NURS FPX 4900 assessment 2 assessing the problem quality safety and cost considerations

Sample Answer for NURS FPX 4900 assessment 2 assessing the problem quality safety and cost considerations Included After Question

Please use stroke for the assessment as it will be used throughout the remaining assessments.

A Sample Answer For the Assignment: NURS FPX 4900 assessment 2 assessing the problem quality safety and cost considerations

Title: NURS FPX 4900 assessment 2 assessing the problem quality safety and cost considerations 

Assessing the Problem

The promotion of optimum health and wellbeing of patients affected by stroke is important in nursing practice. Nurses and other healthcare providers often explore best practice interventions to ensure that the optimum health outcomes of stroke patients are achieved. They also utilize practice interventions such as patient-centeredness and inter-professional collaboration in patient care. Stroke has adverse effects on the health and wellbeing of the patients as well as their significant others. Therefore, this section of the project explores the impact of stroke on patients, effect of state board of nursing practice standards and organizational or government policies on stroke care, and strategies for improving the care outcomes for stroke patients.

Impacts of Stroke

Stroke is one of the health problems with adverse effects to the quality of life, safety, and costs to patients and healthcare systems. Stroke is considered the leading cause of long-term disability among the affected populations in the USA. According to the Center for Disease Control and Prevention (CDC), stroke affects about 795000 people annually in the USA. Of this number, 25% of them will die with 15-30% remaining disabled due to stroke. Stroke has devastating social, physical, and psychological effects to the patients, their families and healthcare systems as a whole. One of the effects is the disability that affects the patients. Patients lose their social and occupational functioning due to the effects of disability (Xu et al., 2018). There is also the fact that the quality of life of the affected patients and their significant others decline substantially.

Studies have shown that stroke has a severe effect on both the short and long-term quality of life on its patients and families (Kariyawasam et al., 2020; Jafari et al., 2020). The effect can be seen from the reduction in mental health scores, health utility, physical health, and self-rate health scores in patients affected by stroke (Jafari et al., 2020). In some cases, patients experience complete paralysis, which increase their dependence on others and worsening further their quality of lives. Aspects such as level of language impairment, dependence, age, level of education, and type of stroke have been identified as the critical predictors of poor quality of life among stroke patients.

Stoke also has high economic effects to patients, their families and healthcare systems. Accordingly, estimates show that the healthcare costs incurred per stroke person including rehabilitation, inpatient care, and follow-up care in the US is USD 140048. The economic burden of the disease worsens significantly in cases of families with low socioeconomic backgrounds and lack of a medical insurance coverage (Rochmah et al., 2021). According to Fadhilah and Permanasari (2020), the average costs that stroke patients in the US incur on a monthly basis for their needed care is $4644. The cost makes the US the leading country in terms of the cost of care incurred by stroke patients followed by Denmark and Norway (Fadhilah & Permanasari, 2020). Cumulatively, the average lifetime cost per ischemic stroke survivor in the US is estimated to be $90981 (Tyagi et al., 2018). Healthcare systems also suffer from stroke.

As asserted by Ramos-Lima et al., (2018), stroke places immense pressure on healthcare systems due to the high costs needed in addressing the care needs of the patients. The consequences of complications of stroke such as functional limitations and serious disabilities require intensive use of healthcare resources, affecting the efficiency of service provision to other populations (Ramos-Lima et al., 2018). Overall, the above effects of stroke predispose patients and their significant others to significant distress, hence, their health and wellbeing. The above evidence is consistent with what I have experienced as a nurse since stroke acts as a source of a considerable burden to patients, families, and healthcare systems. 

Effect of State Board Nursing Practice Standards and/or Organizational or Government Policies

Board of nursing practice standards affects the quality of care, patient safety, and costs of stroke to patients, families and healthcare systems. Accordingly, the standards of nursing practice developed by boards of nursing guide the provision of high quality, safe and efficient care to diverse patient populations affected by stroke. The standards ensure equality in patient care as well as use of best practice interventions in addressing the care needs of stroke patients and their families. The standards also ensure the protection and prioritization of the rights of the patients. By adhering to the standards, nurses provide care that addresses the unique needs of patients without a consideration of factors such as the backgrounds or social status of the patients.

Nursing standards also underpin the utilization of care interventions such as evidence-based practice and multidisciplinary collaboration in caring stroke patients. Nurses understand their scope of practice, which increase their incorporation of interdisciplinary interventions in patient care (Schmidt & McArthur, 2018). The study by Luchsinger et al., (2019) showed that by having nurses adhering to standards of practice, nurses incorporate aspects such as care coordination into their practice, which enhance safety, quality, and efficiency of patient care. Care coordination also reduces costs incurred by patients and healthcare systems through the elimination of unnecessary hospital visits, hospitalizations and complications due to stroke.

How they will Guide my Actions

The standards set by the boards of nursing will guide my actions in addressing care quality, patient safety, and costs to healthcare systems and individuals affected by stroke. Accordingly, the standards will guide my ethical decision-making. I will use standards of nursing practice such as informed consent and informed decision-making to ensure I make moral and ethical decisions (Saposnik et al., 2019). I will also the nursing standards to explore multidisciplinary teams that can be used to address the care needs of stroke patients. The realization of optimum care outcomes for stroke patients requires effective care coordination among different healthcare providers. The standards will inform the roles I play as a team members of the multidisciplinary teams involved in the care process. I will also use the standards to explore innovative solutions for enhancing the care outcomes of stroke patients. For instance, the standards will guide me in the implementation of healthcare technologies such as telehealth to enhance the efficiency of care coordination and reduce costs of care incurred by patients and healthcare systems. Telehealth technologies have been shown to promote cost-efficiency by eliminating the need for unnecessary hospital visits, hospitalizations, and development of complications (Bashir, 2020).

Effects of Local, State and Federal Policies or Legislations

Local, state, and federal policies and regulations have a direct effect on my nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual. One of the effect of the federal policies on the scope of nursing practice is expanding the role of the nurses in patient care. The adoption of policies such as those expanding the roles of nurse practitioners in patient care increases the quality, safety and efficiency of care given to stroke patients. Policies such as independent practice authority for nurse practitioners reduce the costs incurred by patients due to increased availability of nurse practitioners to address the issue of physician shortages. Local, state and federal policies also influence the scope of practice of the nurses through their role in health policies. The recognition and expansion of the existing provisions of the roles of nurses in healthcare policies increases their policy advocacy roles in healthcare. The expansion also implies their increased role and autonomy in influencing the policies that are adopted at the state levels to enhance the safety, quality, and costs incurred by stroke patients and healthcare systems (Brom et al., 2018). Consequently, policies made at any level of government have a direct effect on the scope of nursing practice and cost, safety, and quality indicators of stroke care.

Proposed Strategies

A number of evidence-based practice strategies can be adopted to improve the quality of care, enhance safety, and reduce costs incurred by stroke patients and healthcare systems. One of the strategies is the adoption of health promotion and disease prevention strategies. Stroke is attributable to risk factors such as obesity, diabetes, and hypertension. An effective way to improve the quality of care, enhance safety, and reduce costs incurred by patients is by adopting health promotion initiatives. The provision of services such as screening facilitates early identification of individuals at risk of stroke and implementation of responsive interventions (Oza et al., 2017). Strategies such as health education and promotion of healthy lifestyles and behaviors can be implemented to mitigate the risks of stroke.

The other recommended strategy for prevention of stroke is antiplatelet therapy. Antiplatelet therapy is recommended for use in practice to reduce and prevent the risk of recurrent ischemic stroke and stroke in patients that are identified early before an episode. Nurses and other healthcare providers should consider factors such as cost, timing, effectiveness, safety, and patient preferences in selecting an appropriate antiplatelet therapy for stroke (Oza et al., 2017). Drugs such as aspirin and clopidogrel are recommended to prevent recurrent stroke episodes.

The other recommended strategy to improve the quality of care, enhance safety and reduce costs incurred by stroke patients and healthcare systems is the incorporation of healthcare technologies into the care process. Healthcare technologies such as telehealth can be incorporated to enhance care coordination between different providers involved in the care process. Telehealth would enable stroke patients and healthcare providers to interact remotely, manage effective stroke, and prevent its complications. Telehealth would also increase the self-management skills for patients and their families, hence, their coping with stroke. Telehealth has also been shown to reduce the costs incurred by patients as well as healthcare systems. The reduction in cost is attributed to the elimination of unnecessary hospital visits, hospitalizations, and complications (Bashir, 2020). Therefore, the use of telehealth should be considered for stroke patients discharged for home-based management and rehabilitation.

Conclusion

Stroke has adverse effects on the health and wellbeing of the affected patients and their significant others. Stroke also has enormous cost burden to the patients and healthcare systems. Board of nursing standards affects the safety, quality, and efficiency of care given to stroke patients. Local, state and federal policies also inform improvement interventions that nurses utilize in address the needs of stroke patients. Evidence-based practice interventions that can be used in reducing the impacts of stroke exist. Therefore, nurses and other healthcare providers should explore effective and efficient evidence-based practice interventions that can be adopted in their settings to improve the care outcomes of stroke patients.

References

Bashir, A. (2020). Stroke and Telerehabilitation: A Brief Communication. JMIR Rehabilitation and Assistive Technologies, 7(2), e18919. https://doi.org/10.2196/18919

Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023

Fadhilah, H., & Permanasari, V. Y. (2020). Economic Burden Bore by Patients and Families because of stroke: Policy Assessment. Journal of Indonesian Health Policy and Administration, 5(3), Article 3. https://doi.org/10.7454/ihpa.v5i3.3180

Jafari, J., Kermansaravi, F., & Yaghoubinia, F. (2020). The Effect of Home-Based Rehabilitation on Adherence to Treatment and Quality of Life of Individuals After Stroke. Medical – Surgical Nursing Journal, 9(2), Article 2. https://doi.org/10.5812/msnj.107716

Kariyawasam, P. N., Pathirana, K. D., & Hewage, D. C. (2020). Factors associated with health related quality of life of patients with stroke in Sri Lankan context. Health and Quality of Life Outcomes, 18(1), 129. https://doi.org/10.1186/s12955-020-01388-y

Luchsinger, J. S., Jones, J., McFarland, A. K., & Kissler, K. (2019). Examining nurse/patient relationships in care coordination: A qualitative metasynthesis. Applied Nursing Research, 49, 41–49. https://doi.org/10.1016/j.apnr.2019.07.006

Oza, R., Rundell, K., & Garcellano, M. (2017). Recurrent Ischemic Stroke: Strategies for Prevention. American Family Physician, 96(7), 436–440.

Ramos-Lima, M. J. M., Brasileiro, I. de C., de Lima, T. L., & Braga-Neto, P. (2018). Quality of life after stroke: Impact of clinical and sociodemographic factors. Clinics, 73, e418. https://doi.org/10.6061/clinics/2017/e418

Rochmah, T. N., Rahmawati, I. T., Dahlui, M., Budiarto, W., & Bilqis, N. (2021). Economic burden of stroke disease: A systematic review. International Journal of Environmental Research and Public Health, 18(14), 7552.

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Schmidt, B. J., & McArthur, E. C. (2018). Professional nursing values: A concept analysis. Nursing Forum, 53(1), 69–75. https://doi.org/10.1111/nuf.12211

Tyagi, S., Koh, G. C.-H., Nan, L., Tan, K. B., Hoenig, H., Matchar, D. B., Yoong, J., Finkelstein, E. A., Lee, K. E., Venketasubramanian, N., Menon, E., Chan, K. M., De Silva, D. A., Yap, P., Tan, B. Y., Chew, E., Young, S. H., Ng, Y. S., Tu, T. M., … Tan, C. S. (2018). Healthcare utilization and cost trajectories post-stroke: Role of caregiver and stroke factors. BMC Health Services Research, 18(1), 881. https://doi.org/10.1186/s12913-018-3696-3

Xu, X.-M., Vestesson, E., Paley, L., Desikan, A., Wonderling, D., Hoffman, A., Wolfe, C. D., Rudd, A. G., & Bray, B. D. (2018). The economic burden of stroke care in England, Wales and Northern Ireland: Using a national stroke register to estimate and report patient-level health economic outcomes in stroke. European Stroke Journal, 3(1), 82–91. https://doi.org/10.1177/2396987317746516