NURS 306: Week 9 - My Voice, My Care, My Life

What are some concepts that impact decision-making?

- Ethical principles

- Dignity

- Vulnerability

- Stigma

- Loss

- Culture

- Uncertainty

- Healthcare system

- Health literacy

What are the 4 ethical principles in nursing?

- Autonomy

- Nonmaleficience

- Beneficience

- Justice

Health literacy helps people to _____ health information.

- Access

- Read

- Process

- Understand

- Communicate

- Act on

What are some organizational barriers to health literacy?

- Short appointment times

- Limited training of staff

- Users struggle to understand available resources

- Effects of medications and treatment

- Unfamiliar environment

- Cultural differences

What are some individual barriers to health literacy?

- Sensory deficits

- Cognitive decline

- Mental health

- Multiple information formats

- Language and cultural differences

- Internet access

Information needs to be . . .

- Available

- Accessible

- Valid

- Usable

- Able to support clinical decision making

How can we improve health literacy through verbal communication?

- Slow down

- Use plain language

- Show or draw pictures

- Limit information and repeat it

- Use teach-back

- Create a shame-free environment

- Frame the conversation

- Bring a friend or family member

What is the order upon which health care decisions are made?

1. Individual with capacity

2. Advance care directive

3. Proxy

4. Nearest relative

5. Healthcare provider

If a person scores greater than 3 on the cognitive performance scale (CPS), they have the capacity to make decisions for themselves (True/False).

False

What is an advanced directive?

A form containing a patient's wishes for treatment in the case that they become incapacitated.

What is a proxy?

A person who makes health care decisions on another person's behalf.

A proxy has to be 18 years old or older (True/False).

True

Who usually becomes the proxy if the patient didn't assign themself one beforehand?

Nearest relative.

During what situations can proxies make decisions?

- When the patient lacks capacity

- There is no advanced care plan

During what situations can the nearest relative make decisions?

- No proxy has been appointed

- The proxy appointed is unable to make a decision

What is the hierarchal order for a substitute-decision maker?

1. Spouse

2. Adult child

3. Parent

4. Adult sibling

5. Grandparent

6. Adult grandchild

7. Adult uncle/aunt

8. Adult nephew/niece

Healthcare professional are able to make decisions on a patient's behalf only when a reasonable attempt has been made to find the nearest relative, and another provider agrees with the choice in writing (True/False).

True