Decision-Making Models For APN In Critical Cardiac Care ✓ Solved

Decision-Making Models for APN in Critical Cardiac Care: A Case Study

Choose three types of decision-making models that will assist the APN in providing care to Mr. K and Mrs. K. Compare and contrast the three chosen models making sure to discuss key aspects of these models and the benefits and limitations of these models in addressing the above situation.

Describe the rationale for choosing the decision-making models to apply to the case study scenario.

What do you feel is best decision-making model to use for APN? Provide a rationale.

Sample Paper For Above instruction

Introduction

The role of an advanced practice nurse (APN) in critical care settings necessitates effective decision-making strategies, especially in emotionally charged situations such as post-cardiac arrest care and end-of-life decisions. In the case of Mr. K, who has experienced a cardiac arrest following a myocardial infarction, the APN is central to guiding treatment options while supporting the patient's family. To navigate these complex scenarios effectively, selecting appropriate decision-making models is essential. This paper explores three decision-making models—shared decision-making, ethical decision-making, and clinical decision-making—highlighting their key features, benefits, limitations, and applicability to the case at hand.

1. Shared Decision-Making Model

The shared decision-making (SDM) model emphasizes collaboration between the healthcare provider and the patient and/or family to make informed choices about care. It involves transparent communication, presenting evidence-based options, and considering patient values and preferences. In the context of Mr. K, who is likely to suffer severe neurological injury and may face withdrawal of care, SDM allows Mrs. K to participate actively in decisions aligning with her values and wishes (Elwyn et al., 2017).

Benefits:

  • Empowers families by involving them in care decisions.
  • Enhances satisfaction and adherence to agreed-upon plans.
  • Respects patient autonomy and family values.

Limitations:

  • Requires time for thorough discussions, which may be challenging in critical scenarios.
  • Possibility of conflicts if values diverge or information overwhelms the family.
  • Relies heavily on the family's capacity to understand medical information.

2. Ethical Decision-Making Model

The ethical decision-making model involves applying principles such as autonomy, beneficence, non-maleficence, and justice to resolve morally complex issues. In the case of Mr. K, where prognosis is uncertain and withdrawal of care may be considered, this model guides clinicians to weigh moral obligations and rights (Beauchamp & Childress, 2019).

Benefits:

  • Provides a structured approach to moral dilemmas.
  • Encourages reflection on ethical principles, promoting morally sound decisions.
  • Supports consistency in handling sensitive cases like end-of-life care.

Limitations:

  • Potentially time-consuming, which may delay urgent decisions.
  • Subjective interpretation of principles can lead to disagreements.
  • Requires deep ethical knowledge and consensus among team members.

    3. Clinical Decision-Making Model

    The clinical decision-making (CDM) model relies on evidence-based practice, clinical judgment, and evaluation of the patient's condition to determine the best course of action. It emphasizes a systematic approach to assessing clinical data, prognosis, and available interventions. For Mr. K, this model helps the APN analyze neurological assessments and prognosis to guide decisions about continuing aggressive treatment versus palliative care (Benner et al., 2010).

    Benefits:

    • Ensures decisions are grounded in current evidence and best practices.
    • Supports swift, rational decision-making in acute settings.
    • Helps integrate clinical data with patient and family preferences.

    Limitations:

    • May overlook emotional and ethical complexities.
    • Dependent on the quality and completeness of clinical data.
    • Requires up-to-date knowledge and clinical expertise.

      Comparison and Contrast of the Models

      While all three models aim to inform sound decision-making, they differ in focus and application. The shared decision-making model centers on collaboration and patient-family engagement, making it ideal for respecting autonomy and supporting emotional needs. Conversely, the ethical decision-making model provides moral guidance, which is vital when dilemmas involve life-sustaining treatments and ethical principles conflicts. The clinical decision-making model emphasizes objective analysis and scientific evidence, facilitating rapid assessments critical in acute care settings.

      However, integrating these models offers the most comprehensive approach. For example, combining clinical data evaluation with ethical considerations and shared discussions with the family ensures decisions are both evidence-based and morally sound while honoring the family's wishes and values. Limitations of each model, such as time constraints in the clinical model or potential conflicts in shared decision-making, highlight the importance of a balanced, multifaceted approach tailored to individual cases.

      Rationale for Choosing Decision-Making Models for the Case

      Given the complexity of Mr. K’s prognosis and the emotional impact on Mrs. K, a combined approach utilizing shared, ethical, and clinical decision-making models is appropriate. The clinical model provides objective data to guide prognosis and treatment options. The ethical model helps navigate moral dilemmas regarding life-sustaining treatments and potential withdrawal of care. Lastly, the shared decision-making model ensures Mrs. K is engaged in discussions, respecting her autonomy and providing emotional support during an overwhelming time.

      This multifaceted approach aligns with best practices in critical care nursing, where clinical evidence, ethical principles, and family-centered care converge to support compassionate and morally sound decisions (Doran, 2020).

      Best Decision-Making Model for the APN

      I believe the most suitable decision-making model for the APN in this context is an integrated approach combining shared and ethical decision-making, supported by clinical data. This hybrid model facilitates transparent communication, respects the patient's and family's values, and ensures decisions are grounded in ethical principles and clinical realities. Such an approach is essential in critical care scenarios, where timely yet compassionate decisions can significantly impact patient outcomes and family wellbeing. Ultimately, this model fosters trust, supports ethical integrity, and acknowledges the emotional and moral complexities inherent in end-of-life care decisions (Schwartz & Kahn, 2021).

      References

      • Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
      • Benner, P., Tanner, C., & Chesla, C. (2010). Expertise in nursing practice: Caring, clinical judgment, and ethics. Springer Publishing Company.
      • Doran, E. (2020). Critical care ethics: An overview. Journal of Critical Care Nursing, 15(3), 122-129.
      • Elwyn, G., Frosch, D., Thomson, R., et al. (2017). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361–1367.
      • Schwartz, L., & Kahn, M. (2021). Ethical decision-making in advanced practice nursing: Navigating complex dilemmas. Nursing Ethics, 28(2), 408-419.
      • Author, A., & Contributor, B. (Recent Year). Title of recent scholarly resource on decision models. Journal Name, Volume(Issue), pages.
      • Additional scholarly references as needed, adhering to APA 7th edition formatting.

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