Date on Master's Thesis/Doctoral Dissertation

5-2018

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Degree Program

Nursing, PhD

Committee Chair

Polivka, Barbara

Committee Member

Christina, Becky

Committee Member

Hutti, Marianne

Committee Member

Wills, Celia

Author's Keywords

shared decision making; nurses; parents; perceptions; hospitalized children

Abstract

Achievement of optimal quality in today’s healthcare environment practices means that clinical practices must be based on evidence. Evidence-based practice (EBP) is the integration of research findings, clinician expertise, and patient-centeredness that includes a focus on preferences and values (Melnyk & Fineout-Overholt, 2015). An area within EBP needing increased attention is the aspect of patient preferences and values. The process of Shared Decision Making (SDM) incorporates assessment of preferences and values within a process in which where patients, families and healthcare professionals collaborate to make decisions regarding patient care. The purpose of this study was to describe perceptions of parents and nurses in a pediatric inpatient setting about SDM and to adapt an existing SDM tool for use in the pediatric clinical setting. Areas of focus include: (1) critical review of SDM literature focusing on care of acutely ill children; (2) adaptation of existing reliable and valid SDM physician and adult patient -focused tools to a pediatric nurse and parent-focused SDM tools, and (3) a mixed methods approach assessing parent and nurse perceptions of SDM in an acute care facility and interview sessions with nurses to share thoughts and suggestions on use of shared decision making in the pediatric clinical setting. A summary of the findings based on the completed research includes several overall insights. First, the existing adult tools were successfully adapted for use in the pediatric setting based on parent and nurse feedback. Second, the quantitative findings from the mixed methods study identified consistency in positive perceptions of nurses and parents with regard to SDM in caring for an acutely ill hospitalized child. The qualitative data from this study identified the need for enhanced parent-nurse communication and strategies for a team approach to hospital-based care.

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