Barriers to and Facilitators of Evidence-Based Decision Making at the Point of Care

Responses to classmates must consist of at least 350 words (not including the greeting and the references), do NOT repeat the same thing your classmate is saying, try to add something of value like a resource, educational information to give to patients, possible bad outcomes associated with the medicines discussed in the case, try to include a sample case you’ve seen at work and discuss how you feel about how that case was handled. Try to use supportive information such as current Tx guidelines, current research related to the treatment, anything that will enhance learning in the online classroom. Name/Position/Employer/Nature of Misconduct Research led me to a fellow in the pathology department at Wayne State University, Zhiwei, Wang MD (Case Summary, 2020). The misconduct included falsifying information on grant applications and further falsifying information in published papers (Case Summary, 2020). Zhiwei, Wang M.D, has multiple allegations of misconduct against him, including falsifying images, copying or misrepresenting migration and invasion assays, proteins, controls, and shifts in bands intended to assist with developing therapeutic cancer treatments (Case Summary, 2020). Legal Consequences of the Misconduct The misconduct’s legal consequences include excluding himself from working with any government agency or advisory committee for ten years (Case Summary, 2020). The papers published by Zhiwei, Wang M.D., will be voluntarily corrected or removed at the request of Zhiwei, Wang M.D (Case Summary, 2020). Potential Consequences to the Public/Patients Consequences for patients or the public can be devastating. Dr. Wang was trusted to perform research to improve cancer treatments with funds from the National Cancer Institute, U.S. Public Health Service, and the National Institutes of Health (Case Summary, 2020). By falsifying or copying any portion of the research and publishing the study, the information can be used by any medical provider to provide treatment or develop improved cancer treatments (Mateo & Foreman, 2014). When a provider depends on the research performed to improve cancer treatments, a medical provider or a drug company will be using dangerously false information that will carry over to the patients. For example, if a cancer drug is developed from Dr. Wang’s research, and the drug is delivered to patients’ life-threatening reactions can occur. Patients can take medicine, believing they are using a proven cancer treatment drug, and the drug never affects cancer, cancer can worsen, and death can be imminent. Funds used for the research are wasted on unproven research that could have possibly saved lives. Potential Consequences for Evidence-Based Practice (EBP) Evidence-based practice is known for improving outcomes and medical care (Chien, 2019). Research is to develop knowledge that can be applied in practice and teach medical professionals improved ways to care for patients (Chien, 2019). Medical professionals depend on research generated evidence to make clinical decisions and improve outcomes. Falsifying research as was described in this case puts medical professionals, evidenced-based practice, drug companies, and patients at high risk of errors, treatment of patients that is genuinely not evidenced-based, and injuring a patient (Mateo & Foreman, 2014). The evidence-based approach is intended to be used by all medical providers and staff. Consequences of evidence-based practice when information is falsified can lead to providers not trusting evidence-based research and treating patients based on assumptions instead of evidence (O’Malley, Collins, Contreary, & Rich, 2016). For a provider to give a prescription, that provider must have proven research to trust the medication will provide the patient with the best outcome. The provider depends on research and trusts if the study shows the medicine works in a high percentage of patients, then the medication can be safely administered (O’Malley et al., 2016). If a provider has no faith in research and cannot trust the research outcome, errors will be made in judgment, which will cause patient harm (Mateo & Foreman, 2014). The providers then lose faith in research and make their own non-evidenced based treatment decisions. The consequences to evidence-based practice are various, with the highest importance focused on providers no longer using evidence-based treatment to guide decisions, leading to errors and, ultimately, patient demise (O’Malley et al., 2016). Case Summary: Wang, Zhiwei: ORI – The Office of Research Integrity. (2020, August 12). Retrieved November 03, 2020, from https://ori.hhs.gov/content/case-summary-wang-zhiwei Chien, L. (2019). Evidence-Based Practice and Nursing Research. Journal of Nursing Research, 27(4). doi:10.1097/jnr.0000000000000346 Mateo, M. A., & Foreman, M. D. (2014). Research for Advanced Practice Nurses: From Evidence to Practice. New York, NY: Springer Publishing Company, LLC. O’Malley, A. S., Collins, A., Contreary, K., & Rich, E. C. (2016). Barriers to and Facilitators of Evidence-Based Decision Making at the Point of Care. MDM Policy & Practice, 1(1), 238146831666037. doi:10.1177/2381468316660375

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Scenario 5: Susie and Wang Shu Chen
“My wife and I are both consultants and earn approximately $200,000 jointly. We need to purchase our own
health insurance, but this has always been too expensive, so we have opted to take our chances and go
uninsured. We would like to find out what coverage is being offered through the marketplace in our state and
how much it will cost. We are both 34 years old and have no children. What if we choose not to purchase
health insurance? Will we be fined? If so, how much?”
Age: 34
Marital Status: Married
Children: None
Income: $200,000
Choose a State of Residence: Texas
Pre-existing illness: None, but we both smoke
Describe your character in the above scenario’s options to purchase health care through the marketplace and
choose a state listed in the scenario. Try to choose different states from your peers to maximize your exposure
and education. You may assume that your character does not have employer-sponsored health insurance.
Use and cite legitimate resources on the Internet to complete this activity. Here are some suggested websites
(you may use others, but you must list what you used within your discussion board post for the class to
reference):
Health Insurance Marketplace Calculator (Links to an external site.), which can be accessed with a state and
zip code
State Health Insurance Marketplace Profiles (Links to an external site.)
Include the following in your video post:
Brief description of your character’s situation
Annual Income
State
Whether the state has a state-run marketplace, federally-designated marketplace, or partnership marketplace
Annual cost of health care (for bronze and silver plans)
Tax subsidy (if any)
Reaction regarding the above information (Address how you believe the character would respond on
receiving the information you uncover.)

Sample Solution

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