People with dementia are confronted with many decisions. However, they are often not involved in the process of the decision-making. Shared Decision-Making (SDM) enables involvement of persons with dementia in the decision-making process. In our study, we develop a supportive IT application aiming to facilitate the decision-making process in care networks of people with dementia. A key feature in the development of this SDM tool is the participation of all network members during the design and development process, including the person with dementia. In this paper, we give insight into the first phases of this design and development process in which we conducted extensive user studies and translated wishes and needs of network members into user requirements
Patients with a hematologic malignancy increasingly prefer to be actively involved in treatment decision-making. Shared decision-making (SDM), a process that supports decision-making in preference-sensitive decisions, fits well with this need. A decision is preference sensitive when well-informed patients considerably differ in their trade-offs between the pros and cons of one option, or if more equal treatment options are available, including no treatment. SDM involves several steps: the first is choice talk, where the professional informs the patient that a decision needs to be made between the various relevant options and that the patient's opinion is important. The second is option talk, where the professional explains the options and their pros and cons. In the third step, preference talk, the professional and the patient discuss the patient's preferences. The professional supports the patient in deliberation. The final step is decision talk, where the professional and patient discuss the patient's decisional role preference, make or defer the decision and discuss possible follow-up.
Clinical Decision Support Systems (CDSS) are increasingly developed for hospital nursing practice, yet their impact on decision-making, workflow efficiency, and patient outcomes remains complex. This rapid review synthesizes findings from 21 studies, highlighting both the benefits and challenges of CDSS implementation focused on three key areas. CDSS can enhance nursing decision-making by reducing variability and improving standardization, but there are concerns about system usability and the tendency to override recommendations. While CDSS improve workflow efficiency by prioritizing tasks, issues such as alert fatigue and poor interoperability with hospital systems hinder their potential. Patient outcomes benefit from CDSS-driven medication safety and risk prevention, yet adherence to recommendations varies among nurses. These findings underscore the need for user-centered CDSS that align with nursing values. Future research should explore long-term effectiveness, implementation strategies and best practices for integrating CDSS into nursing workflows.
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