NURS FPX 4900 CAPSTONE PROJECT 2

Sample Answer for NURS FPX 4900 CAPSTONE PROJECT 2 Included After Question

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.

Preparation

In this assessment, you will 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.

A Sample Answer For the Assignment: NURS FPX 4900 CAPSTONE PROJECT 2

Title: NURS FPX 4900 CAPSTONE PROJECT 2 

Professional nurses play a critical role in collecting important healthcare data that can be used by healthcare organizations to make care and management decisions to boost and foster an organization’s performance and improve patient outcomes (Prybil et al.,2019). Such data may include data on patient experience, serious safety events, staff satisfaction, medication errors, patient falls, hospital-acquired infections, and readmission rates. It is, therefore, important to identify a specific population of interest from which necessary data can be collected and the information used from the data used in improving care outcomes. As such, African-Americans living with diabetes and having poorly controlled glycemia were identified at the practicum site. As such, the purpose of this current write-up is to assess the effect of the health problem (poor glycemic control among patients with diabetes) identified earlier on the quality of care, patient safety, and costs to the system and the individuals.

How the Population Problem Impact the Quality of Care, Patient Safety, and Costs

Diabetes is one of the most disabling conditions due to the diseases that come with it and the costs involved. The target of the healthcare professionals is to help the patient achieve various targets such as glycemic control and a healthy leaving style. However, it was noted that glycemic control among African Americans with diabetes is relatively low. The existence of poor glycemic control reflects negatively on the quality of care offered. Even though the healthcare professionals could be doing their best to advise the patients on the importance of medication and dietary adherence, the patients may fail to follow such directions due to various reasons such as ignorance and lack of access to appropriate and sufficient diet and medication (Wittwer et al.,2020).

The problem also impacts patient safety. As earlier indicated, the usual target among patients with diabetes is appropriate glycemic control; however, in the face of poor glycemic control, the patient’s safety is at risk. Poor glycemic control implies that patients have to frequently visit the emergency department, are more likely to have longer in-hospital stays, are prone to more frequent readmissions, and are at a higher risk of mortality. All these are a threat to the patient’s safety hence a need for better solutions (Wittwer et al.,2020). It is important to note that frequent visits to the hospital and consequential hospital admissions further expose the patients to other adversities, such as hospital-acquired infections and potential medication errors, and patient falls. All these put the patient’s life at risk hence compromising the patient safety.

The problem of poor glycemic control among patients with diabetes also impacts costs. For example, poor glycemic control means that these patients have increased hospital admissions which automatically raises treatment and care costs. In addition, poor glycemic control leads to prolonged stays in the hospital. Therefore, the patient has to incur extra costs of staying longer in the hospital. Poor glycemic control among patients with diabetes also leads to more spending on medication which raises the overall costs of care (Wittwer et al.,2020). Hospital costs are also impacted by poor glycemic control. For example, the hospital has to use or hire more personnel to offer care to patients admitted due to glycemic control. Hospitals also incur losses in the cases where patients stay longer in hospital and contract the hospital-acquired infection, as the Centers for Medicare and Medicaid Services in recent times have put penalties on healthcare organizations for excessive mortality and readmission rates. This makes the hospitals spend more.

How Governmental Policies Can Affect the Problem’s Impact on the Quality of Care, Patient Safety, and Costs to The System and Individual

The Federal government, over the years, has enacted various healthcare policies that heavily influence the impact of the various healthcare problems on the quality of care, patient safety, and costs. For example, a recent policy by the Centers for Medicare and Medicaid Services embarked on finding strategies to improve patient care outcomes by reducing readmissions and mortality rates (Parizo et al.,2020). Therefore, the policy was enacted that ensures that hospitals are penalized if the readmission rates pass a certain mark. This policy directly impacts the quality of care for diabetes patients and those who have poor glycemic control. Healthcare facilities have, as a result, come up with various strategies to ensure that care practices and strategies are up to the standard to ensure that readmission rates are contained.

The Affordable Care Act also has provisions that impact patient safety in relation to the identified problem. For example, the policy has a provision known as Hospital Value-Base Purchasing Program (Hong et al.,2020). This is a pay-for-performance initiative where hospitals are rewarded for offering high-quality inpatient care. Such a performance is measured through patient harm rates, reduced readmissions, and patient experience. The same policy reduces payments to those hospitals that do not meet the set standards. Therefore, this policy also prompts the facility to offer quality care to patients with diabetes to avoid reduced payments hence boosting patient safety.

Other policies or impacts on costs related to the identified problem. The Affordable Care Act offered a reprieve to patients with chronic conditions such as diabetes (Hong et al.,2020). Under this law, the providers are prohibited from denying coverage to patients with preexisting conditions such as diabetes or charging them higher premiums. The implication is that patients can spend less by getting insurance coverage. This law also impacts the system’s costs by introducing the Value-Base Purchasing Program, which ensures that hospitals are paid more for offering high-quality care hence making them have better financial health.

Research That Has Tested the Effectiveness of the Policies in Addressing Quality, Patient Safety, and Costs

Various research efforts have been published on the impact of ACA on care quality, patient safety, and costs. In one such report, Huguet et al. (2018) showed that ACA has increased the number of insured diabetic patients. It was evident from this research that the policy led to an increased number of insured patients hence increasing the quality of care. High quality of care has also led to improved patient safety. Casagrande et al. (2018) also showed recently that the policy has led to lower spending among patients with diabetes as well as improved care and healthcare coverage.

The Effects of State Policies On My nursing Scope of Practice

The scope of practice for nursing working in the US is subject to respective state laws. For example, New York state has specific laws governing the scope of practice. Our state recently removed barriers to nursing practice and enacted a law to grant nurse practitioners a wider scope of practice. The implication is that as a nurse practitioner, I am capable of offering more services to African-Americans with diabetes. Therefore, the full practice grants NPs authority to evaluate patients, perform diagnoses, order diagnostic tests, and prescribe and manage treatments. This will improve the quality of care offered to the patients, improve their safety and reduce healthcare spending due to improved access.

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

The adverse impacts of diabetes mean that effective strategies should be used to improve the quality of care, enhance patient safety and reduce costs. Therefore, a culturally tailored diabetes self-management education program has been proposed to improve the quality of care and enhance safety. The patients will be educated on aspects such as adherence to medication and diet hence improving the quality of care and enhancing safety. By following the medication regimen, exercise plan, and recommended lifestyle, the patients will have fewer cases of emergency admissions and fewer cases of longer hospital stay, thus lowering costs. Recent research has shown that culturally tailored diabetes self-management education programs are effective in addressing care quality, patient safety, and costs. For instance, Cunningham et al.(2018) recently found out the impact of the intervention on patient safety and quality of care. The researchers observed that the intervention was effective.

Relevant and Available Sources of Benchmark

Benchmarks serve a critical role as reference points in many aspects. Therefore, it is important to explore appropriate benchmarks related to the problem. One of the relevant benchmarks is the American Diabetes Association which has appropriate data from various states and communities regarding diabetes care, patient safety, and costs. Again the center for disease control also offers valuable data that can be used as a benchmark for this group.

Conclusion

The adverse impacts of diabetes imply that appropriate strategies should be put in place to ensure that patients have positive outcomes. As part of the initiative, it is important to perform an appropriate assessment regarding the impact of the problem on the quality of care, patient safety, and costs related to the individuals and system. This is key in formulating ideas to present to the stakeholders why it is necessary and key to undertaking a quality improvement initiative. As such, a comprehensive assessment has been performed regarding the impact of poor glycemic control among patients with diabetes on costs, patient safety, and quality of care.

References

Casagrande, S. S., McEwen, L. N., & Herman, W. H. (2018). Changes in health insurance coverage under the Affordable Care Act: a national sample of US adults with diabetes, 2009 and 2016. Diabetes Care41(5), 956-962. https://doi.org/10.2337/dc17-2524

Cunningham, A. T., Crittendon, D. R., White, N., Mills, G. D., Diaz, V., & LaNoue, M. D. (2018). The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis. BMC Health Services Research18(1), 1–13. https://doi.org/10.1186/s12913-018-3186-7

Hong, Y. R., Nguyen, O., Yadav, S., Etzold, E., Song, J., Duncan, R. P., & Turner, K. (2020). Early performance of hospital value-based purchasing program in medicare: a systematic review. Medical Care58(8), 734–743. https://doi.org/10.1097/MLR.0000000000001354

Huguet, N., Springer, R., Marino, M., Angier, H., Hoopes, M., Holderness, H., & DeVoe, J. E. (2018). The impact of the Affordable Care Act (ACA) Medicaid expansion on visit rates for diabetes in safety net health centers. The Journal of the American Board of Family Medicine31(6), 905–916. DOI: https://doi.org/10.3122/jabfm.2018.06.180075

Parizo, J. T., Kohsaka, S., Sandhu, A. T., Patel, J., & Heidenreich, P. A. (2020). Trends in readmission and mortality rates following heart failure hospitalization in the Veterans Affairs Health Care System from 2007 to 2017. JAMA Cardiology5(9), 1042-1047. doi:10.1001/jamacardio.2020.2028

Prybil, L. D., Popa, G. J., Warshawsky, N. E., & Sundean, L. J. (2019). Building the case for including nurse leaders on healthcare organization boards. Nursing Economics37(4), 169–197. https://www.proquest.com/docview/2289556434?pq-origsite=gscholar&fromopenview=true

Wittwer, J. A., Golden, S. H., & Joseph, J. J. (2020). Diabetes and CVD risk: special considerations in African Americans related to care. Current Cardiovascular Risk Reports14(10), 1-14. https://doi.org/10.1007/s12170-020-00648-2