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NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

Part 1: How a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.

Type two diabetes is a lifestyle disease where there is high blood sugar. Diabetes affects many people worldwide and keeps increasing, making the condition an issue of concern. Being a chronic condition, type two diabetes affects people’s health, increases healthcare costs, and impacts the quality of health. Diabetes increases the morbidity and mortality rate of people above 45 years, significantly affecting the healthcare system. Diabetes, therefore, is a global problem that should be dealt with (Schmidt et al., 2018). The burden of diabetes increases when the condition is left untreated and left to progress. Type two diabetes is a severe condition that can be fatal and expensive to manage despite the existence of preventive measures (Schmidt et al., 2018). If left unchecked and untreated, diabetes increases morbidity and mortality rates. Major life-threatening complications of diabetes include nerve damage, kidney damage, eye damage, cardiovascular diseases, foot damage, skin damage, hearing issues, Alzheimer’s disease, and even death.

An increase in type two diabetes cases financially impacts both the patient and the healthcare system. The progression of the diseases increases the cost of Healthcare in diagnosing, managing, and treating the condition. As the number of diabetic cases increases, more equipment, such as glucometers, is required to diagnose the condition. The healthcare system also has to increase the number of diabetes medications to control and manage the condition, which increases the cost (Schmidt et al., 2018). More health professionals, such as nurses, nutritionists, lab technicians, and physicians, will be required to diagnose, manage and treat the increasing number of diabetic patients. Buying the equipment and medications and employing more medical professionals is very expensive. There is also a financial burden on the patient with type two diabetes. Diabetes is s chronic disease, and managing is expensive on the patient’s side. Patients who use out-of-pocket as a means of payment for health services use a lot of money diagnosing, buying medications, and managing diabetes. The medical fee charged in managing diabetes is high in most healthcare facilities. Insurance coverage for chronic diseases like diabetes is usually high, making patients spend money on health (Schmidt et al., 2018). Therefore, type two diabetes increases the cost of Healthcare for both the patient and the healthcare system.

NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

The EffeEffectstate board nursing practice standards on Healthcare

Nurses’ scope of practice is determined by specific regulatory bodies establishing nursing standards and guidelines. State nursing board standards set nursing principles, standards, and scope of practice. The principles and standards guide the nurses in their practice to ensure that the quality of care is high and, at the same time, ensure patient safety. State nursing board standards are also concerned with licensing of nursing to ensure that only qualified and well-trained nurses work in healthcare facilities to improve the quality of care (Ortiz et al., 2018). The Nursing Practices Act helps nurses improve care quality and patient safety. One of the strategies used by the regulatory bodies to improve the quality of care is educating nurses on improving nurse-patient relationships and safely providing care (Ortiz et al., 2018). The Nursing Practices Act also determines the nursing scope of practice and sets the standards for nurses to be given practicing licenses.

The state Board of nursing practice standards ensure that healthcare quality is high. The board ensures the practice standards in nursing are enforced and implemented to improve patient care quality. By ensuring that only qualified nurses offer patient care, medical errors are reduced, and patient safety is enhanced. Enforcement of the standards also ensures that nurses practice within their scope and ethics, which leads to better patient outcomes (Ortiz et al., 2018). The state Board of nursing practice standards is also responsible for ensuring the efficiency and effectiveness of health services offered to patients. Education and training enhanced by the board increase the nurses’ skills and knowledge, which in turn increases their competency at work (Ortiz et al., 2018). The state board also encourages nursing research where nurses develop better interventions for managing specific conditions such as diabetes. Therefore, state board nursing practice standards ensure improved care quality, improving patient outcomes.

Implementation of federal laws and policies related to health ensures diabetic patients access healthcare services. The cost of managing diabetes is high, but implementing laws such as the Affordable Care Act ensures all patients access healthcare services. Programs such as Medicaid and Medicare help those vulnerable to health insurance. The government reduces the cost of health care by paying insurance for the people and reducing health insurance costs. Therefore, implementing the laws will ensure that all diabetic patients can afford medical services to manage their conditions. Nursing standards and federal policies and laws ensure patient safety, improve the quality of care, and reduce the cost of healthcare services for patients.

NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

Strategies to improve quality of care

One of the strategies is through the collaboration of health workers or a multidisciplinary approach. Working together as a team will reduce medical errors and improve the quality of care. Effective communication will also improve the quality of care by improving nurse-patient relationships and reducing errors. Patient education on diabetes increases awareness which also improves the quality of care. MHealth and electronic health records will reduce errors, increase accuracy and reduce discrimination, improving patient outcomes. These strategies will reduce patient admission and revisit, reducing Healthcare costs.

Part 2: Report on the Practicum Hours’ experiences.

Meeting the patient and expert

I met a patient named Paul, who had been diagnosed with diabetes when he was 62 years. The patient was a 65-year-old patient whose race was African-American. During the meeting, the patient presented with significant signs and symptoms of type two diabetes, which he claims he had struggled to control for three years. The patient admitted that there was poor communication when he was being taught how to manage his condition. The patient only recalls being taught n importance of adhering to his medications but not modifying his lifestyle. Paul also claimed that he still smokes, takes alcohol, and does not perform any exercise since he was not taught about the relationship between lifestyle factors and his condition.

In the practicum, I also interviewed a diabetic physician Dr. Bill Albert, M.D., through Zoom. Dr. Bill Albert is an expert in diabetes and hypertension. According to Dr. Bill Albert, the signs experienced by Mr. Paul could have worsened if he would not seek medical attention. He stated that the patient’s condition could have worsened if he had continued a sedentary lifestyle. Dr. Bill Albert, during the interview, insisted on the importance of a multidisciplinary approach and effective communication in managing diabetes. A lot of factors affect patients with diabetes, and there should be the collaboration of healthcare professionals in dealing with the condition. The focus should not only be placed only on medication but on other lifestyle factors that other medical professionals can help to meet, including communication between the patient and the healthcare provider on all aspects of the patient’s condition (Hong, Jo, Cardel, Huo & Mainous III, 2020). Efficient and effective communication helps identify patients’ needs, meet patient needs, and provide quality care at a lower cost.

There is evidence for using a multidisciplinary approach in managing patients with diabetes. Brocco et al., in their study, analyzed the effectiveness of a multidisciplinary approach in managing patients with diabetic foot (Brocco et al., 2018). According to the researchers, a multidisciplinary approach addresses all the patient’s needs, which improves the final goals. Healthcare professionals, including nurses, radiologists, physicians, and social workers, have different knowledge and skills to apply to manage diabetes patients. The action of team members by applying their skills and knowledge improves the quality of care and patient outcomes of diabetic patients. Through teamwork and collaboration, medical errors and misdiagnoses reduce, which improves patient safety and quality of care (Patel et al., 2019). Sharing knowledge and skills in a multidisciplinary approach also improves patient outcomes (Patel et al., 2019). Thus, through a multidisciplinary approach, there is improved patient safety and quality of care.

There is also enough evidence linking effective communication to improved patient outcomes and quality of care. Effective communication between health care professionals, patients, and family members improves the quality of care since it helps the patient and the relatives to understand their situations. According to Woo et al. (2017), poor communication increases medical errors, reducing care quality. Healthcare professionals should communicate effectively with the patients to assess their needs and deal with needs through effective strategies. Patient education is critical to improving the quality of care and is effective when there is effective and efficient communication. The education should address all of the patient’s needs.

NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

The Process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem

During the meeting with Mr. Paul, I realized he could not understand most of the information. I had to find a way of making him comfortable and understanding the information we were discussing. I clearly explained to the patient and gave him a chance to ask questions. Mr. Paul’s symptoms, such as general body weakness, made the patient not understand. Mr. Paul was, however, able to understand everything through effective communication.

The leadership, communication, collaboration, or change management skills employed during the interactions to overcome these barriers

The main barrier identified was a lack of cooperation due to poor communication. The relationship between the nurse and the patient was also poor. Poor communication reduces the quality of care and increases medical errors. Effective communication is essential in a multidisciplinary approach. Effective communication ensures proper diagnosis, management, and education of the patient. Effective communication also reduces the cost of Healthcare through the reduction of errors. I educated Mr. Paul on the symptoms of diabetes, the risk factors, the complications, and the management. I emphasized more on lifestyle modification. I created a good relationship with the patient and the family members. I also opted to collaborate with other healthcare professionals, such as social workers, psychologists, physicians, pharmacists, and nutritionists, in managing the patient.

NURS-FPX 4900 Assessment 2 Assessing the Problem – Quality, Safety, and Cost Considerations

What I might have done differently

In this case, I would have devised a plan for educating and training nurses. The training would focus on the importance of having a good relationship with patients and caring for their needs. Nurses would also be taught the importance of effective communication and teamwork with other health professionals. The other plan is to come up with seminars on diabetes. People would be educated on the best strategies for managing diabetes.


Adams, E. K., & Markowitz, S. (2018). Improving efficiency in the healthcare system: Removing anticompetitive barriers for advanced practice registered nurses and physician assistants. Policy Proposal8, 9-13.

Hong, Y. R., Jo, A., Cardel, M., Huo, J., & Mainous III, A. G. (2020). Patient-provider communication with teach-back, patient-centered diabetes care, and diabetes care education. Patient Education and Counseling103(12), 2443-2450.

Li, C., & Lumey, L. H. (2019). Impact of disease screening on awareness and management of hypertension and diabetes between 2011 and 2015: results from the China health and retirement longitudinal study. BMC public health19(1), 1-8.

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018, June). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). Multidisciplinary Digital Publishing Institute.

Patel, U. K., Malik, P., DeMasi, M., Lunagariya, A., & Jani, V. B. (2019). Multidisciplinary approach and outcomes of tele-neurology: a review. Cureus11(4).

Schmidt, C. B., van Loon, B. P., Vergouwen, A. C. M., Snoek, F. J., & Honig, A. (2018). Systematic review and meta‐analysis of psychological interventions in people with diabetes and high diabetes distress. Diabetic Medicine35(9), 1157-1172.

Woo, B. F. Y., Lee, J. X. Y., & San Tam, W. W. (2017). The impact of the advanced practice nursing role on the quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resourceEffecthealth, 15(1), 63.


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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 Core Elms Volunteer Experience Form. Report on your
experiences during your first two practicum hours.

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