Assessing the Impact of Asthma Management on Quality, Safety, and Costs: A Nursing Perspective

Asthma is a chronic respiratory condition that significantly affects the quality of care, patient safety, and costs at both individual and system levels. The condition is marked by episodes of airway constriction and inflammation, which can lead to life-threatening exacerbations if not managed appropriately. During my clinical hours spent with a young male family member who has asthma, we explored his understanding of asthma, his medication regimen, and the potential safety risks related to improper medication use. This assessment focuses on how asthma impacts care quality, patient safety, and associated costs while proposing strategies for improvement based on evidence from the literature and policies affecting healthcare practice (Hashmi & Cataletto, 2024).

Impact of the Problem on Quality of Care, Patient Safety, and Costs

Asthma, especially when inadequately managed, negatively affects the quality of care and patient outcomes. Severe asthmatic attacks often lead to admissions to the emergency department and hospitalization of my patient. He was admitted to the hospital twice in the past year because of a severe asthma attack caused by allergens. Such relapses show that there are gaps in the preventative care that is offered to him routinely as an outpatient that detracts from the quality of care accorded.

            Quality of care is measured by the patient’s ability to manage symptoms independently and minimize hospital admissions. Proper management of asthma is important in order to avoid such exacerbations and enhance patients’ quality of life. However, it is evident that some of the care indicators, such as the use of wrong medication, noncompliance with asthma management plans, and environmental factors affecting asthma, would reduce the quality of care. Kindi et al. (2021) noted that leadership methods aimed at enhancing the safety culture in hospitals have been revealed to decrease medication mistakes and facilitate enhanced patient safety in chronic disease care.

Poor compliance with medications and unproportionate use of the prescribed treatment plan result in the deterioration of the patient’s safety. The Self-reported treatment regime of my patient demonstrates that the use of rescue inhalers often during exacerbations points to a lack of adequate asthma control. Such a paradigm of using short-term relief medicines can lead to the generation of risk factors for exacerbation and potentially fatal outcomes. Through patient teaching as to how to properly use medications and coaching patients to adhere to their asthma management plans, the nurses can safeguard against any safety risks (Zhang et al., 2023).

Further, the cost of asthma care can be substantial. In my patient’s case, most medicines and treatments are covered by insurance. However, other costs, such as the transport costs to frequent hospitals and specialists, the cost of the follow-up appointments, and co-payment for the medicines, are still incurred. Admissions due to asthma are not only expensive for a patient, but they are also expensive for healthcare facilities. Codispoti et al. (2022) estimated that the direct costs of managing asthma in the United States are over $80 billion annually. Lack of adequate control of asthma results in the high frequency of the usage of health services by patients and, in turn, increases the cost of health. Preventive care, therefore, becomes critical in managing these costs.

Consistency with Nursing Practice

Evidence regarding the effects of asthma on the quality of care, safety of patients, and costs tally with what I have seen in nursing practice. This finding can be explained by the fact that asthma patients seldom have problems following their medication regimens. However, they experience exacerbations that could have been avoided. Poureslami et al. (2022) back this up by pointing to the fact that there is a lack of structured asthma education to help enhance the patient’s condition and prevent hospitalization that may otherwise be unnecessary. My nursing practice working with patients confirms that when patients are provided with more information about their condition and more encouragement in managing it, there are fewer safety concerns and symptom crises

State Board Nursing Practice Standards and Policy Impact

State board nursing practice standards and organizational policies play an essential role in guiding care quality, safety, and cost management for asthma patients. Priority of care segments put focus on patient awareness, compliance, and protection. Nursing personnel are anticipated to assess the patient’s knowledge about one’s medications, the use of inhalers, and how to prescribe asthma management plans. This minimizes incidents of relapse and increases patient safety in general (Young & Smith, 2022).

Several studies have shown the efficacy of these current nursing standards with regard to asthma. A systematic review of asthma education-based programs reported that the programs implemented and led by a nurse encompassing medication adherence and self-management had reduced the visits to the ER by 25% (Kindi et al., 2021). The results underscore how compliance with nursing standards leads to quality and risk-free asthma care.

Governmental policies, such as the Affordable Care Act (ACA), also influence asthma management by promoting preventive care and covering services like asthma education and chronic disease management. Preventive care by physicians has been credited to the ACA as a means through which patients, especially those from underrepresented groups, have been able to manage asthma. This means that attributes of the nursing practice are in accordance with governmental policies to support the delivery of quality health care and decrease the burden of cost on the patients as well as the system (Kindi et al., 2021).

Local, State, and Federal Policy Effects on Nursing Scope of Practice

Local, state, and federal policies significantly shape the nursing scope of practice by determining what nurses are responsible for in chronic disease management. For example, the federal goals of the Clean Air Act are to limit certain conditions in the environment that cause the worsening of asthma symptoms. Therefore, nurses have a part to play in helping the patient change their behavior to avoid these triggers and stay on treatment regimens (Poureslami et al., 2022). State Medicaid expansions have been found to enhance asthma patients’ use of preventive care, resulting in low hospital admission rates and better management of asthma symptoms (Hashmi & Cataletto, 2024).

Additionally, these policies influence the duty of performers to handle asthma. For instance, the nurses who work in states that cover as many Medicaid services as possible ensure they practice preventative care because they are sure that the patients they are attending have every single chance of being able to afford the needed facilities. On the other hand, nurses from lower coverage areas pointed out that patients often fail to stick to the recommended treatment regimens because they cannot afford the costs of medical care. The scope of practice of nursing incorporates preventive care policies to help contain asthma disease and reduce costs (Kindi et al., 2021).

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

Several measures can be taken to increase the quality of care for patients and improve the safety of asthma care while at the same time reducing costs. The most significant intervention involves the development of individualized asthma management plans that could come in the form of an action plan that would help the patient continue managing his condition without relapsing. Asthma management and action plans indicate that patients who adhere to such plans have a lesser frequency of asthma attacks and use rapid intervention less often (Lee et al., 2019).

The next is the enhancement of telehealth services in asthma care. Telehealth is useful for monitoring the aspects of a patient’s condition, such as symptoms and compliance with medication, and avoiding frequent physical appointments and admission to the hospital. Research shows that telehealth has been found to cut down asthma readmissions by 20 percent as well as enhance patients’ care (Zhang et al., 2023). Also, telehealth readily facilitates patient education, which is important given that many patients fail to comply with their treatment regimen.

Implementing nurse-led asthma education programs is also essential for improving patient outcomes. Such programs are based on the right use of drugs, refraining from some activities that may trigger a flare, and learning how to recognize any slightest symptoms that indicate worsening of the disease. Research proves that such programs reduce preventable adverse medication occurrences, improve patient outcomes, and reduce general healthcare costs by reducing ER visits and hospital admissions (Zhang et al., 2023).

Effectiveness of Strategies in Addressing Care Quality, Safety, and Costs

Research supports the effectiveness of these strategies in improving care quality, enhancing patient safety, and reducing costs. It has been found that the use of an asthma action plan can cut down the number of hospitalizations and emergency visits. Telehealth, being an innovative modality of managing chronic disease, also contributes to patient safety by minimizing risks of exacerbation through remote tracking. Education interventions conducted by nurses help patients manage their asthma on their own, and this gives patients long-term better health outcomes, reducing the risks of poor quality and compensation (Young & Smith, 2022).

These approaches complement preventive care, defined by state board nursing standards and federal provisions such as the ACA, that stress patients’ knowledge and management of chronic diseases. Through the use of these evidence-based approaches, healthcare providers can likely reduce the cost of healthcare, particularly the cost of managing asthma patients, while at the same time being able to provide better results (Hashmi & Cataletto, 2024).

Sources of Benchmark Data on Care Quality, Safety, and Costs

Other available sources of benchmark data on care quality, safety, and cost include Medicare’s Hospital Compare and Leapfrog Group, with data on hospitals’ performance indicators, including asthma care. These tools assist the healthcare organization in evaluating the performance with respect to patient safety, patient care quality, and cost control analysis. Codispoti et al., 2022 argue that benchmark data help healthcare providers monitor the effectiveness of changes and efforts in asthma management and hospital admission rates.

Conclusion

Asthma is a complex disease, and adequate management calls for the integration of patient safety concerns, quality, and costs. The plans for asthma action andn plans, telehealth, and the role of nurse education, all described in this assessment, have been seen to help enhance asthma management for sufferers. It is possible to state that by following the standards of state board nursing and utilizing government policies, the providers will be able to increase the quality, safety, and affordability of care for asthma patients. In accomplishing these goals, my practicum hours underscore appropriate patient interactions and medication administration for compliance, as well as promote healthy behaviors.

References

Codispoti, C. D., Greenhawt, M., & Oppenheimer, J. (2022). The Role of Access And Cost-Effectiveness in Managing Asthma: A Systematic Review. The Journal of Allergy and Clinical Immunology: In Practice, 10(8). https://doi.org/10.1016/j.jaip.2022.04.025

Hashmi, M. F., & Cataletto, M. E. (2024, May 3). Asthma. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430901/

Kindi, Z. A., McCabe, C., & McCann, M. (2021). Impact of Nurse-Led Asthma Intervention on Child Health Outcomes: a Scoping Review. The Journal of School Nursing, 38(1), 105984052110033. https://doi.org/10.1177/10598405211003303

Poureslami, I., FitzGerald, J. M., Tregobov, N., Goldstein, R. S., Lougheed, M. D., & Gupta, S. (2022). Health literacy in asthma and chronic obstructive pulmonary disease (COPD) care: a narrative review and future directions. Respiratory Research, 23(1). https://doi.org/10.1186/s12931-022-02290-5

Young, M., & Smith, M. A. (2022). Standards And Evaluation Of Healthcare Quality, Safety, and Person-Centered Care. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK576432/

Zhang, X., Ding, R., Zhang, Z., Chen, M., Yin, Y., & Quint, J. K. (2023). Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives. Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives, 16(79), 515–527. https://doi.org/10.2147/jaa.s407552

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

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?
    • 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?

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.

Capella Academic Portal

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

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and 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.