The role of nursing in shared decision-making: a relational approach to implantable cardioverter-defibrillator battery replacement




Lewis, Krystina

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Implantable cardioverter defibrillator (ICD) implantation rates are rapidly increasing as advances in heart failure and arrhythmia management progress. The number of patients who will eventually require an ICD battery replacement will thus rise in consequence. It has been suggested that ICD battery replacement is an opportune time for shared decision-making (SDM) regarding continued ICD therapy to carefully review patients' health status, their lived experience with the ICD, and health care goals. My purpose in this project is to critically explore how a relational ethics lens can inform nurses to assist patients in a SDM process at ICD battery replacement. A comprehensive review and critical analysis of 17 articles was conducted to determine the role of nurses in SDM. My analysis revealed four themes: knowledge as a basis for SDM, sharing power in relationships, utilization of decisional support strategies, and communication. I then considered this evidence in the context of relational ethics. Nurses are indeed well positioned and able to participate in decision-making processes but should adopt certain roles and responsibilities in order to ensure their success. Implications for nursing practice, education, and research are offered.



nursing, decision making