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Title Shared decision making in adult critical care / edited by Matthew N. Jaffa, David Y. Hwang
Published Cambridge, United Kingdom ; New York, NY : Cambridge University Press, 2021
©2021

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Description 1 online resource (xiv, 197 pages) : illustrations
Series Cambridge medicine
Cambridge medicine (Series)
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? -- References -- 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 -- References -- 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 -- References -- 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 -- References -- 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 -- References -- 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 -- References -- Chapter 8 Renal Replacement Therapy -- 8.1 AKI Requiring RRT: Outcomes of Renal Recovery and Mortality
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
Bibliography Includes bibliographical references and index
Notes Online resource; title from digital title page (viewed on June 03, 2021)
Subject Critical care medicine -- Decision making
Clinical medicine -- Decision making.
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 personnel and patient
Clinical medicine -- Decision making
Critical care medicine -- Decision making
Patient participation
Physician and patient
Form Electronic book
Author Jaffa, Matthew, editor.
Hwang, David Y., editor.
LC no. 2020051657
ISBN 9781108633246
1108633242