a public guardian to have someone manage his property and care. He was endangering himself with all the drugs he was taking and was a danger to society. Furthermore, the team stated that the patient would not be managed at home but would be discharged to a locked facility to maintain compliance. Immediately, the patient heard about all these options; he stopped eating and taking his medication and was very angry with all the team members. On several occasions, our units initiated codes (to get help) because he was threatening a healthcare professional or his fellow patient. He was getting aggressive by the day. Patient was very paranoid, stating that we wanted to incarcerate him in prison. He was encouraged to verbalize his feelings to receive help. Consequently, the treatment team summoned a family meeting to discuss all the care options. The patient was advised to use decision aid to make evidence-based choices.
He agreed to conservatorship by his mother instead of a public guardian. He has a special relationship with his mother. The patient and his family were allowed to choose the facility he would discharge. They were happy to pick one that was not too far from the city where they lived. The patient could select the one that had specific amenities he liked. One with gymnasium and other programs. After this great meeting, the patient's mood improved; he started taking his medications and became cooperative with his discharge process. He was informed that if he did well by complying with his treatment, he would be stepped down, and in 6months, he might go home to live with family again. Later, the patient became conserved by his mother and was discharged to the facility.
The decision aid used in this scenario is Antipsychotic Medication Decision Aid. Decision aid is a standard tool that assists people in making informed decision by giving them information about the choices and outcomes (The Ottawa Hospital Research institute 2019). The decision aid helped the patient to know why he should continue, adjust or stop his antipsychotic medications. The information is written in simple terms that the patient will understand. This decision aid is vital in mental help because it has simple but essential information that will help psychiatric patients make an informed decision about taking their medications.