The need for shared decision-making in the selection of vascular access devices: an assessment of patients and clinicians

2002 ◽  
Vol 7 (3) ◽  
pp. 34-39 ◽  
Author(s):  
Cynthia Chernecky ◽  
Denise Macklin ◽  
Katherine Nugent ◽  
Jennifer L. Waller
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Vascular Access ◽  
Shared Decision ◽  
Vascular Access Devices ◽  
Selection Of

Who Should be Involved in the Selection Of Venous Access Devices?

2004 ◽  
Vol 9 (1) ◽  
pp. 41-43
Author(s):  
Cynthia Chernecky ◽  
Katherine Nugent ◽  
Jennifer L. Waller ◽  
Denise Macklin
Keyword(s):  
Decision Making ◽  
Decision Maker ◽  
Vascular Access ◽  
Venous Access ◽  
Decision Making Process ◽  
Convenience Sample ◽  
Vascular Access Devices ◽  
Race And Gender ◽  
And Gender ◽  
Selection Of

Abstract The purposes of this study were to describe who should be involved in the vascular access device (VAD) decision-making process, according to patients and caregivers, and to describe if there were differences associated with persons involved in the selection of VADs according to race and gender. Convenience sample included 32 oncology out-patients and 10 caregivers from the southern United States. There were differences by race and sex in decision-making priorities of patients with vascular access devices indwelling; however, these were not statistically significant. Patients, physicians, and oncology nurses were viewed by both patients and caregivers as significant to the decision-making process. In contrast, caregivers were ranked as the least significant by both patients and caregivers. Females chose the physician as the primary decision-maker while males chose the patient as the primary decision-maker.

scholarly journals Shared Decision-Making in the Selection of Outpatient Analgesics for Older Individuals in the Emergency Department

2013 ◽  
Vol 61 (5) ◽  
pp. 793-798 ◽  
Author(s):  
Cameron G. Isaacs ◽  
Christine Kistler ◽  
Katherine M. Hunold ◽  
Greg F. Pereira ◽  
Mara Buchbinder ◽  
...  
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Older Individuals ◽  
Selection Of

scholarly journals New frontiers in vascular access practice: from standardized to patient-tailored care and shared decision making

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0002882021
Author(s):  
Mariana Murea ◽  
Karen Woo
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Vascular Access ◽  
Venous Catheter ◽  
Shared Decision ◽  
Hemodialysis Vascular Access ◽  
Patient Reported ◽  
Kidney Replacement Therapy ◽  
Personalized Approach ◽  
The Individual

Vascular access planning is critical in the management of patients with advanced kidney disease who elect hemodialysis for kidney replacement therapy. Policies put in place more than two decades ago attempted to standardize vascular access care around the model of optimal-i.e, arteriovenous fistula-and least preferred-i.e., central venous catheter-type of access. This homogenized approach to vascular access care emerged ineffective in the ever increasingly heterogeneous and complex dialysis population. The most recent vascular access guidelines acknowledge limitations of standardized care and encourage tailoring vascular access care based on patient and disease characteristics. In this article we discuss available literature in support of patient-tailored access care based on differences in vascular access outcomes by biologic and social factors-age, sex and race. Further, we draw attention to the overlooked dimension of patient-reported preferences and shared decision making in the practice of vascular access planning. We discuss milestones to overcome as requisite steps to implement effective shared decision making in vascular access care. Finally, we take into consideration local practice co-factors as major players in vascular access fate. We conclude that a personalized approach to hemodialysis vascular access will require dynamic care specifically relevant to the individual based on biological factors, fluctuating clinical needs, values and preferences.

Effect on residual kidney function of shared decision-making in selection of dialysis therapy

2021 ◽  
Author(s):  
Tsutomu Sakurada ◽  
Kenichiro Koitabashi ◽  
Kaori Kohatsu ◽  
Shigeki Kojima ◽  
Yugo Shibagaki
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Kidney Function ◽  
Shared Decision ◽  
Dialysis Therapy ◽  
Residual Kidney Function ◽  
Selection Of

Factors Influencing Provider and Patient Choice of P2Y12 Inhibitor Therapy

2020 ◽  
pp. 089719002096617
Author(s):  
Rebekah M. Benitez ◽  
Kathleen A. Lusk ◽  
S. Hinan Ahmed ◽  
Stephanie A. Hartzell ◽  
Bethany A. Kalich
Keyword(s):  
Decision Making ◽  
Adverse Effects ◽  
Shared Decision Making ◽  
Stent Placement ◽  
Shared Decision ◽  
Related Factors ◽  
Once Daily ◽  
Risk Of Bleeding ◽  
Factors Influencing ◽  
Selection Of

Background: Clopidogrel is the most commonly prescribed P2Y12 inhibitor for acute coronary syndrome (ACS) or stent placement, though ticagrelor or prasugrel may be preferred. Medication-related factors may influence selection of therapy. Objectives: To determine which factors most greatly influence cardiology-provider and patient selection of P2Y12 inhibitor to guide shared-decision making (SDM). Methods: Single-center study assessed survey responses from 32 cardiology-providers who prescribed and 105 patients who received clopidogrel, prasugrel, or ticagrelor for ACS or stent placement. Respondents ranked factors influencing P2Y12 inhibitor selection and reported preference of therapy. Patients reported experience with shared decision-making process. Results: Cardiology-providers ranked risk of bleeding, comfort/experience, and cost as most influential. Patients ranked risk of drug interaction, adverse effects, and reduction in myocardial infarction as most influential. Significant differences between cardiology-providers and patients were found for 5 of 8 factors. Cardiology-providers ranked once daily administration (p = 0.01), risk of bleeding (p = 0.002), and cost (p < 0.001) as more important than patients. Patients ranked risk of adverse effects (p = 0.007) and drug interactions (p = 0.005) as more important than cardiology-providers. Cardiology-providers prescribed ticagrelor 42.3% of the time following ACS, though 78.1% ranked it as their preferred agent. Patients were prescribed ticagrelor 9.3% of the time, though 55.7% ranked it as their preferred agent. Use of SDM was reported by 21.6% of patients and 88.5% were unaware that multiple P2Y12 inhibitors existed. Conclusion: Significant differences exist between cardiology-providers and patients regarding factors influencing P2Y12 inhibitor selection, specifically safety-related factors, once daily administration, and cost. Most patients were not involved in SDM.

scholarly journals Selecting Treatment Options and Choosing Between them: Delineating Patient and Professional Autonomy in Shared Decision-Making

2019 ◽  
Vol 28 (1) ◽  
pp. 4-24 ◽  
Author(s):  
Emma Cave
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Treatment Options ◽  
Professional Autonomy ◽  
Patient Choice ◽  
Shared Decision ◽  
Professional Obligations ◽  
Professional Control ◽  
Medical Paternalism ◽  
Selection Of

Abstract Professional control in the selection of treatment options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies that have potential to elevate the importance of patient and family preferences. In combination, they may be perceived by healthcare professionals as an obligation to follow patient preferences, even where doing so conflicts with other professional obligations. It is argued that a more nuanced approach to shared decision-making could help clarify the boundaries of decision-making responsibility.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

On the evaluation of shared decision making: The Decision Evaluation Scales

2004 ◽  
Author(s):  
P. F. M. Stalmeier ◽  
M. S. Roosmalen ◽  
L. C. G. Josette Verhoef ◽  
E. H. M. Hoekstra-Weebers ◽  
J. C. Oosterwijk ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Shared Decision
Sign in / Sign up

Export Citation Format

Share Document