Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
Capella University Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations-Step-By-Step Guide
This guide will demonstrate how to complete the Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
Whether one passes or fails an academic assignment such as the Capella University Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
The introduction for the Capella University Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
After the introduction, move into the main part of the Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations
In the previous assignment, I discussed client M.N, a 46-year-old African American male diagnosed with Type 2 Diabetes. Quality and safety are key aspects of diabetes care, which significantly determine patient outcomes. Cost is a major barrier in accessing health services and also determine patient outcomes. This essay aims to discuss the effect of Type 2 Diabetes on the quality of care, patient safety, and costs to the system and individual.
How Type 2 Diabetes Impacts the Quality of Care, Patient Safety, and Costs to the System and Individual
Type 2 Diabetes significantly impacts the quality of care provided to patients since health providers must provide aggressive and top-notch care to prevent the development of diabetes-related complications. Furthermore, health providers have to be alert to identify symptoms of low or very high blood glucose in diabetic patients (Nikitara et al., 2019). There has been a growing demand to enhance the quality of care for diabetes to more comprehensive health care that addresses the physical, social, and emotional challenges attributed to the condition (Nikitara et al., 2019). Health professionals are recommended to promote patient participation in decision-making regarding their care.
A report by the American Diabetes Association (ADA) reveals an estimated overall diabetes cost of $327 billion in 2017, with $237 billion used in direct medical costs and $90 billion in reduced productivity. The largest components of diabetes costs include hospital inpatient care and prescription treatments to treat complications, which account for 30% of the total medical cost each (ADA, 2018). Other components include antidiabetic agents and diabetes supplies, which account for 15%, and physician office visits at 13%. Diabetic patients incur an average medical cost of $16,752 annually, of which approximately $9,601 is used in diabetes care (ADA, 2018). On average, diabetic patients have medical costs roughly 2.3 times higher than what medical costs would be in the absence of diabetes.
How State Board Nursing Practice Standards and Governmental Policies Can Affect Type 2 Diabetes Impact on the Quality of Care, Patient Safety, and Costs to the System and Individual
State board nursing practice standards dictate how nursing care is provided and the quality of care for diabetic patients. The standards guide nurses to provide standard care to patients regardless of the healthcare setting (ADA, 2016). Consequently, nursing practice standards can positively impact the quality of diabetes care by guiding nurses in assessing and managing patients to provide the best quality care possible. Nursing practice standards also provide the minimum standards that nurses should meet when providing patient care to avoid complications and promote patient safety (ADA, 2016). Besides, they guide nurses on assessing for complications, evaluating the effectiveness of care, and providing patient education on preventing complications.
The standards guide nurses on how to provide quality care that will promote reduced complications, hospital stays and readmission rates and increase patient outcomes, thus reducing patient and hospital operational costs. Nursing standards direct nurses on the actions to take on each step of management to avoid unnecessary procedures, investigations, or treatments, thus reducing patient and operational costs (Nikitara et al., 2019). They direct the evaluation of the overall care given to patients for nurses to evaluate whether the care was cost-effective and, if not, how it can be improved to make it more efficient.
Government policies can significantly affect diabetes’ impact on the quality of care, patient safety, and costs to the system and individual. Policy actions can improve the availability and quality of care for diabetes and support persons to make healthier choices. According to Timpel et al. (2019), government policies can help eliminate two major health system obstacles to successful type 2 diabetes care and management: financial barriers for patients and limited access to health services and medication. Government policies can address health system factors to promote effective type 2 diabetes care and management (Timpel et al., 2019). These factors include the utilization of innovative care models, increased pharmacists’ inclusion in care delivery, and education programs facilitated by healthcare professionals.
Improving patient safety practices can support health care delivery systems and enhance health sector performance. Government policies can direct the adoption of strategies by health systems to promote quality improvement in the care of diabetic patients. According to El-Jardalim & Fadlallah (2017), government policies can introduce sets of standardized and applicable quality indicators for performance measurement and benchmark. Besides, they can direct the establishment of incentive systems that connect contractual agreements, accreditation, regulations, and performance indicators to improve patient care quality and safety (El-Jardalim & Fadlallah, 2017). Lastly, government policies can help establish a culture of continuous quality improvement in the health systems and support professional training in quality improvement and patient safety.
The cost of diabetes care, particularly medication, is a critical factor, especially for elderly patients. Government policy strategies can impact patient costs by reducing or eliminating out-of-pocket costs for diabetes medication and self-management supplies (Timpel et al., 2019). Furthermore, policies can direct more resources to diabetes preventive services since disease prevention promotes healthcare efficiency and cost-savings (Timpel et al., 2019). To the health system, government policies can reduce or eliminate taxes on diabetes medications and diagnostic supplies to make medications more affordable for patients and reduce the hospital’s operational costs.
Strategies to Improve the Quality of Care, Enhance Patient Safety, and Reduce Costs to the System and Individual
The priority of all health systems caring for patients with diabetes should be to provide high-quality care. The quality of care for diabetic patients can be improved by determining care interventions through evidence-based guidelines to promote the best possible outcomes (ADA, 2016). Nurses and physicians can ensure that the interventions selected in the care of diabetic patients are based on evidence-based research that has proved to increase patient outcomes and safety. Besides, hospitals can expand healthcare teams’ functions to carry out more intensive diabetes management strategies to enhance the quality of care and patient outcomes (ADA, 2016). By expanding the team’s role, health providers will be able to take immediate action without having to follow a protocol.
Quality of care can also be enhanced by providers increasing the processes of care for diabetic patients. This includes periodic testing of hemoglobin A1C, urinary albumin, and lipids levels (ADA, 2016). Providers can ensure that patients have a periodic examination of the retina and feet as per the ADA guidelines for early detection and management of eye and foot complications. Patient education resources and formal case management can be used to influence providers to enhance processes of care.
Patient safety can be enhanced by the need for adequate resources by hospitals adhering to the recommended nurse-patient ratios so that nurses can have sufficient time to assess clinical problems and potential complications. Increasing nursing staffing will also prevent medication errors and incidences of missed nursing care, which compromise patient safety (ADA, 2016). Embracing technology in the care of diabetic patients can improve safety by reducing medical errors (Dhatariya et al., 2020). For instance, hospitals can use network glucose monitoring, enabling providers to focus on patients who have severe or recurrent hypoglycemia and hyperglycemia and enable providers to target limited resources appropriately. Health costs associated with Diabetes care can be reduced by eliminating financial barriers and reducing patient out-of-pocket costs for eye exams, self-monitoring of blood glucose, diabetes education, and medications.
Conclusion
Diabetes impacts the quality of care since it is associated with never-ending demands such as daily monitoring blood glucose, nutrition counseling, creating exercise programs, and monthly or bimonthly assessment and review of patients’ treatment plans. Associated safety concerns include the risk of hypoglycemia and hyperglycemia, hospital-acquired foot ulcers, medication errors, and mortality. Diabetes is also associated with high inpatient care costs, purchase of medications, antidiabetic agents and diabetes, and physician office visits. The quality of diabetic care can be enhanced by using evidence-based guidelines, increasing processes of care, and expanding the functions of health teams. Patient safety can be enhanced by increasing staffing ratio and using technology, while costs can be reduced by eliminating financial barriers and reducing out-of-pocket costs.
References
American Diabetes Association (2018). Economic Costs of Diabetes in the US in 2017. Diabetes care, 41, 917. https://doi.org/10.2337/dci18-0007
American Diabetes Association. (2016). Standards of medical care in Diabetes-2017, Classification, and Diagnosis of Diabetes. https://doi.org/10.2337/dc16-S004
Dhatariya, K., Mustafa, O. G., & Rayman, G. (2020). Safe care for people with diabetes in the hospital. Clinical medicine (London, England), 20(1), 21–27. https://doi.org/10.7861/clinmed.2019-0255
El-Jardali, F., & Fadlallah, R. (2017). A review of national policies and strategies to improve the quality of health care and patient safety: a case study from Lebanon and Jordan. BMC health services research, 17(1), 568. https://doi.org/10.1186/s12913-017-2528-1
Nikitara, M., Constantinou, C. S., Andreou, E., & Diomidous, M. (2019). The Role of Nurses and the Facilitators and Barriers in Diabetes Care: A Mixed-Methods Systematic Literature Review. Behavioral sciences (Basel, Switzerland), 9(6), 61. https://doi.org/10.3390/bs9060061
Timpel, P., Harst, L., Reifegerste, D., Weihrauch-Blüher, S., & Schwarz, P. E. (2019). What should governments be doing to prevent diabetes throughout the life course?.Diabetologia, 1-12. https://doi.org/10.1007/s00125-019-4941-y
Health problems have significant adverse effects on the social and economic wellbeing of patients and their significant others. Nurses and other healthcare providers have a critical role to play in ensuring that the burden of disease to the patients is eased. Nurses and other healthcare providers achieve the outcome by embracing patient-centered and evidence-based interventions to improve the health outcomes in disease management. Therefore, this paper examines the burden of hypertension and pre-diabetes to the selected patient in the case study.
You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:
- Minority Health: http://www.cdc.gov/minorityhealt/index.html
- Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Part 1
Hypertension and diabetes have considerable adverse effects to the health and wellbeing of the patient in the case study. The adverse effects of the health problems on the patient can be seen from evidence-based literature. According to evidence provided by Zhang et al., (2017), the total annual expenditure for patients with hypertension in America between 2000 and 2001 was $1399. The spending rose to $1494 in the years 2012-2013. The annual national spending on hypertension is also high as seen from the statistics that $58.7 billion to $109.1 billion is used in treating hypertension in the US (Zhang et al., 2017). Hypertension and pre-diabetes also increase the need for frequent hospital visits and admissions for the patients. The impact is the loss of social and occupational productivity by the patients due to increased spending of resources in seeking healthcare (Sikachi et al., 2017). Similar cost burden can also be seen in diabetes. For example, it is estimated that the total cost of diagnosed diabetes in the US in 2017 was $327 billion, with $90 billion incurred due to reduced productivity and $237 billion in direct medical costs (Association, 2018). Patients with hypertension and pre-diabetes are also predisposed to a number of health risks. The health risks include stroke, cardiovascular complications such as cardiomyopathy, diabetes, diabetic foot, renal failure, and diabetic retinopathy (Deoraj et al., 2021; Nazir et al., 2018). The above burden of hypertension and diabetes are consistent with what is being experienced in practice due to the increasing number of people affected by the conditions.
The state board of nursing standards and government policies affect the impact of hypertension and pre-diabetes on the health of the patient significantly. Accordingly, the state board of nursing provides guidelines and professional standards that should be embraced in caring patients with different health problems. Nurses have to ensure that ethical considerations such as the promotion of safety in the provision of care to the patient are upheld (de Assunção Bezerra et al., 2018). Nurses have to embrace evidence-based interventions to optimize the treatment outcomes for patients with hypertension and pre-diabetes.
Government polices also have an impact on the burden of hypertension and pre-diabetes to the patient. Government influences the care given to the patient through the implementation of policies such as the Affordable Care Act that increases the access and utilization of care by patients from diverse backgrounds. The government also allocates resources to be utilized in providing preventive, health promotion, curative and rehabilitation care to patients affected by hypertension and pre-diabetes. The effect of government policies on health is that patients incur minimal costs in seeking healthcare due to the subsidized care through government inputs to health care organizations. An example of a study that has examined the effectiveness of government policies in improving the burden of hypertension and diabetes in the population is the research by de Assunção Bezerra et al., (2018). The study showed that the collaboration of government agencies and schools to promote school-health educational programs on healthy lifestyles led to behavioral change among school-going children. Therefore, government policies and state boards of nursing influence the burden of disease in patients affected by diabetes and hypertension.
The state boards of nursing standards and government policies will guide my actions in addressing the quality of care, patient safety and costs to the patient in the case study in a number of ways. The state boards of nursing standards will guide me in ensuring that I demonstrate professionalism in addressing the care needs of the patients. I will abide by the board of nursing regulations such as the promotion of patients’ rights to quality, safe and efficient care. I will also make ethical decisions to ensure responsibility and accountability in the provision of care to the patient. I will also use the state boards of nursing standards to implement evidence-based care that will optimize the outcomes of treatment for the patient. I will adhere with the government policies in advocating the adoption of interventions that eliminate barriers to care for the patient in the case study (Gorina et al., 2018). Through the above interventions, I will achieve outcomes of care that include high quality, patient safety and cost-effectiveness in the care provision process.
The state, local, and federal policies also influence my scope of practice in relation to the context of quality care, patient safety and cost to the patient in the case study as well as the system as a whole. The state, local and federal policies guides the standards of practice for bachelor-level prepared nurse. The policies define the boundaries of the care that is acceptable for the bachelor-level prepared nurse to provide to their patients. For example, as a bachelor-level prepared nurse, I have the responsibility of providing care that promotes the health of the patient, prevent complications and empowers patient to use the available resources to cope with the disease. The state legislatures also provide guidelines on the standards of practice that will inform the care given to the patient (Sikachi et al., 2017). Lastly, the policies support the evolution of my practice to ensure that nurses are prepared to address the current and emerging care needs of the diverse populations.
A number of strategies can be embraced to improve the quality of care, patient safety and reduce costs to the patient in the case study affected by hypertension and is pre-diabetic. One of the interventions is providing health education on the optimum management of hypertension and pre-diabetes. The patient needs education on the importance of medication adherence and the incorporation of non-pharmacological interventions into the management of his health problems (Gorina et al., 2018). The patient can also embrace the use of self-management interventions for hypertension and pre-diabetes. Self-management interventions focus on empowering the patient to take responsibility for his health. It entails the use of interventions such as daily monitoring of blood pressure, dietary modifications, and engaging in active physical exercises on a regular basis (Li et al., 2020).
Health education and self-management of hypertension and pre-diabetes have been shown to be effective in research. For example, Gorina et al., (2018) found that health education was effective in promoting lifestyle and behavioral changes in patients with chronic illnesses that included diabetes and hypertension. Li et al., (2020) found that self-management interventions for hypertension delivered via m-health were effective in reducing systolic blood and diastolic blood pressure and improvement in the self-management behaviors as well as medication adherence by the patients. The relevant and available sources of benchmark data for improving quality, cost and patient safety in hypertension management include those obtained from institutions such as WHO, CDC, and the American Diabetes Association among others.
Assessment 2
The assessment was conducted with a family member who is hypertensive and pre-diabetic. The assessment showed that the patient has experienced safety events due to hypertension. He has experienced uncontrolled blood pressure in the recent past that led to his hospitalization for symptom management. The patient reported that the frequency of visits to the emergency departments have increased over the past few months. He estimated that his visits to the emergency department have been at least two in every month for the past three months. The patient also reported to have been hospitalized once since this year started. The admission was due to uncontrolled blood pressure. The patient is currently on two anti-hypertensive medications to manage his health problem. He manages pre-diabetes using dietary modification and engaging in regular physical activity. The patient has a medical insurance cover. As a result, it pays for the medications that he uses. The patient reported that he has high level of tolerance to the medications that he currently uses. Therefore, he rarely experiences any side effects associated with the medications. The patient also reported that he visits the doctor’s office on a monthly basis for his medical checkups. The insurance however does not pay for the visits. This forces him to incur out-of-pocket payments for his regular medical checkups. The information obtained from this visit increased the need for the adoption of interventions to improve the burden of the disease to the patient.
Conclusion
Overall, hypertension and diabetes have significant adverse consequences to the patient and the healthcare system as a whole. The conditions predispose patients to complications that lower their quality of life. Patients also incur considerable costs in seeking the care that they need alongside the loss of their productivity. Therefore, best practices should be embraced to optimize the treatment of care to patients affected by hypertension and pre-diabetes.
References
Association, A. D. (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care, 41(5), 917–928. https://doi.org/10.2337/dci18-0007
de Assunção Bezerra, M. K., Freese de Carvalho, E., Souza Oliveira, J., Pessoa Cesse, E. Â., Cabral de Lira, P. I., Galvão Tenório Cavalcante, J., & Sá Leal, V. (2018). Health promotion initiatives at school related to overweight, insulin resistance, hypertension and dyslipidemia in adolescents: A cross-sectional study in Recife, Brazil. BMC Public Health, 18(1), 223. https://doi.org/10.1186/s12889-018-5121-6
Deoraj, S., Moutzouris, D. A., & Bellini, M. I. (2021). Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation. BioMed Research International, 2021, e5460672. https://doi.org/10.1155/2021/5460672
Gorina, M., Limonero, J. T., & Álvarez, M. (2018). Effectiveness of primary healthcare educational interventions undertaken by nurses to improve chronic disease management in patients with diabetes mellitus, hypertension and hypercholesterolemia: A systematic review. International Journal of Nursing Studies, 86, 139–150. https://doi.org/10.1016/j.ijnurstu.2018.06.016
Li, R., Liang, N., Bu, F., & Hesketh, T. (2020). The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis. JMIR MHealth and UHealth, 8(3), e17776. https://doi.org/10.2196/17776
Nazir, M. A., AlGhamdi, L., AlKadi, M., AlBeajan, N., AlRashoudi, L., & AlHussan, M. (2018). The burden of Diabetes, Its Oral Complications and Their Prevention and Management. Open Access Macedonian Journal of Medical Sciences, 6(8), 1545–1553. https://doi.org/10.3889/oamjms.2018.294
Sikachi, R. R., Sahni, S., Mehta, D., Agarwal, A., & Agrawal, A. (2017). Nationwide trends in inpatient admissions of pulmonary hypertension in the United States from 2000 to 2013. Advances in Respiratory Medicine, 85(2), 77–86. https://doi.org/10.5603/ARM.2017.0014
Zhang, D., Wang, G., Zhang, P., Fang, J., & Ayala, C. (2017). Medical Expenditures Associated With Hypertension in the U.S., 2000–2013. American Journal of Preventive Medicine, 53(6, Supplement 2), S164–S171. https://doi.org/10.1016/j.amepre.2017.05.014