Assessment: Assessing the Problem: Quality, Safety, and Cost Considerations

Assessing the Problem

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.

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. Gover

Assessment Assessing the Problem Quality Safety and Cost Considerations

Assessment Assessing the Problem Quality Safety and Cost Considerations

nment 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.


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.




Association, A. D. (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care, 41(5), 917–928.

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.

Deoraj, S., Moutzouris, D. A., & Bellini, M. I. (2021). Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation. BioMed Research International, 2021, e5460672.

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.

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.

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.

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.

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.

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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

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Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource