Assessing the Problem Healthcare Quality Safety & Cost Considerations
Opioid analgesics maintain effectiveness in the management of chronic pain. Chronic pain affects millions of Americans, with research findings putting the prevalence of chronic pain at 18-45%. As this number rises, the number of people requiring opioid analgesics also rises. The current opioid addiction crisis has shed light on the challenges related to prescription and illicit opioid use. This crisis has resulted in quality compromises in the American health systems and continues to jeopardize the safety of the patients. The healthcare costs incurred in managing the crisis are also high. This paper details how the opioid crisis has impacted the quality of care, the safety of the patients, and its cost considerations.
The Impact of Opioid Crisis on the Quality of Care, Patient Safety, and Costs to the System and Individual
As the opioid addiction crisis continues to ravage healthcare systems in the U.S., healthcare providers and organizations are implored to uphold high-quality care in their interventions to preserve lives. However, the crisis continues to lower the quality of care processes, resulting in increased morbidity and mortality from overdose and addiction. As the prevalence of opioid misuse and overdose increases, the subsequent burden on the healthcare system compromises the quality of care. Samuels et al. (2019) report that the current opioid crisis has resulted in fragmentation of care with no recognizable quality indicators utilized in managing opioid use disorders. This fragmented approach has lowered the effectiveness of care responses to the prevention of opioid misuse and overdose as well as the treatment responses that are required at the emergency departments to reduce the mortality risks. However, the quality improvement guidelines designed by the CDC have maintained significance in informing preventive measures for all at-risk patients. Implementing these guidelines on prescription opioid use is aimed at saving lives and is in concert with guidelines on prescription opioid use in managing chronic pain.
The safety of the patients remains a priority care intervention for all healthcare organizations. The opioid epidemic has considerably jeopardized safety safeguards in communities established by various public health agencies and the healthcare system. Many lives continue to be lost as a result of overdose and addiction to opioids despite heightened awareness of the harmful effects of opioid use. In the U.S., 37.8% of adults use prescription opioid analgesics. Misuse of these medications has been reported in over 11 million adult Americans. The consequent addiction and overdose are also increasingly reported in healthcare systems across the U.S., with over 1.9 million people developing opioid use disorder (van den Brink et al., 2022). Safety compromises in the opioid crisis also stretch beyond the affected individuals to the neighborhoods they live in. Zhong et al. (2020) demonstrate a nexus between illicit opioid use to violence risk in neighborhoods with opioid users.
The opioid addiction crisis fetches considerable economic costs. Research findings place estimates of the healthcare costs of the opioid crisis at over 78 billion dollars (Sanyal, 2021). These costs encompass healthcare costs incurred when treating patients presenting with opioid addictions and overdose and the logistical costs used in facilitating treatment processes. Individuals affected incur treatment costs due to out-of-pocket payments and logistical costs. Florence et al. (2021) place the economic burden of the crisis at over one trillion. This includes loss of life and reduction in the quality of life indices that have always accompanied the opioid crisis.
Nursing practice upholds, with high standards, quality care provision as a measure for preserving the lives of individuals in the community. Fragmentation of care processes and lack of universally acceptable indices of quality are against the nursing provision of concerted and collaborative care. This explains why research findings reveal that care fragmentation is attributable to quality compromises in healthcare approaches to effective interventions in the epidemic.
How State Board Nursing Practice Standards and Organizational or Governmental Policies Affect the Quality of Care, Safety, and Cost of Opioid Crisis
The American Nursing Association (ANA) recognizes the opioid epidemic and outlines nursing standards of practice as part of nurses’ interventions in the crisis. It requires nurses to provide preventive care by educating vulnerable groups on the harmful effects of opioid analgesics. It also requires nurses to provide basic care to patients presenting with overdose and addiction. Due to their role in patient handling, nurses should enhance prescription monitoring to support appropriate pain management using opioids and to enable early recognition of misuse. These efforts will safeguard the safety of the patients and uphold quality improvement measures outlined by the CDC. The establishment of the prescription drug monitoring programs, as required by the HHS, and its consequent rollout ensured greater accountability for patients taking prescription opioid analgesics. Nurse prescribers should know about these programs to heighten their patient monitoring role.
Federal policies such as the Substance Use-Disorder Prevention that Promote Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and the Opioid Crisis Review Act (OCRA) also play a role in quality and safety enhancement measures. These legal provisions enhance preventive approaches as intervention measures to the crisis and promote the treatment of opioid abuse disorder. These provisions act as safety and quality safeguards as they protect the affected patients from the devastating consequences of these disorders. They also lessen the economic burden that would have otherwise been incurred if the patient’s quality of life deteriorates. Rizk et al. (2019 ) opine that opioid stewardship in healthcare facilities has significantly improved the quality of care provided, the safety of the patients, and the healthcare burden of the epidemic. Policies that support care interventions thus maintain significance in containing the epidemic and should be promoted.
Nursing standards on nursing interventions in the crisis and the policy provision on care provision inform nurses’ roles in containing the crisis. In this regard, they should use their nursing knowledge and skills in caring to provide basic care to patients with substance abuse disorder and overdose. They should also employ their advocacy skills in policy formulation processes required for bettering currently available interventions for containing the epidemic. Polices on opioid crisis interventions that target preventive approaches, early identification through prescription drug monitoring programs, and antidote availability may effectively reduce mortality risks and the prevalence of opioid addicts and those presenting with overdose. As health educators, nurses should engage in preventive care by educating vulnerable groups on the harmful effects of opioid misuse and how it jeopardizes their safety.
Policy provisions on opioid crisis interventions focus on enhancing access to treatment and preventive care. However, the nursing scope of practice on chronic pain management, opioid use disorder, practice authority, opioid analgesic prescribing, and comprehensive patient education on opioid use disorders are still limited. Nikpour & Broome (2021) note that these limitations are yet to meet their intended goal of reducing misuse of prescription opioid overdose. These limitations jeopardize nurses’ ability to conform to the SUPPORT Act provisions and the ANA standards that require nurses and other caregivers to assume an active role in preventing care by providing a comprehensive education to at-risk patients. The overall effect may be visible in quality and safety reductions in care processes involving patients with overdose and addiction from opioid use and those at risk, ultimately increasing healthcare costs.
Strategies for Improving the Quality of Care, Enhancing Patient Safety, and Reducing Costs to the System and Individual
Quality improvement and safety safeguards are integral components of healthcare interventions in the opioid crisis. CDC outlines quality improvement measures that apply to the opioid addiction crisis. Opioid prescription is one quality improvement area that can help contain the epidemic. Opioid analgesics should only be prescribed for pain management when other drug options for pain management are not warranted. All new opioid prescriptions should be admitted into the patient drug monitoring programs to enhance contact between them and their caregivers. This strategy will improve surveillance efforts on the patients and help identify them.
The availability of an antidote at the emergency departments and the primary level of care is another quality enhancement measure and safety safeguard for vulnerable patients. Antidote medications such as naloxone maintain significance in treating overdose symptoms. These medications reduce the mortality risks of patients presenting with overdose symptoms. Enhancing their accessibility to patients remains one of the safety safeguard measures. The majority of the states in the U.S. allow the dispensing and prescription of this medication to family members and friends of individuals at risk for opioid overdose. This measure has ensured the protection of many American lives that would have otherwise been lost due to delays in accessing this medication.
Healthcare providers play a role in enhancing the safety of patients at risk for overdose. These are patients with chronic pain requiring regular prescription opioid analgesics. Their role in this regard is to intensify preventive approaches to vulnerable patients. This can be achieved by comprehensive education on the patients, highlighting the significance of rational use of these medications to prevent overdose. They should be aware that overdose is a safety and quality compromise in healthcare and fetches economic considerations to them and the healthcare system. Healthcare providers should also maintain vigilance and proceed with concertedness in treating overdose symptoms and managing patients with addiction. These measures may enhance the quality of care during the opioid crisis and the effectiveness of interventions against the epidemic. These measures will also promote the safety of the patients by ensuring no harm befalls them and considerably lower the cost of treating them. Rizk et al. (2019) reinforce the need for providers’ stewardship in curtailing the harmful effects of the opioid crisis and opine that providers maintain vitality in their preventive and treatment roles during the opioid epidemic. Their excellence in their caring roles will save many lives and the country billions of dollars in healthcare costs.
Benchmark data on the quality of care, safety measures, and costs of the system can be obtained from the CDC and HHS websites. These websites give full accounts of quality measures implemented by various states and the government and their effectiveness in containing the epidemic. Data contained in these websites informs on the current state of the epidemic and measures taken so far to contain it. Information from these websites can inform future interventions and policy development to better current interventions and intensify preventive approaches in the opioid addiction crisis.
Conclusion
As the U.S. continues to struggle with the opioid crisis, details on the toll the crisis has taken on the quality of care, safety measures on patients, and costs of care continue to emerge. The opioid addiction crisis has resulted in compromises in the quality and safety safeguard measures in healthcare with resultant increases in costs. The healthcare burden of the opioid crisis remains high, with the economic burden even greater. Healthcare interventions to uphold quality and safety amidst this epidemic have been successful, with many lives saved through policies and practice standards that give provisions for prevention and treatment.
References
Florence, C., Luo, F., & Rice, K. (2021). The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug and Alcohol Dependence, 218, 108350. https://doi.org/10.1016/j.drugalcdep.2020.108350
Nikpour, J., & Broome, M. (2021). Impact of Nurse Practitioner Scope of Practice on Treatment for Chronic Pain and Opioid Use Disorder: A Scoping Review. Journal of Nursing Regulation, 11(4), 15-25. https://doi.org/10.1016/s2155-8256(20)30176-9
Rizk, E., Swan, J., Cheon, O., Colavecchia, A., Bui, L., & Kash, B. et al. (2019). Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. American Journal of Health-System Pharmacy, 76(4), 225-235. https://doi.org/10.1093/ajhp/zxy042
Samuels, E., D’Onofrio, G., Huntley, K., Levin, S., Schuur, J., & Bart, G. et al. (2019). A Quality Framework for Emergency Department Treatment of Opioid Use Disorder. Annals of Emergency Medicine, 73(3), 237-247. https://doi.org/10.1016/j.annemergmed.2018.08.439
Sanyal, C. (2021). Economic burden of the opioid crisis and the role of pharmacist-led interventions. Journal of the American Pharmacists Association, 61(3), e70-e74. https://doi.org/10.1016/j.japh.2020.11.006
van den Brink, W., Pierce, M., & van Amsterdam, J. (2022). What lessons from Europe’s experience could be applied in the United States in response to the opioid addiction and overdose crisis? Addiction, 117(5), 1197-1198. https://doi.org/10.1111/add.15839
Zhong, S., Yu, R., & Fazel, S. (2020). Drug Use Disorders and Violence: Associations with Individual Drug Categories. Epidemiologic Reviews, 42(1), 103-116. https://doi.org/10.1093/epirev/mxaa006
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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.
Assessing the Problem Healthcare Quality Safety & Cost Considerations
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.