Decision Support for Patient Preference-based Care Planning
Effects on Nursing Care and Patient Outcomes
- Case Western Reserve University, Cleveland, Ohio. Dr. Ruland is now with the Institute of Nursing Science, University of Oslo, Norway
- Corresdpondence and reprints: Cornelia M. Ruland, RN, PhD, Institute of Nursing Science, University of Oslo, P.b. 1120 Blindern, 0317 Oslo, Norway. e-mail: 〈ruland{at}online.no〉
- Received 28 December 1998
- Accepted 11 March 1999
Abstract
Objective While preference elicitation techniques have been effective in helping patients make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. The purpose of this study was to evaluate a decision support system for eliciting elderly patients' preferences for self-care capability and providing this information to nurses in clinical practice—specifically, its effect on nurses' care priorities and the patient outcomes of preference achievement and patient satisfaction.
Design Three-group quasi-experimental design with one experimental and two control groups (N = 151). In the experimental group computer-processed information about individual patient's preferences was placed in patients' charts to be used for care planning.
Results Information about patient preferences changed nurses' care priorities to be more consistent with patient preferences and improved patients' preference achievement and physical functioning. Further, higher consistency between patient preferences and nurses' care priorities was associated with higher preference achievement, and higher preference achievement with greater patient satisfaction.
Conclusion This study demonstrated that decision support for eliciting patient preferences and including them in nursing care planning is an effective and feasible strategy for improving nursing care and patient outcomes.
Footnotes
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This work was supported by a predoctoral fellowship from the Norwegian Research Council and by Vital/Norwegian Nurses' Association, Sigma Theta Tau, and the Alumni Association of the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
