NURS FPX4900 Assessment 2 Assessing the Problem Quality, Safety, and Cost Considerations

Assessment 2: Assessing the Problem: Quality, Safety, and Cost Considerations

Student Name
NURS-FPX4900: Capstone Project for Nursing
Capella University
Prof Name
Month Date, Year

How a Patient Problem impacts the quality of care and safety

he issue of hypertension in young adults is becoming a menace in the United States (Carthon et al., 2019). Many people face several stressful situations in life; their cultural, economic, social, economic, and personal factors matter in shaping the lifestyle of hypertension patients. The current case relates to Mr. Ahmad Ul Hassan, a Somalian male who resides in Wisconsin and has a history of consuming extensive alcohol and tobacco. Due to neglecting his cholesterol levels and rising health blood pressure, the individual has been suffering from hypertension and also showing signs of cardiac pain. The current healthcare plan related to hypertension focuses on hypertension prevention and intervention to help the patient improve his wellbeing. Similar to many hypertension patients, Hassan has failed to meet his glycemic targets set by the National Standard Guidelines for Hypertension Management which has boosted the threat of hypertension.  The patient also faced some vascular problems; nurses felt that due to rising hypertension patients, the healthcare system is facing high-cost challenges. 

Medical Case Study

In the 2-hour practicum session, nurses found out that the particular patient has been hospitalized twice in the past two months due to his cardiovascular and chest pain issues. The ineffective treatment of this patient also led to hypertension. The professionals plan to help the patient use the best treatment according to the best standards and rely on Healthy People 2030 goals. The patient received hydrochlorothiazide twice, however, the night nurse had no information of this intervention due to a lack of communication issues with the day-time nurses. Since medication and drug errors significantly influence patients’ health, there is a need for reducing the communication gap (Carthon et al., 2019).

The practicum hours also showed that the patient has been using beta-blockers with high salt levels and was relying on hypoglycemic oral medications.  The patient had to buy glucose strips for completing his medical tests and without medical insurance, his medical bills were too much for him to bear. This shows that the management of hypertension requires nurses to create a plan to invest more in the medication and diet of the patient. Several prescription charges for the patient increased his costs which had a determined health impact. Therefore, hypertension care is necessary to reduce the financial strain on patients’ minds and their families to improve drug adherence and reduce hypertension symptoms (Kashani et al., 2019).

Moreover, due to high blood pressure and hypertension, damage to blood vessels and arteries is also done. Blocked arteries in the body of Hassan can prevent blood flow and can cause a stroke. This can also lead to heart failure and kidney failure. The best protection is the knowledge and management of hypertension and blood pressure. Therefore, there are several safety threats caused by hypertension. The self-monitoring blood pressure cannot help the patient significantly. In terms of cost, wrong medication and treatment are increasing costs for healthcare organizations. This issue is also resulting in many readmissions and operating expenses of hospitals. This shows that the issue of hypertension is not related to nursing performance.

Evidence-Based Practices Role of State Board and Policy Interventions on Quality, Safety, and Costs

medical ethics woman

To ensure that hypertension patients are treated well and readmission costs reduce, many researchers suggest using Self-management Education and Support (DSMES) to connect the patient with many resources to enhance health outcomes. However, the self-management of hypertension also requires nurses to guide the patients in the right direction which requires better education of nurses. According to Bress et al(2017) study, nurses should know more about Hypertension Self-Management Education (HSME) techniques to improve patients’ overall health outcomes.

Through better education, nurses can gain better skills to combat hypertension with the implementation of the HSMES paradigm. The strategy improves skills and helps nurses to acquire more knowledge about the best interventions to improve the quality of care. for example, nurses can better learn how to guide patients about medication adherence, taking exercise, and a healthy diet. The role of education in hypertension is vital in terms of using knowledge-based compliance and a patient-centered approach. Moreover, the implementation of the HSMES techniques will empower nurses with financial and non-financial resources to combat hypertension and seek the right supervision. Moreover, another model that can help to increase the skills of nurses is the DSMES model to gain more knowledge related to hypertension and heart diseases, etc. The program is important because it allows cost-effectiveness and also promotes medication adherence and lowers pharmaceutical costs.

The government has suggested and established several other insurance schemes government to regulate national insurance firms to help patients reduce their healthcare expenditures. This includes getting the right hypertension equipment. The National Standards and Guidelines from the NHA also suggest using a knowledgeable and trained nursing workforce who can rely on the guidance of hypertension experts. This will ensure that interdisciplinary teams are interacting well to ensure patient-related results and promote a healthy environment for nurses to reduce hospitalizations (Powers, 2019). Moreover, for better management of hypertension, nurses require an integrated therapeutic approach that includes following a nutrition plan that follows guidelines of the NHA to provide the best diet to the patients. More technological apps can link nurses with better hypertension management. This brings us to the importance of using telehealth tools. 

medical ethics woman

Modern health practices need a better plan for blood pressure management and hypertension. The stress of patients as well as of nurses’ have been increasing due to long working hours of non-stop hard work. The chosen patient was not aware of the consequence of hypertension on his mental health. The research shows that the healthcare system in the US is also plagued by a prevalence of hypertension issues and there is an acute shortage of good trained nursing instructors’ experts in this field Luger (2019). Therefore, from the United States Nursing Health Care Board suggests nurses and hospitals improve their coordination and use good leadership practices. These policies and guidelines can impact the scope of nurses to improve the interventions. Nurses can use these state board and government rules to mitigate better plans for abatement of hypertension in the organizations.

Strategies to Improve Quality, Safety, and Costs to the System​

The American Hypertension Association’s National Standard Guidelines are helpful in this context to help nurses implement the right blood glucose levels within a specified range. This practice also helps nurses to plan the best dietary changes for hypertension patients. Moreover, the International Hypertension Federation also provides nurses with HbA1C management guidelines; nurses should use a target range of 7.0 percent and ensure that they can help patients make lifestyle changes to maintain normal body blood pressure (Bress et al., 2017). Similarly, the role of the National Heart Association is also crucial in helping nurses suggest lower cholesterol levels by consuming healthy fats and avoiding oily meals. Using these strategies can help to reduce the costs of patients and also allow hospitals to reduce their financial burden by ensuring the use of effective equipment, sphygmomanometers, and medications.

Doctors communication

Moreover, according to the study published by   Kashani et al. (2019), the role of organizational culture is pivotal in ensuring safe, efficient, and high-quality outcomes of hypertension. The study suggests training, education, and coaching of administration and nurses to enhance safe practices. The study also emphasizes the role of effective coordination between nurses and their physicians to avoid drug administration errors which increase the cost of hospitals. Moreover, nurses and physicians must maintain the hypertension indicators in collaboration with nutritionists. The use of telemedicine can prove to be effective due to the effectiveness of technology in streamlining pharmaceutical information to ensure optimum health care outcomes. Moreover, nurses and administrators must also take active participation in the educational courses, seminars, and training sessions to better plan the diet and medication of patients and guide them to improve their lifestyles. I also examined that the case of this particular patient in our organization is critical; he requires dietary changes and effective blood pressure monitoring. Using telemedicine in his case can ensure reducing high costs of the health care system.

For example, the use of telehealth in the treatment of hypertension patients is effective to ensure better glucose monitoring. Nurses can easily use mobile phones or computers to deliver instructions through videoconferences; these interventions are effective in lowering hypertension distress and enhancing glucose monitoring efforts to change the quality of life of the patient (Cohen et al., 2018).  

The benefit of telemedicine has been demonstrated by several other researchers for improving hypertension problems such as the study by Carthon and Hatfield (2019) which advocates the use of telemedicine for fostering quality of care (QoC) in hospital settings The study states that telemedicine helps nurses to better engage with their patients and reduce medical errors. Moreover, Hypertension Nurse Specialists (HNS) also play a crucial role in primary healthcare settings to enhance patient-focused outcomes. The HNS allows better collaboration of physicians and nurses and other stakeholders such as patients’ families; the professional’s assistance is given to nurses related to the improvement of education. Therefore, the adoption of the HNS is vital which requires mitigating some regional challenges to improve overall outcomes (Alqenae, 2020).


Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Drug safety43(6), 517-537.

Bress, A. P., Bellows, B. K., King, J. B., Hess, R., Beddhu, S., Zhang, Z., & Moran, A. E. (2017). Cost-effectiveness of intensive versus standard blood-pressure control. New England Journal of Medicine377(8), 745-755.

Carthon, J. M. B., Davis, L., Dierkes, A., Hatfield, L., Hedgeland, T., Holland, S., & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of nursing care quality34(1), 40.

Cohen, D. J., Dorr, D. A., Knierim, K., DuBard, C. A., Hemler, J. R., Hall, J. D., … & Balasubramanian, B. A. (2018). Primary care practices’ abilities and challenges in using electronic health record data for quality improvement. Health Affairs37(4), 635-643.

Kashani, K., Rosner, M. H., Haase, M., Lewington, A. J., O’Donoghue, D. J., Wilson, F. P., & Wu, V. C. (2019). Quality improvement goals for acute kidney injury. Clinical Journal of the American Society of Nephrology14(6), 941-953.

Luger, S. J., & Ford, D. J. (2019). A Pilot Quality Improvement Project Facilitating Leadership Skills in Rural New Graduate Nurses. Online Journal of Rural Nursing & Health Care19(1).

Powers, K., Herron, E. K., & Pagel, J. (2019). Nurse preceptor role in new graduate nurses’ transition to practice. Dimensions of Critical Care Nursing38(3), 131-136.