Assessing the Problem- Quality, Safety, and Cost Considerations

Assessing the Problem- Quality, Safety, and Cost Considerations

Alzheimer’s disease is an incurable disease that impacts the quality of care and patient safety. Healthcare providers should offer patient-centered care to address the unique needs of each patient. Patient-centeredness improves the quality of care and patient outcomes. This paper discusses the impact of Alzheimer’s disease on cost, safety, and healthcare quality.

Part 1

The Impact of Alzheimer’s Disease on the Quality of Care

Alzheimer’s disease (AD) has a significant impact on the healthcare system. The disease progresses from mild to severe AD, which impedes patients’ ability to complete their activities of daily living. Additionally, AD impairs a person’s thought process and leads to memory loss. Also, patients are predisposed to conditions such as aspiration pneumonia. The health impacts of AD necessitate the provision of quality care (ALZ.org, n.d.). To accomplish this, a patient-centered approach should be adopted. Patient-centeredness acknowledges the unique needs of each person living with AD (ALZ.org, n.d.). This approach ensures that patients with mild, moderate, or severe AD receive individualized care. Patient-centeredness requires care coordination that involves an interdisciplinary approach. Notably, physicians, nurses, pharmacists, and dieticians should collaborate to achieve holistic care and patient-centeredness.

Impact on Patient Safety

AD impacts patient safety by affecting patients’ physical, emotional, and social well-being. For instance, patients with severe AD experience extrapyramidal dysfunction that impedes their mobility (Mok et al., 2020). This predisposes the patients to environmental hazards such as a high risk of falls and injuries. Furthermore, prolonged immobilization increases the risk of conditions such as aspiration pneumonia (Mok et al., 2020). Limited mobility and diminished motor function impede patients’ ability to accomplish their daily living activities. Subsequently, this increases the risk of malnutrition and medication errors (Galvin et al., 2021). Also, patients’ social lives are affected because they depend on others for activities such as bathing and toileting (Galvin et al., 2021). Early onset and poorly managed AD have poor prognoses and are associated with high morbidity and mortality rates. CDC.gov (2020) reports that AD ranks fifth among the major etiologies of deaths in patients aged above sixty-five years.

Impact on Cost

CDC.gov (2020) reported that by 2020, more than 5.8 million people were living with AD. The high prevalence of AD impacts the direct and indirect costs of managing the disease. According to CDC.gov (2020), more than $210 billion is spent on the annual management of additionally, AD. ALZ.org (n.d.) reports that in 2022, the annual cost of managing AD was about $320 billion. Further, CDC.gov (2020) projects that the prevalence of AD will triple by 2060. As such, the costs of managing the disease are anticipated to increase. For instance, CDC.gov (2020) estimates that by 2040, the annual costs of managing AD will exceed $500 billion.

The Impact of Organizational and Government Policies

The American Nurses Association (ANA) is an organization whose standards of practice impact the quality of care provided to AD patients. ANA’s standards of nursing practice have three thematic areas. The first theme addresses professional standards. This provision guides nurses’ actions during patient assessment and diagnosis, development and execution of care plans, and during patient follow-up (MO.gov, n.d.). Accurate diagnosis, care of patients, and patient follow-up increase the quality of care. By so doing, patient outcomes and safety are optimized. Optimized patent outcomes are associated with reduced hospitalizations hence lower healthcare costs. The second theme addresses performance standards. This delineates nurses’ role in patient care, quality assurance, and interdisciplinary collaboration (MO.gov, n.d.). These standards enable nurses to uphold patient-centeredness to improve the quality of care. The third theme addresses practice guidelines (MO.gov, n.d.). These guidelines provide a standardized procedure in patient care. Practice guidelines are evidence-based procedures that create harmony in healthcare delivery. As a result, they improve the quality of healthcare services.

Moreover, various governmental policies impact my scope of practice. Firstly, the National Alzheimer’s Project Act aims to minimize the impact of AD on healthcare costs (HHS.gov, n.d.). To accomplish this, the Act champions the appropriate allocation of resources to facilitate AD-related research and improve the quality of healthcare services (HHS.gov, n.d.). As a nurse, I should participate in research and promote evidence-based practice when caring for patients with AD. Also, I should provide patient-centered quality healthcare services to minimize hospitalization and reduce healthcare costs. Secondly, the Affordable Care Act champions healthcare coverage for more people (Patel et al., 2020). This Act requires me as a nurse to educate patients and their families about healthcare coverage options. This will enable them to access affordable and quality care. Furthermore, the Act directs me as a nurse to collaborate with other healthcare providers to provide individualized care.

Strategies for Improving the Quality of Care and Patient Safety

Healthcare facilities should ensure that quality care that improves patient safety is delivered. To accomplish this, they should embrace various strategies. Firstly, they should train healthcare providers on the management of AD (Galvin et al., 2021). Training creates a competent workforce committed to quality care and patient safety, and periodic refresher training should be provided for all healthcare providers. Also, comprehensive training should be provided to recruits. Secondly, healthcare facilities should develop standardized procedures for managing patients with AD. The standardized procedures should address aspects such as patient assessment and screening, patient and family education, and the formulation of evidence-based treatment plans (Galvin et al., 2021). Annual assessment of patients with AD will allow monitoring of cognitive function, behavioral manifestations, and the prognosis of the disease (Galvin et al., 2021). These findings promote an informed decision-making process regarding treatment and care plans. Patient and family education emphasizes adherence to the treatment plan. This is associated with optimized patient outcomes. Thirdly, performance evaluation will enable healthcare facilities to improve the quality of care (Galvin et al., 2021). Performance evaluation also enables healthcare providers to identify underperforming metrics. After that, they set goals aimed at improving metric performance.

Strategies for Reducing Costs

Healthcare facilities should embrace various strategies to reduce the healthcare costs of AD. The first strategy entails educating patients, their families, and the public. Availing evidence-based information to patients and their families will enable them to have better control over AD (Mok et al., 2020). For instance, patient education will promote adherence to care plans. This is associated with optimized patient outcomes, lower visits to the emergency department, and reduced hospitalizations (Mok et al., 2020). As a result, the cost of treatment is lowered. The other strategy entails optimizing clinical workflows. In this context, healthcare providers should embrace clinical decision support systems to formulate evidence-based treatment plans and embrace technology to mitigate medical errors. Optimized workflows improve the quality of healthcare services and mitigate unnecessary expenses incurred by medical errors and ineffective treatment plans (Mok et al., 2020). The third strategy is the adoption of alternative approaches to managing AD. For instance, cognitive stimulation therapy is a non-pharmaceutical technique that can be used to manage patients with mild to moderate AD (Mok et al., 2020). These techniques can substitute or complement pharmacological approaches in the management of AD.

Sources of Benchmark Data

The Alzheimer’s Association is a source of benchmark data on AD. It provides annual reports on various aspects of AD. Notably, it addresses the incidence and prevalence of AD, AD-associated morbidity and mortality rates, management of AD, cost of health care, and the impact of AD on society (Alzheimer’s Association, n.d.). Also, the association publishes reports on the awareness of AD. These reports enable healthcare facilities to make informed decisions and initiate pertinent strategies to manage AD. Furthermore, the reports enable healthcare facilities to evaluate the performance of their benchmark metrics and tailor individualized strategies to improve metric performance.

Part 2

I interacted with a seventy-four-year-old Hispanic American with AD. According to her family (spouse and two children), the patient was diagnosed with AD five years ago. They report that she has struggled with medication adherence for the past five years. Currently, she presents with muscle twitches, confusion, and vocalization of repetitive statements. Additional evaluation reveals that the patient experiences difficulty recognizing her children. The patient’s spouse reports that the patient has demonstrated anterograde amnesia over the past two months. Her thought process and impulse control are preserved. As such, the patient is likely to have moderate Alzheimer’s disease.

I spend four hours with the patient and her family. During our interaction, I learned that the patient did not adhere to the treatment plan. This is attributed to limited family involvement in her treatment process. We agreed that her family would be actively involved in her treatment process. The main barrier in my interaction with the patient and her family was health illiteracy. Further, I embraced active listening to interact with the patient and her family. Notably, active listening enabled me to get their buy-in and create a therapeutic relationship. I obtained my evidence from organizational websites and online medical databases such as PubMed.

References

ALZ.org. (n.d.). Quality of Care. https://www.alz.org/professionals/public-health/public-health-topics/quality-of-care#:~:text=Alzheimer’s%20places%20a%20huge%20burden,share%20of%20costly%20residential%20care.

Alzheimer’s Association. (n.d.). Alzheimer’s Disease & Dementia Help. https://www.alz.org/

CDC.gov. (2020). Alzheimer’s Disease and Related Dementias. https://www.cdc.gov/aging/aginginfo/alzheimers.htm

Galvin, J. E., Aisen, P., Langbaum, J. B., Rodriguez, E., Sabbagh, M., Stefanacci, R., Stern, R. A., Vassey, E. A., de Wilde, A., West, N., & Rubino, I. (2021). Early Stages of Alzheimer’s Disease: Evolving the Care Team for Optimal Patient Management. Frontiers in Neurology, 11(January), 1–8. https://doi.org/10.3389/fneur.2020.592302

HHS.gov. (n.d.). NAPA – National Alzheimer’s Project Act. https://aspe.hhs.gov/collaborations- committees-advisory-groups/napa#:~:text=The%20National%20Alzheimer’s%20Project%20Act,dementias%2 0(AD%2FADRD).

MO.gov. (n.d.). Standards of Nursing Practice. https://health.mo.gov/living/lpha/phnursing/standards.php.

Mok, V. C. T., Pendlebury, S., Wong, A., Alladi, S., Au, L., Bath, P. M., Biessels, G. J., Chen, C., Cordonnier, C., Dichgans, M., Dominguez, J., Gorelick, P. B., Kim, S. Y., Kwok, T., Greenberg, S. M., Jia, J., Kalaria, R., Kivipelto, M., Naegandran, K., Scheltens, P. (2020). Tackling challenges in care of Alzheimer’s disease and other dementias amid the COVID-19 pandemic, now and in the future. Alzheimer’s and Dementia, 16(11), 1571–1581. https://doi.org/10.1002/alz.12143

Patel, M. R., TerHaar, L., Smith, A., Tariq, M., Worthington, K., Hinton, J., & Lichtenstein, R. (2020). Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities. Journal of Immigrant and Minority Health, 22(3), 456–466. https://doi.org/10.1007/s10903-019-00924-3.

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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 the subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during your first two practicum hours.

Assessing the Problem- Quality, Safety, and Cost Considerations

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. Healthcare 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 groups 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.

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

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 individuals.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individuals.
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 groups in the Capella Academic Portal Volunteer Experience Form.
Paraphrasing and summarization are used 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.
Apply APA style and formatting to scholarly writing.