NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

Hypertension Effect on Quality, Safety, And Costs

Hypertension is a multifaceted, long-term health problem. It need intervention throughout one’s life. Hypertension has been linked to a burden on the patient’s social, economical, and personal life events (Alqenae et al., 2020). As a chronic hypertensive, John takes a variety of drugs. Hypertension was escalating into heart and stroke problems. According to the research, failing to meet the glycemic target set by the National Standard Guidelines for Hypertension Management has increased the risk of complications in Hypertension. The most common are vascular problems, which increase the cost on the health-care system while reducing the patient’s quality of life (Bryant et al., 2021). According to the research, hypertensives are at a higher risk of heart failure and cardiovascular disease globally. He noted several hospitalizations owing to elevated glucose load and hypertension throughout the 2-hour practicum. He had been hospitalized twice in the previous month for chest discomfort and hypertension. Complications were growing as a result of the patient’s inadequate condition treatment. Hypertension with complications is frequently found, with a high probability of rehospitalization (Bryant et al., 2021). 

The numerous types of drugs were perplexing for John, and the staff at the hospital also gave him hydrochlorothiazide twice since the second shift nurse was unaware of the earlier dose. The nurse neglected to include the excessive salt level on the chart. Nurses’ poor communication frequently leads to patient-centered medication mistakes, which can be fatal if left unchecked. At the time of admission and release, primary health care units had the greatest rate of medication mistakes in Hypertension patients (Chen et al., 2018). Medication errors impact 16 to 27 percent of all nursing home residents, according to a study published in the Journal of the American Geriatrics Society. While drug-related deaths are infrequent, serious repercussions are possible. The most common cause of medication errors is poor communication between your providers. There is a communication gap between you and your docter.  

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

Multiple drugs for the management of his current illness, which included heart symptoms, necessitated a significant financial outlay. He was using beta-blockers, had a high salt level, and was taking hypoglycemic oral medications. He frequently had to purchase the glucose strips that are necessary everyday for normal glucose tests. There were no negative interactions or side effects with the drug. After two hospitalizations, he needed to see a cardiologist for chest symptoms in the previous month. He was concerned about his problems. He had to pay the financial bills himself because he did not have insurance. The expenses of chronic illness are expensive. Hypertension management necessitates a multifaceted investment in medicine, diet type, and care dependency. The US gathimed data projected yearly expenses of $327 in 2017, invested in the direct prescription costs of Hypertension (American Heart Association, 2018). John was also financially insecure as a result of a large number of prescription charges, which caused him to frequently fail to take dosages at regular intervals. He had no insurance to afford his pharmaceutical costs. Cost-related non-adherence is common in hypertensives; these cost-related difficulties have a detrimental health impact. It has been observed that half of all diagnosed hypertensives suffer from financial insecurity. While one-fifth of those polled claimed food hardship and financial insecurity (Alqenae et al., 2020). The expenditures of hypertension care place a financial strain on patients’ families and health-care measures. It also lowers drug adherence, exacerbates Hypertension symptoms, and leads to poor Hypertension treatment (Bryant et al., 2021). 

I’ve encountered numerous hypertensives in my hospital nursing practice who are anxious about the price of medicine and visit charges. The majority of them had no insurance and had to pay out of their own pockets. After discussing the patient’s concerns regarding expenses and safety with my nurse manager, He had an episode on his previous hospital visit and still required the services of a cardiologist. The nurse manager explained the national and international policies that I can apply to improve the provision of hypertension treatment. The nurse manager also emphasized the insurance and financial assistance programs available to Hypertension patients. 

Evidence-Based Role of Nursing Board and Organizations in Quality, Safety, and Cost 

The introduction of a Hypertension Self-Management Education (HSME) program has been shown to enhance patients’ overall health outcomes in group settings and using a patient-centered approach. It also enhances nurse education and expertise in hypertension care (Chen et al., 2018). The HSMES paradigm supports skill development, knowledge acquisition, and ability development in order to improve patient care. It also includes favorable behavioral improvements in patients, such as medication adherence, exercise augmentation, and nutrition restriction (Tariq et al., 2020). The use of technology into the HSMES model expands the reach of the care program to nurses as well as patients. The self-management program has been successful in terms of intervention implementation and health outcome monitoring. Education’s function in hypertension is viewed as an intervention based on knowledge-based compliance and a patient-centered approach. It gives the patient the ability to make adjustments for better health results (Alqenae et al., 2020). The adoption of the HSMES program will give nurses with financial and non-financial resources for Hypertension care management training. The program teaches nurses about hypertension treatment recommendations in a multi-sectoral setting under professional supervision (Tariq et al., 2020). Nurses will eventually be able to deliver instructional recommendations to patients as well as practice Hypertension control practices in the hospital care setting.

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

The HSMES program’s cost-effectiveness implementation promotes medication adherence and lowers pharmaceutical costs in Hypertension patients (Chen et al., 2018). The regulations developed by the government to regulate national insurance firms in order to manage the health expenditures for Hypertension equipment, prescriptions, and treatment consultation. Hypertension management necessitates a multifaceted intervention and strategy at both the individual and organizational levels. Care stakeholders, nurses, and health care organizations are accountable for providing safe and high-quality health care (Chen et al., 2018). It lowers clinical risk factors and associated expenditures. 

These National Standards and Guidelines from the NHA will offer a trained workforce of nurse hypertension educators to address the health challenges of hypertensive patients (Lawler et al., 2019). The interaction of interdisciplinary teams will deliver patient-related results and foster a healthy working environment in primary health care settings (Ihm et al., 2019). Hypertensive rehospitalization rates will be reduced if hypertension management therapy is properly addressed. It will also save the person and the organization money on rehospitalizations (Chen et al., 2019). Nurse education and skill development will minimize prescription mistakes and the related health-care expenditures (Ihm et al., 2020).

Hypertensives require an integrated thimapeutic approach to hypertension therapy, which includes nutrition and dietary regimen changes. Nurses’ understanding of hypertension nutrition recommendations is limited. Dietary adjustments recommended by the NHA are not well known among nurses. The availability of time to learn about guidelines, new apps, and attend courses has been proven to favorably link with nurses’ understanding of Hypertension care in health care units (Alqenae et al., 2020). In basic health care settings, nurses’ expertise of hypertension management was also found to be lacking.

The utilization of telehealth and technology-based Hypertension care management tools is restricted in hospital care settings due to a lack of technological competence among nurses. In modern health practices, opinions of conventional high salt level administration and glucose monitoring have shifted. The general acceptance of virtual remote monitoring of hypertension has been hampered by a lack of suitable training and instruction, as well as a nurse’s unwillingness to learn. Long working hours and shifts have also been linked to an increase in stress (Bress et al., 2017).

The patient’s own lack of education was the biggest impediment to the adoption of hypertension-centered treatment. John was not aware of the basic rules and related criteria for assessing his health. He was also unaware of any financial assistance programs for Hypertension treatment. To make him aware of the impending change in regimen, I discussed the potential risks of cardiovascular consequences and worldwide Hypertension prevalence. He also managed the shared viewpoint and vision of his existing health’s prospective health outcomes efficiently.

Hypertension and its exacerbated consequences place a significant burden on chronic illness. Its incidence is rising as a result of patients’ poor adherence to hypertension control strategies, an increase in medication mistakes in hospitals, and a failure to address post-discharge recommendations for long-term illness care. It is compromising the safety and quality of health-care delivery in health-care institutions. Furthermore, the entire expenditures of the disorders in terms of care and diagnosis place a strain on the patient’s financial situation. The health-care system is likewise plagued by a high prevalence of hypertension and a scarcity of trained instructors.

Strategies to Improve Quality, Safety, and Cost 

Improving the quality, safety, and affordability of hypertension care necessitates the application of the American Hypertension Association’s National Standard Guidelines. It necessitates the control of blood glucose levels within a specified range as well as adherence to dietary changes. The multidisciplinary team can assist in achieving the guidelines’ objectives. The International Hypertension Federation produced HbA1C management recommendations, with a target range of 7.0 percent established (Bress et al., 2017). Maintaining a normal blood pressure range should be the goal of all hypertension care, including self-care and primary care. (Flack et al., 2020). The National Heart Association suggests lowering cholesterol levels by consuming healthy fats and avoiding bad fats and oils (NHA, 2020). Individuals’ health care expenditures can be reduced by insuring their equipment, sphygomonometers, and medications, particularly those with high salt levels. 

In primary hospital care settings, organizational culture is critical for providing safe, efficient, and high-quality treatment. Education training and skilled workforce recruiting provided by businesses and administration can improve safe care practices. Increasing coordination among health-care workers and using an interdisciplinary approach to tackling health-care issues help to reduce drug mistakes in hospitals and other settings. It also improves drug administration and adherence habits after discharge (McGill et al., 2017). The Hypertension indicators must be maintained by a team of physicians, nurses, and nutritionists. Because of the long-term therapy consequences, hypertensives have acknowledged telemedicine as trustworthy among hypertensives (Constanti et al., 2021).  

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations JJ

Modernized technology, up-to-date pharmaceutical information, and optimum health care provisions are all lacking in present nursing procedures. The educational courses can improve nurses’ understanding of hypertension therapy in a multisectoral approach integrating dietary, pharmacological, and lifestyle improvements. Professional educational programs involving NHA recommendations implementation in primary health care settings have been shown to increase overall nurse performance, knowledge, and attitude (Bress et al., 2017).

Following John’s description of the practicum questions, I explained his current health situation, as reviewed with my nurse manager. Throughout the session, he was really helpful and trustworthy. I defined the essence of hypertension care to him as dietary adjustments, medication adherence, and blood pressure monitoring. He was willing to make an attempt to improve his health. He also considered purchasing financial Hypertension insurance, equipment, and medicine. The poor state of the worsened consequences of hypertension, such as chest discomfort and hypertension, might be fatal, leading to stroke. Hypertensives with hypertension and cardiovascular consequences are frequently found to be at increased risk of stroke. It was a frightening moment to adjust the routine and achieve personal health benefits. 

The utilization of some technologies, like as telemedicine, can help to reduce the high costs of the health care system and Hypertension care. The use of telehealth in Hypertension patients for glucose monitoring and high sodium level delivery has been shown to enhance glycemic management. The instruction can be delivered through videoconference or phone by a qualified hypertension nurse. The relevant findings were noteworthy in terms of lowering hypertension distress, improving glucose monitoring, quality of life, and patient satisfaction (Hammoudi et al., 2018).

Telemedicine has been demonstrated to be beneficial for people suffering from chronic diseases. It aids in the long-term illness management of chronic patients, resulting in better results and lower healthcare expenditures. Telemedicine and quality of care (QoC) have proven to be useful for hypertensive patients. It dramatically decreased blood pressure by 10.4/4.8 mm/Hg and improved glycemic control. A high level of engagement was seen between nurses and patients, which resulted in greater medication adherence and self-efficacy (Bress et al., 2017).

The involvement of Hypertension Nurse Specialists (HNS) in primary and community-based health care settings improves patient-centered health outcomes. HNS plays an integrated role in hypertension management by engaging with physicians and organizational stakeholders. The nurse-led hypertension clinic offers professionals with assistance and education on excellent care (Bress et al., 2017). The HNS implementation challenges a number of regional structural and service concerns that must be addressed.


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.

Bryant, K. B., Moran, A. E., Kazi, D. S., Zhang, Y., Penko, J., Ruiz-Negrón, N., … & Bellows, B. K. (2021). Cost-effectiveness of hypertension treatment by pharmacists in black barbershops. Circulation143(24), 2384-2394.

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Chen, T., Chen, J., Chen, C., Zheng, H., Chen, Y., Liu, M., & Zheng, B. (2020). Systematic review and cost‐effectiveness of bosentan and sildenafil as therapeutic drugs for pediatric pulmonary arterial hypertension. Pediatric Pulmonology.

Constanti, M., Floyd, C. N., Glover, M., Boffa, R., Wierzbicki, A. S., & McManus, R. J. (2021). Cost-Effectiveness of Initiating Pharmacological Treatment in Stage One Hypertension Based on 10-Year Cardiovascular Disease Risk: A Markov Modeling Study. Hypertension77(2), 682-691.

Flack, J. M., & Adekola, B. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in cardiovascular medicine30(3), 160-164.

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences32(3), 1038-1046.

Ihm, S. H., Bakris, G., Sakuma, I., Sohn, I. S., & Koh, K. K. (2019). Controversies in the 2017 ACC/AHA Hypertension Guidelines: Who Can Be Eligible for Treatments Under the New Guidelines?―An Asian Perspective―. Circulation Journal83(3), 504-510.

Tariq, R. A., Vashisht, R., & Scherbak, Y. (2020). Medication errors. StatPearls [Internet].

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