Assessing the Problem – Quality, Safety, and Cost Considerations

Assessing the Problem – Quality, Safety, and Cost Considerations

Part 1

The Impact of Anxiety on Quality of Care, Patient Safety, and Costs

During my practicum, I’ve had a close relationship with a patient suffering from anxiety. Anxiety, a common mental health problem, immensely, plays a role in quality, patient safety, and healthcare costs at the system and individual levels (Szuhany & Simon, 2022). Looking back on my communication with the patient and using the evidence at hand, it appears anxiety provides a wide range of challenges across these fields.

Firstly, anxiety certainly has the power to interfere with treatment compliance and co-morbid condition management. People with anxiety disorders might have problems with their adherence to a treatment schedule, therefore leading to unfavorable health outcomes (Laranjeira et al., 2023). During my practicum, I observed situations where the patient’s anxiety was so high that they could not follow through with the prescribed interventions like therapy sessions and medication. Adherence to the treatment is not only an essential part of care but also determines the quality of care delivered.

Moreover, anxiety increases patient risk, and hence self-harm and medical errors are more likely. Higher stress levels and worsened judgment as a result of anxiety can increase the likelihood of accidents occurring (Laranjeira et al., 2023). In my relationship with the patient, I found that their anxiety did show itself in certain actions that undermined their level of safety, like avoiding social interactions, or even giving up self-care. These safety issues highlight the importance of all-rounded anxiety management within healthcare environments so that patients may not be harmed in any way.

When it comes to costs, the treatment of anxiety imposes a large amount of money both on healthcare systems and patients. Healthcare costs related to the utilization of healthcare services, such as physician consultation, medicine, and emergency room visits, can quickly add up in the case of individuals suffering from anxiety disorders, as indicated by Lamoureux-Lamarche et al. (2022). Besides, the indirect ones, like a drop in productivity because of limited function, also make the economic side effects of anxiety more challenging. My practicum experiences brought into focus an issue of the financial strain experienced by people in need of treatment for anxiety conditions, as affordability issues are among the factors generally affecting the choice of care-seeking behavior.

Research has demonstrated that anxiety disorders present a huge financial burden in the USA. The latest evidence shows that the annual expenses related to adult anxiety disorders reach at least $200 million (Lamoureux-Lamarche et al., 2022). For instance, the direct costs associated with the management of anxiety disorders constitute only 10% of the overall economic burden. Along with this, for every dollar given to anxiety treatment, $2.50 is spent on indirect costs related to anxiety disorders (Lamoureux-Lamarche et al., 2022). Among the indirect costs, there are a variety of components that include decreased productivity, increased healthcare visits, caused by aggravated comorbid states, and absenteeism from work.

The Impact of State Board Nursing Practice Standards and Governmental Policies

The application of nursing practice standards and governmental policies is of utmost importance in designing the way anxiety is managed in healthcare institutions (Molina-Mula & Gallo-Estrada, 2020). These standards and policies provide rules for medical practice and define the scope of responsibilities, competencies, and ethical issues related to treating anxiety and other mental disorders. This study proves that the adoption of these standards can improve the quality of care, patient safety, and cost-effectiveness when it comes to anxiety management.

Primarily, the state boards’ nursing practice standards set the scope of practice and skills nurses are expected to possess, including those focusing on mental health. Mental health policies related to the scope of practice for mental health nurses also improved the patient care outcomes of patients with anxiety. Research proves the value of policies that help advanced practice nurses (APN) provide complete care for anxiety disorders like those done by psychiatric mental health nurse practitioners (PMHNP) (Kumar et al., 2020). The policies that allow PMHNPs to assess, diagnose, and serve patients with this condition within the scope of their practice will facilitate timely interventions, holistic care approaches, and enhanced access to quality mental health services. These studies have proven that these policies are instruments for better results, such as decreased severity of the symptoms, fewer hospitalizations, and improved patient service.

Moreover, nurses are guided by standards and policies in nursing to take action on different interventions for anxiety-related problems during practicum experiences (Cassidy et al., 2021). Nurses must adhere to established protocols, evidence-based guidelines, and laws regarding the safety and quality of clinical services. For instance, the state board standards on assessment protocols for anxiety let nurses undertake thorough reviews, identify the risk factors, and create care plans tailored to the needs of the patients. Also, adherence to medication administration guidelines, psychotherapy techniques, and interprofessional collaboration ensure coordinated and evidence-based care that positively influences patient outcomes and prevents complications.

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

The combination of telehealth services for remote monitoring and therapy will be beneficial in terms of improving the provision of quality care, reducing risks, and lowering costs. Telehealth is a great option for mental health counseling because it delivers mental health services remotely and helps people with anxiety easily receive care remotely from the comfort of their homes or other locations (Haleem et al., 2021). Research proves that telehealth is effective in the management of anxiety disorders and reaching outcomes similar to traditional face-to-face therapy sessions. Through the utilization of telehealth platforms, medical care practitioners can conduct routine meetings, provide psychoeducation, and deliver evidence-based treatments like CBT to persons with anxiety. On top of that, telehealth offers choices in scheduling appointments, which reduces barriers related to transportation, time constraints, and distance, therefore increasing access to care for the underprivileged population.

In addition to telehealth strategies, finding well-known sources of benchmark data for anxiety treatment quality, health security, and costs is vital for making informed decisions and improving processes. The data from national healthcare initiatives, for instance, the National Institutes of Health (NIH) database on mental health, sheds light on the incidence rates, treatment responses, and the use of healthcare facilities for anxiety disorders (Colizzi et al., 2020). Professional organizations’ directives, like those ordained by the American Psychiatric Association (APA) and the American Psychological Association (APA), provide evidence-based guidelines for the evaluation, diagnosis, and treatment of anxiety. Those kinds of resources lead us to evaluate care practices, identify areas for improvement, and implement the best practices guaranteed to improve the quality of care and ensure patient safety at minimum costs.

To sum up, providing telehealth services and using appropriate benchmark data could be considered two strong strategies for the achievement of the goals of improving care quality, making patients safer, and reducing costs in anxiety management. Through innovative service delivery styles and evidence-based practice interventions, healthcare practitioners can go a long way in meeting the unique needs of people with anxiety disorders while promoting accessibility, effectiveness, and efficiency in care delivery.

Part 2

Practicum Experience

Through the practicum, I devoted two hours to engaging Jasmine, a 32-year-old Black American female, on the influence of anxiety on the safety of the patient, quality of care, and costs. This discussion has been useful to me, and now I have an in-depth understanding of how her anxiety disorder impacts the healthcare course.

Following this, Jasmine revealed that she became a multiple ED patient due to panic attacks which were followed by the intense overwhelming feeling of stress and anguish. Such episodes have led to a lot of safety incidents for her as she usually ends up feeling unsettled and exposed during these difficulties. Moreover, her frequent hospital visits have caused an increase in resource needs, thus increasing the cost. Jasmine’s scenarios thus emphasize the need for implementing measures to minimize the dangers that might ensue from this condition and curb avoidable use of hospitalization.

Regarding healthcare utilization, Jasmine shared the fact that she has attended the emergency department numerous times and has had multiple hospitalizations over the past year associated with her anxiety symptoms. These frequent hospitalizations break Jasmine’s routine and cause huge economic stress not only on her but also on the healthcare system. Next, Jasmine’s anxiety gives her a hard time going to scheduled doctor’s appointments, and she cannot fully follow through with recommended therapies, resulting in gaps in her care and her condition worsening. This points to the need to arrange the accessibility and cooperation of care in individuals with anxiety disorders to avoid disruptions in their schedules and improve treatment outcomes.

When it comes to drug management, Jasmine takes several medications to treat anxiety symptoms. However, not all drugs are covered by insurance and Jasmine has sometimes experienced difficulties acquiring certain medications due to insurance qualifications or formulary restrictions. These access barriers to her healthcare not only affect her to stick to the treatment plan but also create a gap in care and worsen health outcomes for people with anxiety disorders. Tackling these obstacles will call for policy-level interventions to make sure even individuals with mental health conditions can get access to the drugs that they need.

Jasmine also spoke about the downside of taking certain medications, such as drowsiness, dizziness, and gastrointestinal discomfort. Jasmine endures these adverse effects in addition to the strain of controlling her anxiety disorder; thus, her quality of life suffers as a result of it. Furthermore, Jasmine seems to be very upset about the complicated management of her care and the healthcare logistics system which prolongs her illness symptoms and disables her from recovery. To overcome these challenges, a comprehensive multidisciplinary approach that emphasizes patient education, shared decision-making, and support offerings is what is needed to enable people with anxiety disorders to take control of their treatment.

References

Cassidy, C. E., Harrison, M. B., Godfrey, C., Nincic, V., Khan, P. A., Oakley, P., Ross-White, A., Grantmyre, H., & Graham, I. D. (2021). Use and effects of implementation strategies for practice guidelines in nursing: A systematic review. Implementation Science, 16(1). https://doi.org/10.1186/s13012-021-01165-5

Colizzi, M., Lasalvia, A., & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? International Journal of Mental Health Systems, 14(1), 1–14. https://doi.org/10.1186/s13033-020-00356-9

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2(2), 100117. NCBI. https://doi.org/10.1016/j.sintl.2021.100117

Kumar, A., Kearney, A., Hoskins, K., & Iyengar, A. (2020). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. Archives of Psychiatric Nursing, 34(5), 275–280. https://doi.org/10.1016/j.apnu.2020.07.022

Lamoureux-Lamarche, C., Berbiche, D., & Vasiliadis, H.-M. (2022). Health care system and patient costs associated with receipt of minimally adequate treatment for depression and anxiety disorders in older adults. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03759-9

Laranjeira, C., Carvalho, D., Valentim, O., Mendes, S., Morgado, T., Tomás, C., Gomes, J., & Querido, A. (2023). Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis. International Journal of Environmental Research and Public Health, 20(5), 3869–3869. https://doi.org/10.3390/ijerph20053869

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835

Szuhany, K. L., & Simon, N. M. (2022). Anxiety Disorders. JAMA, 328(24), 2431. https://doi.org/10.1001/

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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.

Assessing the Problem – Quality, Safety, and Cost Considerations

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.