NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

Name

Capella university

NURS-FPX 4900 Capstone project for Nursing

Prof. Name

Date

Introduction

This assessment of the capstone project discusses the case of my mother, who recently got diagnosed with diabetes, and how it impacts the quality of care, costs to hospital setting, and patient and patient safety. The discussion will proceed to policies from nursing state board practice and government that impact diabetes care, patient safety, and cost. Furthermore, the assessment includes strategies to improve the quality of care and patient safety and reduce costs to healthcare systems and patients.

Diabetes’ Impact on Quality of Care, Patient Safety, and Costs to System and Individual

Type 2 diabetes is a chronic health disorder that requires ongoing care and adherence to medication and treatment.  The nurses and other healthcare professionals are expected to monitor patients’ blood glucose levels intricately for effective management. Furthermore, it requires consistent modification to a healthy lifestyle where patients must intake healthy food and practice physical activity. When healthcare professionals fail to educate and convince patients about diabetes care, the quality of care is badly impacted.

Diabetes effective care requires care coordination from a multidisciplinary team of physicians, nurses, dieticians, endocrinologists, pharmacists, and fitness experts, This is necessary for providing comprehensive care to diabetics to avoid gaps in treatments (Bilous et al., 2021). In the case of my mother’s diabetes, the quality of care was due to fragmented care coordination while she had not been instructed about diabetes self-management, as she wasn’t monitored at her home. 

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

Patient safety is another paramount factor that is impacted by diabetes. If left untreated, diabetes can lead to hyperglycemia, which causes peripheral neuropathy, blindness, and life-threatening conditions such as ketoacidosis (ADA, n.d.). Hence, poorly managed diabetes impacts patient safety. In the case of my mother, her safety is at stake as her unhealthy lifestyle and poor control of blood glucose levels can lead to these complications. Similarly, patients suffering from diabetes may bear direct medical costs, including medications and medical supplies for monitoring blood glucose levels.

Furthermore, a healthcare organization can incur indirect costs due to the need for specialized care for diabetes emergency room visits and increased hospitalization visits. About $237 billion is spent on direct medical costs annually, and a further $90 billion is incurred by the US nation due to reduced productivity (CDC, 2020). This shows the financial burden of diabetes on healthcare organizations and patients cumulatively. My mother is suffering from considerable costs due to medications, monitoring devices, and purchasing healthy food. This is leading to financial constraints, requiring monetary assistance for managing healthcare expenditures.

State Board Nursing Practice Standards and/or Organizational/ Governmental Policies and Their Impact on Care Quality, Patient Safety, and Costs

The California Board of Registered Nursing has provided standard guidelines in the Nursing Practice Act Section 2725, guiding nurses in improving quality of care and patient safety. The standard guidelines state that registered nurses must collaborate with healthcare providers to care for patients with chronic diseases like diabetes. Furthermore, they must monitor the patient’s health records for outcome evaluation and further treatments. This will enable them to monitor diabetics’ consistent fluctuations of blood glucose levels that can be regulated accordingly, improving the quality of care provided (California Board of Registered Nursing, n.d.).

The American Diabetes Association also provides guidelines on diabetes, such as measuring blood glucose levels through A1C tests and estimating their status of standard, pre-diabetes, and diabetes. These guidelines help nurses evaluate the current diabetes condition in patients based on regularly monitored blood glucose levels (ADA, n.d.). Furthermore, it provides resources on diabetes education, which nurses can avail to provide education and support to patients for diabetes self-management. These guidelines help improve the quality of care and enhance patient safety as patients strictly adhere to treatment plans and control their diabetes (Alshammari et al., 2021). The Affordable Care Act (ACA) helps patients manage their financial burden due to diabetes as it has policy provisions on providing health insurance coverage to low-income people through Medicaid and Medicare expansion.

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

Moreover, the ACA has provisions in policies about pre-existing conditions like diabetes, which bound health insurers not to charge higher premium prices to these patients. Consequently, they can obtain medication for diabetes at a low price (Furmanchuk et al., 2021). This is helpful in the case of my mother’s diabetes, as exorbitant costs can be alleviated through this policy. This also facilitates hospitals as more and more diabetics will be able to manage their condition without worrying about financial constraints. The healthcare systems will tolerate less diabetes burden, leading to better allocation of resources for managing other patients and contributing to lowering costs overall in the organization. 

Nursing scope of practice describes nurses on their responsibilities, duties and activities towards patient care. These activities are governed by certain guidelines and policies. The aforementioned policy and guidelines will impact the nursing scope of practice as nurses will acquire better knowledge of managing diabetes and improve the quality of care, ultimately enhancing patient safety. The guidelines from the ADA will inform them about choosing a particular intervention that can manage diabetes and guide patient-centered care. Furthermore, the availability of financial assistance will enable patients to seek care treatment from nurses and can select an intervention for them based on their health needs and preferences. 

Strategies to Improve Quality of Care, Enhance Patient Safety, and Reduce Costs

The evidence-based strategies to treat diabetes in my mother, which will ultimately improve quality of care, enhance patient safety, and reduce costs, must be investigated and implemented. These strategies include diabetes self-management education and support (DSMES) program and adherence to medication therapy. Diabetes self-management education and support program is an evidence-based strategy that can potentially improve the quality of care among patients and enhance safety. The DSMES program involves nurses who educate patients on self-management behaviors for managing their diabetes by practicing lifestyle modification where they perform regular physical activity, increase their intake of healthy foods such as fruits and vegetables, and quit alcohol and smoking, which are impacting their health negatively.

The patients are further educated on monitoring their blood glucose levels and compliance with medication therapy, This holistic approach of care improves the quality of care for diabetics as the nurse directed program will develop a therapeutic nurse-patient relationship which will help nurses to provide patient-centric care and improving patient’s health conditions (Mikhael et al., 2020). Moreover, minimal complications and self-management behaviors will lead positive patient experiences. Additionally, the DSMES education will lead to patient empowerment, who will actively be in charge of their diabetes management. As a result, complications associated with diabetes will be prevented, and patient safety will be enhanced.

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

DSMES plays a vital role in reducing costs associated with diabetes complications and hospital-related costs in unmanaged hyperglycemia. When patients with diabetes are educated through DSMES and employ self-management behaviors, the chances of hospital readmissions are reduced, and subsequent costs are prevented. Furthermore, the costs of treating complex diseases due to untreated diabetes are reduced. Similarly, hospital costs are reduced when resources are allocated to other needed units, and diabetes care through DSMES reduces out and in-patient numbers (Rodriguez et al., 2022). 

Medication adherence is another strategy that will improve the quality of care and patient safety. By strictly adhering to medications for diabetes management, the patients will show a regulated blood glucose level. Consequently, the quality of care will be improved as nurses monitor their medication adherence behavior. Furthermore, compliance with prescribed medication will enhance patient safety as patients’ hyperglycemia is under control, and complications are prevented due to a consistent and regulated blood glucose level. This will ultimately reduce costs incurred when medications are not adequately taken as prescribed and severe health problems arise (Sugandh et al., 2023).

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

The effectiveness of these strategies can be evaluated from evidence-based resources, as all treatment plans are substantial and have sound references. They have shown valuable results in the research, and conclusions are accurately drawn in the literature, showing their efficacy and practicality among diabetics. The available sources of relevant benchmark data are the guidelines and standards created by the American Diabetes Association on blood glucose measurement and how these ranges can guide patients on whether their diabetes is under control or requires further interventions. These interventions can improve the quality of care and patient safety for my mother while reducing costs for her and the healthcare systems at the same time. Lastly, I have documented the two hours spent with my mother in the Capella Academic Portal Volunteer Experience Form.

Conclusion

This assessment discusses the case of my mother’s diabetes from the perspective of quality of care, patient safety, and cost perspective. Diabetes is a chronic health condition that impacts the quality of care due to its chronic nature and patient safety due to harmful complications. Furthermore, it requires an excessive amount of money for adequate treatments. The policies and guidelines established by California Board of Nursing, ADA, and ACA can guide nurses in improving the quality of care and patient safety and reduce costs. Lastly, DSMES and medication adherence to antidiabetic drugs are evidence-based strategies that can improve the quality of care, enhance patient safety and reduce costs to system and patient. 

References

ADA. (n.d.). Hyperglycemia (high blood glucose) | ADA. https://diabetes.org/living-with-diabetes/treatment-care/hyperglycemia#:~:text=What%20if%20it%20goes%20untreated

Bilous, R., Donnelly, R., & Idris, I. (2021). Handbook of Diabetes. In Google Books. John Wiley & Sons. https://books.google.com.pk/books?hl=en&lr=&id=EHwlEAAAQBAJ&oi=fnd&pg=PR9&dq=diabetes&ots=6vagy_ESgi&sig=ESZgp_b4JYNGNXs90hSdmTAHaqI&redir_esc=y 

Alshammari, M., Windle, R., Bowskill, D., & Adams, G. (2021). The role of nurses in diabetes care: A qualitative study. Open Journal of Nursing, 11(08), 682–695. https://doi.org/10.4236/ojn.2021.118058 

California Board of Registered Nursing. (n.d.). An explanation of standardized procedure requirements for nurse practitioner practice. https://www.rn.ca.gov/pdfs/regulations/npr-b-20.pdf 

CDC. (2020). Cost-Effectiveness of diabetes interventions | power of prevention. https://www.cdc.gov/chronicdisease/programs-impact/pop/diabetes.htm 

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

Furmanchuk, A., Liu, M., Song, X., Waitman, L. R., Meurer, J. R., Osinski, K., Stoddard, A., Chrischilles, E., McClay, J. C., Cowell, L. G., Tachinardi, U., Embi, P. J., Mosa, A. S. M., Mandhadi, V., Shah, R. C., Garcia, D., Angulo, F., Patino, A., Trick, W. E., & Markossian, T. W. (2021). Effect of the affordable care act on diabetes care at major health centers: Newly detected diabetes and diabetes medication management. BMJ Open Diabetes Research & Care, 9(1), e002205. https://doi.org/10.1136/bmjdrc-2021-002205 

Mikhael, E. M., Hassali, M. A., & Hussain, S. A. (2020). Effectiveness of diabetes self-management educational programs for type 2 diabetes mellitus patients in middle east countries: A systematic review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 13(13), 117–138. https://doi.org/10.2147/dmso.s232958

Rodriguez, K., Ryan, D., Dickinson, J. K., & Phan, V. (2022). Improving quality outcomes: The value of diabetes care and education specialists. Clinical Diabetes, 40(3). https://doi.org/10.2337/cd21-0089 

NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations

Sugandh, F. N. U., Chandio, M., Raveena, F. N. U., Kumar, L., Karishma, F. N. U., Khuwaja, S., Memon, U. A., Bai, K., Kashif, M., Varrassi, G., Khatri, M., Kumar, S., Sugandh, F., Chandio, M., Raveena, F. N. U., Kumar, L., Karishma, F. N. U., Khuwaja, S., Memon, U. A., & Bai, K. (2023). Advances in the management of diabetes mellitus: A focus on personalized medicine. Cureus, 15(8). https://doi.org/10.7759/cureus.43697