NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Student Name
Capella University
NURS-FPX 4900 Capstone project for Nursing
Prof. Name
Date
Assessing the Problem: Quality, Safety, and Cost Considerations
Obesity is an issue that affects the wellbeing of an individual in multiple ways. According to the Centers for Disease Control and Prevention (CDC), it is the cause of various diseases such as hypertension, heart issues, and diabetes. It also impacts physical functioning due to breathing issues associated with obesity (CDC, 2022c). It has a detrimental impact on mental health concerns because of unhealthy habits of binge eating, stress eating, and conditions like stress and depression. This paper is to assess obesity concerns for a patient named Evelyn, a 32-year-old woman with multiple health issues, majorly obesity but including hypertension, lack of energy, and joint pain, in terms of factors affecting quality care, patient safety, and cost. Strategies will be integrated into her care plan based on the potential factors affecting her life.
Problem’s Effect on Care Quality, Patient Safety, and Care Costs
Obesity has the potential to impact an individual’s life in multiple ways. Its prevalence shows the inability of various people to control, manage, or treat this condition. It takes mental, physical, and financial input to address obesity or its impacts on a person’s wellbeing (CDC, 2022c). Evelyn is currently taking no medications, but she is visiting the hospital for hypertension concerns. Her condition can have a negative impact on care quality, her safety, and the costs associated with a treatment plan.
Effect on Care Quality
Evelyn’s obesity has a significant impact on the quality of care she receives. Firstly, her obesity-related health issues, such as hypertension, lack of energy, and joint pain concerns, can affect her wellbeing and ability to engage effectively in her healthcare. This leads to challenges in adhering to treatment plans, attending appointments regularly, and actively participating in discussions about her care (Lam et al., 2023).
Healthcare providers can face difficulties in delivering high-quality care tailored to Evelyn’s specific needs due to the complexities associated with obesity management. For example, personalized care plans involving dietary modifications, physical activity routines, and weight management strategies require more time and resources to develop and implement effectively. Moreover, the emotional distress and societal stigma experienced by Evelyn due to her weight can also impact the care quality she receives. Negative attitudes or biases from healthcare providers, even unintentional, can lead to poor communication, decreased trust, and a lack of patient-centered care (NCOA, 2024).
Effect on Patient Safety
Evelyn’s obesity poses significant challenges to patient safety. Firstly, her obesity-related conditions, like hypertension (for which she has visited the hospital recently), increased her risk of developing further complications like stroke. This highlights the importance of closely monitoring her health status, medication adherence, and managing potential medication interactions to ensure patient safety. Her physical limitations, such as struggling to climb stairs, indicate possible safety hazards in her daily environment (Lee et al., 2019).
The healthcare team must assess and address safety concerns to prevent accidents and injuries, especially considering her recent hospitalization. Further, her mental health can impede effective outcomes because of her inability to make decisions and perform self-care activities. It is crucial to consider the psychological aspects and provide appropriate support to ensure patient safety and wellbeing (Singh et al., 2022).
Effect on Care Costs
Evelyn’s obesity contributes to increased care costs both for the healthcare system and for her as an individual. Firstly, managing obesity-related health issues like hypertension and joint pain requires ongoing medical interventions, consultations, and expensive treatments or medications. This leads to higher healthcare expenditures for Evelyn and her family, including out-of-pocket medical expenses, doctor visits, and hospitalizations. It has substantial financial implications in all forms, like in-patient or out-patient care services and medications, burdening public insurers ($2868) and private insurers ($2058) (Cawley et al., 2021).
Moreover, obesity-related complications can result in increased utilization of healthcare services, such as emergency room visits or specialized care, further adding to costs (Okunogbe et al., 2021). For example, Evelyn’s recent hospitalization due to hypertension not only incurred immediate medical expenses but also reflects the long-term financial burden associated with managing obesity-related conditions. Indirect costs related to productivity loss can also contribute to economic instability. Addressing these cost implications requires a comprehensive approach that includes preventive measures, practical strategies, and patient education to promote long-term health outcomes while managing financial strain (Okunogbe et al., 2021).
State Board of Nursing Practice Standards
In Evelyn’s case, standards and policies play an essential role in addressing the consequences of obesity on quality healthcare, patient wellbeing, and related expenses. The American Nurse Association (ANA) sets standards that guide nursing practice, emphasizing patient-centered care and interdisciplinary collaboration (ANA, n.d.). These standards ensure that nurses like the one overseeing Evelyn’s care adhere to best practices in obesity management, including personalized care plans and regular monitoring. It also encourages nurses to educate patients (like Evelyn) on self-management strategies (ANA, n.d.).
Organizational policy presents information and guidelines based on evidence that can help healthcare personnel in integrating preventive strategies for patients with obesity. For example, CDC and World Health Organization (WHO) provide standardized protocols for obesity assessment, treatment, and follow-up, ensuring consistent and effective care. It also highlights the social factors that impact obesity treatment, like housing, health literacy, and cultural aspects (CDC, 2022b).
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Healthcare professionals can devise a plan based on the important factors for Evelyn and develop a holistic care plan based on her needs and preferences.Multiple governmental policies help in safety and cost management. For instance, the Affordable Care Act (ACA) helps with cost coverage for obesity management. The national obesity expense is over $190 billion (Thapa et al., 2020). The policy extends insurance through the expansion of Medicaid for struggling individuals.
It includes coverage for drug or behavioral therapy and, if needed, bariatric surgery (Rdesinski et al., 2023). Another significant government policy is Healthy People 2030 (HP2030), an initiative that sets objectives and targets to improve wellbeing across various domains, including obesity. It can help healthcare professionals in setting preventive strategies through dietary interventions. It aims to address the root cause of the problem (HP2030, 2022).
Policy Impacts on Nursing Scope of Practice
These policies impact the scope of nursing practice by providing a framework for evidence-based care and multidisciplinary collaboration. It binds nurses to evidence, standards, and guidelines best suited for obesity management and safeguards from ethical/legal implications. The standards set by the ANA ensure that nurses prioritize individualized care and tailor interventions (ANA, n.d.).
These expand the scope of duties and responsibilities for nurses to enable collaboration and patient education to address obesity-related challenges, as Evelyn has faced. Organizational policies, such as those from the CDC and WHO, guide healthcare professionals in implementing evidence-based protocols for obesity screening and treatment. Considering social and cultural factors allows nurses to advocate for policies that benefit obesity management for enhanced care quality, patient security, and cost-effectiveness.
Moreover, governmental policies like the ACA and HP2030 expand the scope of practice by increasing access to preventive services and coverage for obesity management (HP2030, 2022). These policies aid nurses and healthcare teams in developing evidence-based and personalized care plans for Evelyn through educational and dietary strategies. For instance, HP2030 will help nurses focus on treatment, including weight loss, preventive strategies through healthy habits, and self-management through measuring progress tools like BMI.
Strategies to Improve the Quality of Care for Patient
Based on Evelyn’s case and evidence from literature regarding effective obesity management, the following strategies are proposed. Firstly, evidence-based practices should be utilized, such as behavioral therapy, dietary modifications, and physical activities (Niemiro et al., 2023). Behavioral therapy is effective for patients with obesity, as it focuses on modifying eating and physical activity behavior to promote weight loss and healthy lifestyle habits. This approach includes self-monitoring, goal setting, and cognitive restructuring. Behavioral therapy is effective in helping individuals with obesity make sustainable changes in their eating patterns, activity levels, and overall health (Grave et al., 2020).
Developing personalized care plans for patients like Evelyn, with comorbid health conditions and obesity, is also an effective strategy. For instance, it considers individual needs, preferences, and social health factors to enhance engagement and outcomes (Dvorák et al., 2021). Further, it will foster interdisciplinary collaboration among caregivers, including nurses, dieticians, physicians, and psychologists, in making holistic care plans and provide holistic support to Evelyn. Studies have shown that an interdisciplinary approach to managing obesity is more effective in reducing weight and improving health outcomes by error reduction and treatment adherence (Ruiz et al., 2020).
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Lastly, the patient (Evelyn) should be educated about self-management strategies, healthy lifestyle, nutrition, and physical activity to empower her in managing her condition. Providing information about strategies and resources would cultivate positive outcomes in obesity management. Preventive strategies like behavior therapy can reduce the onset of conditions like hypertension and cardiovascular concerns, which ultimately reduce costs for Evelyn. Moreover, personalized care and empowerment through self-management can reduce medication dependency, complications, and reliance on healthcare services, thereby reducing costs for the patient and healthcare system.
Several benchmark data based on organizational standards are adequate to measure the effectiveness of the recommended strategies. For instance, BMI is a technique to know about the overweight and obesity factors. The CDC states that a BMI of less than 30 means the person is not obese. However, a healthy range is 18.5-24.9 (CDC, 2022a). Further, healthcare professionals can utilize goal-setting tools, which include exercise routines and diet plans, and track them to determine the progress of the strategies introduced. It consists of the steps monitored every day for obesity management. Lastly, patient feedback for patient satisfaction and adherence to the intervention can be noted (Varela et al., 2021).
Part Two
Documentation of Practicum Hours
The two practicum hours are documented to highlight engagement with the patient (Evelyn) for developing and implementing targeted strategies to improve health outcomes and reduce costs related to obesity management. Evelyn discussed the objective of implementing evidence-based dietary and behavioral therapy. We also discussed collaboration among healthcare professionals and Evelyn’s role in shared decision-making. The hours spent addressing the obesity problem regarding care quality, Evelyn’s safety, and cost enhanced my understanding and knowledge of managing obesity.
I reviewed EBP documents and websites like CDC and WHO to reinforce the recommendations and learned about the latest research and guidelines in obesity management. While exploring communication and collaboration, I encountered barriers related to Evelyn’s motivation and understanding of the severity of her health condition. However, through effective communication and education, I helped Evelyn and her immediate family recognize the significance of obesity and the need for proactive engagement. I employed empathetic and clear communication through a shared decision-making approach for active understanding and engagement. Based on our discussion, I aligned my approach to Evelyn’s needs and preferences.
Conclusion
In conclusion, addressing obesity in patients like Evelyn requires a multifaceted approach encompassing evidence-based practices, interdisciplinary collaboration, patient education, and adherence to nursing standards and policies. By integrating these strategies, healthcare providers can elevate the standard of care, foster patient security, and cut expenses. Ultimately, healthcare teams improve health outcomes for individuals with obesity-related conditions.
References
ANA. (n.d.). About ANA enterprise. www.nursingworld.org. https://www.nursingworld.org/ana-enterprise/about-us/#:~:text=The%20American%20Nurses%20Association
Cawley, J., Biener, A., Meyerhoefer, C., Ding, Y., Zvenyach, T., Smolarz, B. G., & Ramasamy, A. (2021). Direct medical costs of obesity in the United States and the most populous states. Journal of Managed Care & Specialty Pharmacy, 27(3), 354–366. https://doi.org/10.18553/jmcp.2021.20410
CDC. (2022a, June 3). Defining adult overweight and obesity. www.cdc.gov. https://www.cdc.gov/obesity/basics/adult-defining.html
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
CDC. (2022b, September 24). The health effects of overweight and obesity www.cdc.gov. https://www.cdc.gov/healthyweight/effects/index.html
CDC. (2022c, September 27). Overweight & obesity. www.cdc.gov. https://www.cdc.gov/obesity/index.html
Dvorák, M., Tóth, M., & Ács, P. (2021). The role of individualized exercise prescription in obesity management—case study. International Journal of Environmental Research and Public Health, 18(22), 12028. https://doi.org/10.3390/ijerph182212028
Grave, R. D., Sartirana, M., & Calugi, S. (2020). Personalized cognitive-behavioral therapy for obesity (CBT-OB): theory, strategies, and procedures. BioPsychoSocial Medicine, 14(1). https://doi.org/10.1186/s13030-020-00177-9
HP2030. (2022, September). Obesity – Healthy People 2030. Health.gov. https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/obesity
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Lam, B. C., Lim, A. L., Chan, S., Yum, M. S., Koh, N. Y., & Finkelstein, E. (2023). The impact of obesity: A narrative review. Singapore Medical Journal, 64(3), 163. https://doi.org/10.4103/singaporemedj.smj-2022-232
Lee, A., Cardel, M., & Donahoo, W. T. (2019). Environmental factors influencing obesity. Ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK278977/
NCOA. (2024, February 27). How excess weight impacts our mental and emotional health. Www.ncoa.org. https://www.ncoa.org/article/how-excess-weight-impacts-our-mental-and-emotional-health#:~:text=Patients%20may%20internalize%20society
Niemiro, G. M., Rewane, A., & Algotar, A. M. (2023, November 17). Exercise and fitness effect on obesity. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539893/
Okunogbe, A., Nugent, R., Spencer, G., Ralston, J., & Wilding, J. (2021). Economic impacts of overweight and obesity: Current and future estimates for eight countries. BMJ Global Health, 6(10), e006351. https://doi.org/10.1136/bmjgh-2021-006351
Rdesinski, R., Chamine, I., Valenzuela, S., Marino, M., Schmidt, T., Larson, A., Huguet, N., & Angier, H. (2023). Impact of the Affordable Care Act Medicaid expansion on weight loss among community health center patients with obesity. The Annals of Family Medicine, 21(Supplement 1). https://doi.org/10.1370/afm.21.s1.3731
Ruiz, V. E. F. -, Morcillo, A. J. R., Agustí, M. S., Urbano, J. A. P., & Barranco, D. A. (2020). Effectiveness of an interdisciplinary program performed on obese people regarding nutritional habits and metabolic comorbidity: A randomized controlled clinical trial. International Journal of Environmental Research and Public Health, 17(1), 336. https://doi.org/10.3390/ijerph17010336
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Singh, V., Kumar, A., & Gupta, S. (2022). Mental health prevention and promotion—A narrative review. Frontiers in Psychiatry, 13(13). https://doi.org/10.3389/fpsyt.2022.898009
Thapa, J. R., Zhang, D., MacLeod, K. E., & Thapa, K. (2020). Impact of Medicaid expansion on insurance coverage rates among adult populations with low income and by obesity status. Obesity, 28(7), 1219–1223. https://doi.org/10.1002/oby.22793
Varela, C., Montecinos, C. O., Andrés, A., & Saldaña, C. (2021). Effectiveness of web-based feedback interventions for people with overweight and obesity: Systematic review and network meta-analysis of randomized controlled trials. Journal of Eating Disorders, 9(1). https://doi.org/10.1186/s40337-021-00432-6
WHO. (2023, May 17). New WHO framework available for prevention and management of obesity. Ww.who.int. https://www.who.int/news/item/17-05-2023-new-WHO-framework-available-for-prevention-and-management-of-obesity