Shared decision making in adult critical care edited by Matthew N. Jaffa, David Y. Hwang

Format:

Book

Contributor:

Jaffa, Matthew, editor.

Hwang, David Y., editor.

Series:

Cambridge medicine (Series)

Cambridge medicine

Language:

English

Subjects (All):

Critical care medicine--Decision making.

Critical care medicine.

Clinical medicine--Decision making.

Clinical medicine.

Patient participation.

Physician and patient.

Medical personnel and patient.

Critical Care--methods.

Clinical Decision-Making.

Decision Making, Shared.

Patient Participation.

Professional-Patient Relations.

Professional-Family Relations.

Physician-Patient Relations.

Medical Subjects:

Critical Care--methods.

Clinical Decision-Making.

Decision Making, Shared.

Patient Participation.

Professional-Patient Relations.

Professional-Family Relations.

Physician-Patient Relations.

Physical Description:

1 online resource

Place of Publication:

Cambridge, United Kingdom New York, NY Cambridge University Press 2021

Summary:

"Decisions about life, quality of life, and death are routine in critical care practice. To promote the ethical principle of patient autonomy, clinicians often find themselves incorporating their medical expertise into value-laded conversations with patients and families of incapacitated patients-with regard to whether clinical care plans are consistent with patients' wishes, or the best approximation thereof. Guiding patients and families through these shared decisions can be difficult, not necessarily because of detailed technical knowledge needed to understand how ICU interventions work, but because of the uncertainty of what ICU interventions might achieve at any given time for a certain patient and the challenges of conveying difficult news to overwhelmed patients and families-whether that news is certain or uncertain. ICU teams are generally large and multidisciplinary, and while the complexity of such conversations warrants a clinician with expertise and compassion guiding them, it is not infrequent that these conversations are led by clinical trainees who build close relationships with patients and families but who may not have a wealth of experience from which to draw"-- Provided by publisher

Contents:

Cover

Half-title

Title page

Copyright information

Dedication

Contents

List of Contributors

Preface

Chapter 1 When Does Shared Decision-Making Apply in Adult Critical Care?

1.1 Challenges with Practicing Shared Decision-Making in Critical Care

1.2 Situations in Which Principles of Shared Decision-Making Apply in ICUs

References

Chapter 2 How Much Does the Family Want to Be Involved in Decision-Making?

Chapter 3 Show Me the Data: Tips for Discussing Numerical Risk in Critical Care

3.1 Understanding the Difficulty of Numeracy

3.2 Cognitive Biases

3.3 Methods to Improve Insight If Numbers Are Presented

Chapter 4 Communication Skills for Critical Care Family Meetings

4.1 Framework Steps in Detail

4.1.1 Gather the Clinical Team for a Pre-Meeting

4.1.1.1 Meeting Location and Setup

4.1.2 Introduce Everyone at the Family Meeting

4.1.3 Use Ask-Tell-Ask to Exchange Information about the Clinical Condition and Prognosis

4.1.3.1 The First Ask

4.1.3.2 The Tell

4.1.3.3 The Next Ask

4.1.4 Responding to Emotion with Empathy

4.1.5 Explain Treatment Options

4.1.6 Elicit the Patient's Goals, Values and Preferences by Highlighting Their Voice

4.1.6.1 Highlighting the Patient's Voice

4.1.6.2 Aligning with the Patient

4.1.7 Allow for Deliberation about Options and Ask Permission to Make a Recommendation

4.1.7.1 Deliberation

4.1.7.2 Recommendation

4.1.8 Develop a Plan

Chapter 5 The Do-Not-Resuscitate Order

5.1 Incidence and Outcomes of Patients with In-Hospital Cardiac Arrest

5.1.1 Incidence

5.1.2 Hospital Survival

5.1.3 Long-term Survival

5.1.4 Quality of Life

5.2 Predicting the Outcome of Hospitalized Patients

5.3 Challenges Associated with DNR Decision-Making

5.4 How DNR Shared Decision-Making Can Go Well

5.5 Interventions to Improve CPR Decision-Making

5.6 Conclusions

Chapter 6 The Do-Not-Intubate Order

6.1 The Need to Discuss Intubation Preferences in the ICU

6.2 Epidemiology of Acute Respiratory Failure

6.3 Prognostication in Acute Respiratory Failure

6.4 Proposed Approach to the ''Do-Not-Intubate'' Order

6.4.1 Set the Stage

6.4.2 Values Elicitation

6.4.3 Description of Intervention

6.4.4 Physician Recommendation

6.4.5 Make a Decision

6.5 Role of Surrogates

6.6 Evidence for Decision Aids in the ICU

6.7 Conclusions

Chapter 7 Prolonged Ventilator Dependence for the Pulmonary Patient

7.1 Chronic Critical Illness

7.2 Tracheostomy

7.3 Post-ICU Disposition

7.4 Weaning from Mechanical Ventilation

7.5 Long-term Mechanical Ventilation

7.6 End-of-Life Care

7.7 Conclusions

Chapter 8 Renal Replacement Therapy

8.1 AKI Requiring RRT: Outcomes of Renal Recovery and Mortality

Notes:

Includes bibliographical references and index

Online resource; title from digital title page (viewed on June 03, 2021)

Other Format:

Print version Shared decision making in adult critical care

ISBN:

9781108633246

1108633242

OCLC:

1224045506

Access Restriction:

Restricted for use by site license