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

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

Hypertension is a threat to people’s quality of life, safety, and well-being. The Centers for Disease Control and Prevention [CDC] (2021) explains hypertension as blood pressure that is higher than systolic and diastolic blood pressure thresholds. In this sense, guidelines for diagnosing high blood pressure recommend 120/80 mm Hg as the normal systolic and diastolic blood pressure, enabling healthcare professionals to identify at-risk populations and diagnose hypertension based on figures above this cut-off value. As a chronic condition, high blood pressure is the primary risk factor for various cardiovascular diseases, including heart disease, ischemic stroke, and peripheral arterial disease (Carey et al., 2018). Globally, about 1.28 billion adults aged 30-79 years have hypertension yet approximately 46% of the affected people are unaware of the condition or effective treatment options (World Health Organization, 2021). People’s unawareness of hypertension exacerbates more advanced and life-threatening conditions, such as heart disease and stroke. Based on the association between high blood pressure and more burdensome chronic conditions, it is valid to argue that elevated blood pressure affects the quality of care, patient safety, and healthcare costs.

Impacts of Hypertension on the Quality of Care

Quality of care is a multifaceted concept that underpins the roles and standards of practice for healthcare professionals. The World Health Organization (2020) defines the quality of care as “the degree to which health services for individuals and populations increase the likelihood of desired outcomes and are consistent with evidence-based professional knowledge.” In this sense, the desired outcomes of nursing practice and healthcare services include restoring people’s health, promoting recovery, alleviating suffering and pain, and safeguarding patient safety. When defining the quality-of-care phenomenon, it is vital to consider its multiple dimensions proposed by the Institute of Medicine (IOM). These dimensions are safety, people/patient-centeredness, timeliness, equity, efficiency, and effectiveness (World Health Organization, 2020). For example, healthcare professionals should provide care that respects and responds to individual preferences, values, and needs, while avoiding harm, addressing the underlying disparities, and incorporating the best evidence to support practices and inform clinical decisions.

Although providing quality care is an overarching goal of healthcare organizations and professionals, it is a daunting endeavor due to the prevailing internal and external environments. For instance, a high prevalence of chronic diseases is one of the significant challenges facing healthcare systems amidst the need to provide quality service. Hypertension is equally burdensome to healthcare professionals and facilities since its prevalence and effects affect the overall quality of care.

High blood pressure increases the individual propensity to more burdensome chronic conditions, including stroke and heart disease. Oparil et al. (2018) argue that hypertension is a preventable risk factor for cardiovascular diseases (CVDs) and the leading contributor to all-cause death and disability-adjusted life years (DALYs). The association between high blood pressure and other chronic diseases prompts healthcare professionals to understand the individual’s genetic, social, economic, environmental, and cultural issues that contribute to people’s propensity to high blood pressure. As a result, unmet needs for at-risk populations and people with hypertension affect the quality of care by requiring care providers to focus on primary, secondary, and tertiary prevention approaches. Finally, people with high blood pressure require individualized care interventions and regular follow-ups to enhance the effectiveness and impacts of pharmacological and non-pharmacologic strategies. These demands affect the perspectives of quality care.

Impacts of Hypertension on Patient Safety

Patient safety is a crucial dimension of quality care since it entails preventing, averting, and confronting issues or events that can jeopardize or threaten a patient’s health and wellness. According to Varkey (2021), healthcare professionals are responsible for preventing harm and benefiting the patient. On the other hand, Lawati et al. (2018) adopt the World Health Organization’s definition of patient safety as the determination to avert harm and the prevention of adverse events, including medication errors. A high prevalence of hypertension and associated morbidities compromise of patient safety by contributing to premature deaths, disability-adjusted life years, poor quality of life, and prolonged hospitalization. Once healthcare professionals diagnose patients with hypertension, they shift focus to secondary and tertiary prevention strategies, including medications and modifying risk factors to prevent the condition’s progression.

Impacts of Hypertension on Cost to the System and the Individual

Hypertension inflicts massive economic burdens on healthcare systems and Individuals, including upsurged costs of improving symptoms and alleviating complications associated with elevated blood pressure. The Centers for Disease Control and Prevention (2022) presents hypertension as a costly public health problem that cost the US healthcare system approximately $131 to $198 billion annually. The economic burden of hypertension includes the loss of productivity due to premature death, the costs of healthcare services, and medications for treating elevated blood pressure (Centers for Disease Control and Prevention, 2021). Equally, individuals with hypertension bear the cost burden of the condition, especially if they are underinsured or uninsured. In this sense, they face increased out-of-pocket expenses for paying for frequent consultations, medications, and other healthcare services.

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How State Board of Nursing Practice Standards and Organizational or Governmental Policies Affect Hypertension’s Impact on the Quality of Care, Patient Safety, and Costs to the System and individual

Primary, secondary, and tertiary prevention strategies for hypertension are consistent and dependent on practice standards, organizational policies, and governmental policies. Firstly, practice standards guide healthcare professionals by establishing professional and ethical responsibilities. For example, the American Nurses Association (ANA) Code of Ethics contains nine provisions that focus on various thematic areas, including demonstrating compassion and respect for inherent dignity, commitment to work with patients, families, and communities, the advocacy role of nurses, improving environmental conditions to support quality healthcare, incorporating research and scholarly inquiry into clinical practices, and the need to collaborate with other professionals and integrate the principles of social justice (Haddad & Geiger, 2022). These practice standards can guide my actions for improving patient safety, care quality, and reducing care costs.

Secondly, our organization has a functional policy of early hypertension screening and community health promotion through educational programs. According to Schmidt et al. (2020), early hypertension detection enables healthcare professionals to identify high-risk groups, promoting timely treatment and management of risk factors for high blood. Also, timely screening can contain health-related costs associated with hospitalization and reduces the risk of premature death (Schmidt et al., 2020). Equally, community-based educational programs promote health literacy, improve individual awareness of self-management interventions, and enhance adherence to treatment options. This policy is consistent with the need to implement primary, secondary, and tertiary prevention strategies.

Finally, the Affordable Care Act (ACA) of 2010 through the Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) influences healthcare professionals’ practices and approaches for preventing, managing, and treating hypertension. According to Witman et al. (2018), the MIPCD supports smoking cessation programs, quit attempts, and cessation counseling. These interventions focus on intercepting the causal factors for hypertension, including cigarette smoking and other forms of tobacco product use. As a result, they result in reduced mortality rates and improved community health.

Proposed Strategies to Improve the Quality of Care, Enhance Patient Safety, and Reduce Costs to the System and Individual

Early hypertension detection, providing opportunities for physical exercise, supporting smoking cessation programs, and educating people about healthy diets are ideal strategies for preventing and controlling high blood pressure (World Health Organization, 2021). Equally, these approaches prevent the disease’s progression, reduce care costs associated with life-threatening cardiovascular conditions and safeguard patient safety. Although these interventions are universally accepted standards for tackling hypertension, it is essential to implement tailored measures that improve care quality.

For instance, incorporating telehealth technology in hypertension prevention, treatment, and management can be an ideal strategy for alleviating health inequalities and barriers to care accessibility. Wang et al. (2021) argue that incorporating telemedicine in the management of hypertension results in multiple benefits, including timely detection of elevated blood pressure, virtual consultations, improved communication between healthcare professionals and patients, and telemonitoring. Further, this technology can effectively address the problem of geographical barriers to care access and utilization. Therefore, it is a profound tool for improving care quality, safeguarding patient safety, and reducing the costs associated with in-office visits. When implementing the proposed interventions, the organization should establish performance metrics and utilize data to track progress and identify areas of improvement. The available and relevant sources of benchmark data include the hospital dashboard, patient medical reports, patient feedback, and surveys.

Conclusion

High blood pressure is a primary risk factor for more burdensome cardiovascular conditions, such as heart disease and stroke. These complications are the leading causes of premature deaths, increased care costs, prolonged hospitalization, and compromised quality of life. These adverse effects impact the quality of care, safety, and costs of the system. Nursing practice standards, and organizational, and governmental policies support the tenets of developing collaborative care plans, respecting patients’ values and preferences, and operating in interdisciplinary teams to address hypertension. It is possible to capitalize on policy inputs by incorporating telehealth technology in the management of hypertension and educating people about the disease’s risk factors and self-management approaches.

References

Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of hypertension. Journal of the American College of Cardiology, 72(11), 1278–1293. https://doi.org/10.1016/j.jacc.2018.07.008

Centers for Disease Control and Prevention. (2021, May 18). High blood pressure symptoms, causes, and problems. https://www.cdc.gov/bloodpressure/about.htm#

Centers for Disease Control and Prevention. (2022, October 3). Health topics – high blood pressure. https://www.cdc.gov/policy/polaris/healthtopics/highbloodpressure/index.html#

Haddad, L. M., & Geiger, R. A. (2022, August 22). Nursing ethical considerations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Lawati, M. H. AL., Dennis, S., Short, S. D., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: A systematic review. BMC Family Practice, 19(1), 1–12. https://doi.org/10.1186/s12875-018-0793-7

Oparil, S., Acelajado, M. C., Bakris, G. L., Berlowitz, D. R., Cífková, R., Dominiczak, A. F., Grassi, G., Jordan, J., Poulter, N. R., Rodgers, A., & Whelton, P. K. (2018). Hypertension. Nature Reviews Disease Primers, 4(4), 18014. https://doi.org/10.1038/nrdp.2018.14

Schmidt, B.-M., Durao, S., Toews, I., Bavuma, C. M., Hohlfeld, A., Nury, E., Meerpohl, J. J., & Kredo, T. (2020). Screening strategies for hypertension. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd013212.pub2

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Wang, J., Li, Y., Chia, Y., Cheng, H., Minh, H. V., Siddique, S., Sogunuru, G. P., Tay, J. C., Teo, B. W., Tsoi, K., Turana, Y., Wang, T., Zhang, Y., & Kario, K. (2021). Telemedicine in the management of hypertension: Evolving technological platforms for blood pressure telemonitoring. The Journal of Clinical Hypertension, 23(3), 435–439. https://doi.org/10.1111/jch.14194

World Health Organization. (2020, July 20). Fact sheet: Quality health services. Www.who.int. https://www.who.int/news-room/fact-sheets/detail/quality-health-services

World Health Organization. (2021). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension#

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In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you\’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you\’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during your first two practicum hours.

Introduction

Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.

Preparation

In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Instructions

Complete this assessment in two parts.

Part 1
Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2
Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.

Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?

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What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
What changes, if any, did you make to your definition of the problem, based on your discussions?
What might you have done differently?
Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.