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NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC

Quality, Safety and Cost Considerations Issue 

The issue of diabetes is increasing all over the globe including the United States. It is a health issues that needs special attention of nurses and also requires treatment and care for the rest of its period in patients’ lives. Terry is a female patient of age 47 who has been facing problems due to chronic type 2 diabetes for more than 15 years. The case history of Terry reveals that the patient has been a victim of type 2 diabetes because her mother and grandmother and most of her family members also had the same disease. Moreover, Terry spends many hours in the emergency department in Prime Hospital, United States due to her severe condition causing her macro vascular issues. Moreover, her case also reveals that she failed to achieve the climatic goal that is often provided by the National Standard Guidelines in diabetes management. This has led to creating more complex problems for the patient to take admission in the emergency department of Prime Hospital. The benchmarks followed by the hospital often comply with the regulations of the National Standard Guidelines in Diabetes Management. However, even though Terry received good attention of nurses, her vascular complications kept increasing which shows a significant load on doctors and nurses in the healthcare organisation. This also resulted in the reduction of patient’s satisfaction and damaging her life quality. Another great danger lurking Terry is the chance of a heart attack due to her previous heart problems history. Therefore, Terry was immediately sent to the emergency department for chest pain interventions to improve her condition. The analysis of the patient’s case shows that her complications were mainly due to mismanagement of disease and she had no idea of self-management of diabetes type 2 (Williams et al., 2017). 

Moreover, nurses also made the mistake of feeding Terry with wrong drugs during the night shift and also provided her increased level of insulin. Nurses thought they had not given the previous dose; this caused them to provide Terry an overdose of insulin in the hospital settings. This implies that the hospital was facing an issue of poor nurses’ collaboration and discussion about drugs given to the chosen patient; this issue remains a case of mismanagement in the hospital. Moreover, researchers claim that wrong medicines or overdoses can often cause behavioral changes in patients. The patient also got hypoglycemic oral medicines and glucose strips; however, her daily glucose dosage was not recorded perfectly. This is the reason her chest pain was extremely high and she had to be admitted into the emergency ward for 2 weeks. 

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC

The patient seemed utterly confused about her complications and effects of wrong medications.   In Prime Hospital, working as a senior registered nurse, the cost of drugs is mainly an issue that I observed in the patients of diabetes type 2. The insurance covers ages such as Medicare is effective, however, not for 100% patients needing expensive drugs for type 2 diabetes (Staines, et al., 2021). Moreover, such patients having multiple issues like Terry also have to bear costs for vesting heart specialists. Even though our hospital uses the National and international policies to enhance the quality outcomes of diabetic patients, the financial support initiatives and insurance claims in favor of patients need to increase who often lack financial resources to have a sustainable health. 

Evidence-Based Role of Nurses to Boost Quality, Safety, and Cost 

Evidence based practices are vital in the hospital settings for nurses to follow. It helps medical healthcare professionals to promote programs that reduce financial burden on diabetic patients. For instance, according to the research published by  Riaz (2017), the Diabetes self-management Education and Support (DSMES) is an initiative that helps and guides diabetic patients like Terry to connect with the community to improve positive healthcare outcomes. The goal of doctors in Prime Hospital must be to ensure diabetic education that focuses more on the self-management of the disease that will surely play a vital role in improving the overall health of patients such as Terry and others in the emergency ward. Moreover, evidence-based practices will also be helpful for nurses working in Prime Hospital because they can definitely boost their own know-how of what strategies to follow when they tackle such patients and how to ensure error-free drug administration and delivery to avoid major health complications (Mitha, 2021). This means that following the DSMES framework in the hospital can improve the knowledge and skills or nurses dealing with type 2 diabetic patients and will also incorporate positive behavioral changes in the patients. This includes making changes and enhancing the quality of several things such as exercise, medication, and food in such patients to enhance their overall health. This means that the role of evidence-based practices is crucial that is considered by man scholars and researchers as the dissemination of the right knowledge to protect patient’s health suffering from diabetes (McAllen, 2018). 

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC

Moreover, another research published by Grady (2014) states that the American Diabetes Association is a crucial organization involved in the safe and secure quality of treatment and financial stability in patients suffering from major chronic issues such as type 2 diabetes. For improving the care for diabetes, the American Diabetes Organization is a prime functional body that has done significantly well over the years to provide the necessary financial resources for diabetes care (Knight, 2018). Moreover, the Diabetes Cost reduction Act (2004) is another most important and sought-after resourceful organization that can be followed as a guiding light to advocating for the insurance organization to offer the best advantages to type 2 diabetes patients in the United States. The organization also helps and guide people lacking diabetes education and knowledge and provides insurance for handling this disease. The fact remains that as long as the healthcare professionals at Prime Hospital in the US will use the best implementation of the DSMES, they will enhance the medication adherence and will also reduce the expenses spend by patients such as Terry on costly medications (Kamran, 2018). Therefore, the government is doing an admirable job to improve the health of citizens by regulating the national programs of insurance companies and their procedures. This can significantly improve the drug administration costs and reduce medication errors in Prime Hospital as well. 

Moreover, another damaging disease is Diabetes mellitus type 2 and when it becomes a chronic issue, it is more complex and difficult for nurses and physicians to tackle in the hospital settings in their busy routines. The issue’s analysis shows that poor compliance with all the above mentioned benchmarks and evidnece-based practices have resulted in low patient care outcomes in the case of type 2 diabetes treatment. Besides, due to putting more than enough load on the backs of middle-income patients, there is a need for increasing educated and knowledgeable nurses and healthcare professionals (Grilo et al., 2019). 

Strategies to Improve Quality, Safety and Cost 

As discussed above, the National Standard Guidelines issued by the American Diabetes Association often serve as a roadmap for healthcare professionals to manage specific issues related to drug miscues and poor diabetic treatments. For instance, if the maintenance of serum glucose is not done properly in diabetic patients, patients cannot understand what they are doing wrong and how they can improve their lifestyles and dietary choices.  For instance, a research published by Gong (2017) states that the American Diabetes Association suggests professionals to educate patients about reducing the level of oily foods and consuming more fats to control and effectively manage their chronic issues. Moreover, another vital strategy that can change the quality outcomes of Prime Hospital in the US includes using the insured equipment such as glucometers and other insulin-related tools which can significantly decrease the cost of treating such patients (El-Jardali, 2017). 

Another vital strategy that must be followed by the management of Prime Hospital is to cultivate and promote the culture of teamwork and collaboration in the complex settings. Safe and efficient quality of care is possible when the culture of the healthcare organization changes positively in the favor of both professionals and nurses. To meet such a vital goal, the organization must use evidence based practices and use communication and coordination strategies to employ the safe patient care practices. The interdisciplinary collaborative approach is also vital for the professionals for addressing the type 2 diabetes healthcare problems and complications in patients like Terry. Improved communication can help nurses reduce and control their increasing medication and drug administration errors as well. Moreover, post-discharge drugs are also managed well by improving interdisciplinary communication. This implies that the team of doctors, administrators, and nurses can all use these techniques for long-term benefits of patients (Dankbaar 2017). 

Furthermore, another most crucial intervention for improving the quality and safety is to utilize the latest technology to benefit healthcare outcomes and promote patients’ health using telemedicin. Many researchers claim that among diabetic nurses and physicians, telemedicine has been considered as a trustworthy long-term remedy that has positive impacts on patient’s health. Setting up and deploying telemedicine tools also increases nurses skills and technical capabilities to handle tools in all situations with minimum technical support (Dankbaar,  et al., 2017). This also provides them an edge to treat patients with type 2 diabetes with ease while staying at the comfort of their homes and making informed judgments about diagnosis. Therefore, these interventions are important to understand and implement practically in Prime Hospital to enhance the skills and competencies of professional nurses and doctors to achieve better outcomes regarding treatment of type 2 diabetes patients (Bari,  et al., 2017). 

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC


Using evidence-based practices can help nurses in the chosen American hospital to reduce the drug and medication administration and delivery errors and also help them to improve the image of the hospital by incorporating fair and transparent policies and procedures. The cost of middle-income patients can decrease by implementing remote collaboration and treatment technologies such as video calls and Smartphone interactions. Diabetes equipment cost and other hospital expenses can reduce significantly if nurses pay attention to guidelines provided by the ADA. 


Bari, A., Jabeen, U., Bano, I., & Rathore, A. W. (2017). Patient safety awareness among postgraduate students and nurses in a tertiary health care facility. Pakistan journal of medical sciences33(5), 1059.

Dankbaar, M. E., Richters, O., Kalkman, C. J., Prins, G., Ten Cate, O. T., van Merrienboer, J. J., & Schuit, S. C. (2017). Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness. BMC medical education17(1), 1-10.

El-Jardali, F., & Fadlallah, R. (2017). A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan. BMC health services research17(1), 1-13.

Gong, Y., Kang, H., Wu, X., & Hua, L. (2017). Enhancing patient safety event reporting. Applied clinical informatics8(03), 893-909.

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality Safety and Cost Considerations SC

Grilo, S. A., Catallozzi, M., Santelli, J. S., Yan, H., Song, X., Heitel, J., … & Klein, J. D. (2019). Confidentiality discussions and private time with a health-care provider for youth, United States, 2016. Journal of Adolescent Health64(3), 311-318.

Kamran, R., Bari, A., Khan, R. A., & Al-Eraky, M. (2018). Patient safety awareness among undergraduate medical students in Pakistani medical school. Pakistan journal of medical sciences34(2), 305.

 Knight, M., & Tuffnell, D. (2018). A view from the UK: the UK and Ireland confidential enquiry into maternal deaths and morbidity. Clinical obstetrics and gynecology61(2), 347-358.

McAllen, E. R., Stephens, K., Swanson-Biearman, B., Kerr, K., & Whiteman, K. (2018). Moving shift report to the bedside: An evidence-based quality improvement project. OJIN: The Online Journal of Issues in Nursing23(2).

Mitha, A. A., & Mahboob, U. (2021). Patient safety awareness and attitude among interns of a tertiary care hospital. Journal of the Pakistan Medical Association71(11), 2645-2647.

Riaz, S., Khan, E. A., & Jafar, T. (2017). Ethics in health care settings: practices of healthcare professionals and perceptions of patients regarding informed consent, confidentiality and privacy at two tertiary care hospitals of Islamabad, Pakistan. Journal of Ayub Medical College Abbottabad29(3), 472-476.

Staines, A., Amalberti, R., Berwick, D. M., Braithwaite, J., Lachman, P., & Vincent, C. A. (2021). COVID-19: patient safety and quality improvement skills to deploy during the surge. International Journal for Quality in Health Care33(1), mzaa050.

Williams, G. D., Muffly, M. K., Mendoza, J. M., Wixson, N., Leong, K., & Claure, R. E. (2017). Reporting of perioperative adverse events by pediatric anesthesiologists at a tertiary children’s hospital: targeted interventions to increase the rate of reporting. Anesthesia & Analgesia125(5), 1515-1523.

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