Decision support for patient preference-based care planning: effects on nursing care and patient outcomes.
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.


METHODS
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.


CONCLUSIONS
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.
Ruland
C M
CM
Case Western Reserve University, Cleveland, Ohio, USA. ruland@online.no
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D009732:Nursing Care; D010347:Patient Care Planning; D010358:Patient Participation / Q000379:methods*; D011594:Psychometrics; D012648:Self Care; D016896:Treatment Outcome