NURS FPX 4900 Assessment 2 Instructions: Assessing The Problem: Quality, Safety, And Cost Considerations

In a 6 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.


Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.


In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

  • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
  • Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.


Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual.

Part 2

Report on your experiences including how you presented your ideas about the health problem to the patient, family, or group.

  • Whom did you meet with?
  • What did you learn from them?
  • Comment on the evidence-based practice (EBP) documents or websites you reviewed.
  • What did you learn from that review?
  • Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
  • What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
  • Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
  • What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
  • What changes, if any, did you make to your definition of the problem, based on your discussions?
  • What might you have done differently?


The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

  • Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
  • Cite evidence that supports the stated impact.
  • Note whether the supporting evidence is consistent with what you see in your nursing practice.
  • Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
  • Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
  • Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.

Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.

  • Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
  • Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
  • Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
  • Document the time spent (your practicum hours) with these individuals or groups in the Core Elms Volunteer Experience Form.
  • Use paraphrasing and summarizing to represent ideas from external sources.
  • Apply APA style and formatting to scholarly writing.

Additional Requirements

A title page and reference page. An abstract is not required.

  • A running head on all pages.
  • Appropriate section headings.
  • Length: Your paper should be approximately 6 pages in length, not including the reference page.
  • Supporting evidence: Cite at least 6 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
  • Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
  • Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.

Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or groups in the Core Elms Volunteer Experience Form.

  • Competency 5: Analyze the impact of health policy on quality and cost of care.
  • Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
  • Competency 8: Integrate professional standards and values into practice.
  • Use paraphrasing and summarizing to represent ideas from external sources.
  • Apply APA style and formatting to scholarly writing.

Assessing The Problem: Quality, Safety, And Cost Considerations Sample Paper

Everyone desires to receive quality healthcare services, and nobody wants to settle for less. Hypertensive patients are not left behind in this quest for the need to access quality healthcare services. Several elements of care are vital for the delivery of quality healthcare services. Ratna (2019), for instance, states that quality healthcare services lead to improved patient safety and general patient welfare. Poor communication has been identified as a significant challenge and a prominent barrier to quality healthcare service access.

The quality of communication determines many aspects of healthcare and thus, acts as the foundation of care. Most of the healthcare services are patient-centered; hence achieving patient satisfaction with healthcare services is paramount. Services determining patient satisfaction include affordability of care, quality of care, personal care, diagnosis accuracy and effectiveness, and prompt checkups, among others discussed later.

Healthcare delivery involves collaboration between various professionals responsible for patient care (Ratna, 2019). Breakages of the chain of information between healthcare providers, patients, and the family can be calamitous, especially for conditions that require round-the-clock care. Interprofessional collaboration and patient involvement during their care, patient satisfaction, delivery of cost-effective care, patient safety throughout the treatment process, and the effects on the state nursing board on quality care delivery are essential factors to consider.

Communication is an issue of significant clinical concern, and effective communication is vital when educating patients and their families regarding other care areas, such as enhancing care collaboration (Spruill, Nazario & Birenbaum, 2020). As seen earlier, care collaboration results in improved patient health outcomes. Moreover, it leads to increased healthy behaviors such as drug adherence and knowledge on self-care and decreased health risk behaviors such as poor dieting in these patients living with hypertension.

Effect Of The Issue Of Health Communication On Patient Protection, Quality Of Treatment, And Expenses

Value-based personalized care is a function of good and effective communication

(Gentry & Badrinath, 2017). Existing evidence shows that the existing organizational communication culture determines the quality of care delivered to the patients. There is a positive correlation between effective communication and the quality of care delivered to the patients. Effective communication supports care collaboration leading to a more serene working environment (Spruill et al., 2020).

When individuals and their families are involved in care provision, they are more relaxed, promoting psychological wellbeing that in turn leads to better patient outcomes. On the contrary, poor communication is the leading cause of medical errors and subsequent patient mortality and morbidity (Ratna, 2019). It also causes poor care collaboration and thus poor patient outcomes. Patients who experience negative healthcare experiences tend to take longer to heal, a factor that culminates into increased overall healthcare costs.

Rosen et al. (2018) notes that building a good workplace relationship is integral in informing patient satisfaction and the quality of care delivered to the patients.

Satisfied patients tend to collaborate in care provision leading to improved patient outcomes. Additionally, a good patient-nurse relationship leads to nurses’ work satisfaction as such nurses tend to work wholeheartedly, leading to a better quality of care delivery. The healthcare workplace relationship is the foundation of the value-based healthcare equation. Thus, when nurses collaborate with other nurses and other healthcare providers, improved quality of care and errors of poor communication such as medication errors are avoided.

Hypertensive patients can greatly benefit from interprofessional collaboration and good healthcare workplace relationships due to their varying health and care challenges (Rosen et al., 2018). Patients with poorly managed hypertension often present with complications such as edema, fatigue, and inability to perform activities of daily living.

A study by Buawangpong et al. (2020) established that care collaboration between the healthcare providers, patients, and the patient’s family members can greatly improve patient health outcomes. Promoting workplace relationships and instituting a culture that supports care collaboration in a hospital would thus be vital in the care of hypertensive patients.

Adequate communication determines the costs of care, quality of treatment, and patient safety to a great extent (Ratna, 2019: Spruill et al., 2020). Availing information about certain care methods influences patient’s decisions on care strategies to adopt and, ultimately, the healthcare costs. In addition, informed patients often seek early medical care when symptoms appear, thus avoiding increased healthcare costs associated with advanced disease processes.

Poor communication, as Ratna (2019) observes, often leads to misinterpreted information, overlooked status changes, lack of crucial information, and unclear orders. Such occurrences often put the patient at risk for medical errors. Wrong dosages and sometimes wrong drugs administered to hypertensive patients may lead to comorbidities and, at times, mortalities among the hypertensive patients. Good interprofessional collaboration enhances the quality of care by expanding intervention knowledge specific to a patient’s case since different care providers intervene. Further, such collaboration also tends to factor in patient and family preferences in the decision-making process, thus improving quality of care (Buawangpong et al., 2020). Decisions made are often well thought out and improve the quality of care provided to the patients.

Report On The Practicum Hours’ Experiences

In my practicum session, I discussed with my mother for approximately two and a half hours his hypertensive state, what it means to her, how she is coping, and how she can improve her healthcare outcomes. From the discussion, I learned that hypertension as a disease is not only physiological but also psychological. Inability to perform activities of daily living sufficiently, having to rely on others, and taking drugs for the rest of one’s life is psychologically traumatizing.

Thus, as Carey et al. (2018) observe, care for hypertensive patients should be holistic, involving their spiritual and psychological well being. From the studies reviewed, hypertension emerged as a major cause of depression and mood-related disorders. Depression is associated with poor health status, treatment non-compliance, lower quality of life, and increased healthcare costs (AbuRuz, 2018). Thus, it is advisable to regularly monitor patients with hypertension for signs and symptoms of depression and other mood-related illnesses such as depression.

My mother exhibited good insight and judgment as to the existence and relevance of hypertension. She showed compliance with medications and dietary advice because her blood pressure had stabilized over the last month. The major challenge in this discussion was opening up to me as a healthcare provider and not as her child. Parents often withhold information from their children, but she finally opened it due to the perceived benefits of the undertaking in this case. The health belief model was instrumental in enhancing her collaboration.

Using the constructs of the health belief model (perceived risks, severity, susceptibility, and benefits) and explaining the importance of the activity to her using the constructs, she collaborated. Thus, we had a productive meeting. I reminded her of the benefits of exercising regularly, adhering to medications, and taking a balanced diet, aspects of living equally proposed by Carey et al. (2018) as beneficial to individuals living with hypertension. She promised to follow the advice and exhibited an eagerness to live a healthy life despite living with hypertension.

How State Board Nursing Requirements Influence The Effect Of Contact On Healthcare

The state nursing board standards vastly utilized standards in outlining the nursing scope of practice, care guidelines, nursing obligations, and issuing licenses. The Nursing Practice Act (NPA) was developed to ensure high-quality healthcare delivery. The NPA is instrumental in training and educating nurses on maintaining good workplace relationships and their importance in care delivery (Mueller et al., 2018). As seen earlier, good workplace relationships enhance care collaboration and subsequently improve the quality of healthcare. The NPA also sets licensure standards and determines the nurses’ scope of practice.

Patient safety is paramount, which is the reason why healthcare costs in mot developed countries are highly regulated to avoid the exploitation of the patients (Henry, Scholle & French, 2018). Healthcare organizations practice accountable care where nurses are responsible for providing patient-centered care at all times. Accountability breeds responsibility which leads to improved quality of care delivered to the patients. Federal laws seek to enhance quality care delivery by ensuring healthcare provider compliance to guidelines, implementation of ethical standards, and promoting healthcare systems efficiency. 

These laws, such as those regarding the quality of care and care collaboration, inform nursing care. The healthcare costs, for example, are predetermined by the federal laws designed to shield patients from exploitation. The regulations also demand that the patient and their family are involved in care provision, promoting the quality of care delivered.

Proposed Methods For Improving The Safety, Quality Of Treatment, And Cost Of Patients

Healthcare quality management is a system that reviews, tracks, and improves an organization’s healthcare service performance. The system helps optimize patients’ healthcare experiences. Every healthcare organization targets a certain percentage of healthcare transformation. Organizations should thus employ strategic policies to ensure they achieve their targets. The policies serve to improve system efficiency, cost-effectiveness and promote care consistency. To provide quality holistic care, any nurse should ensure that their knowledge and practice experiences align with current practices. Several policies, such as those highlighting quality improvement priorities, in-depth views of current challenges, change plans, and purpose, should be implemented.

Patients’ needs are dynamic, and satisfying any patient requires an in-depth understanding of their needs. For this reason, nurses should ensure that they spend most of their time interacting with their clients. They should continually develop ways to interact productively with clients. Putting patients at the center of care shall ensure that nurses deliver quality, holistic and efficient healthcare (Buawangpong et al., 2020). Also, developing policies that wholly support the inclusion of the patient and family members in care provision should be implemented to enhance the quality of services delivered to patients.


As discussed in this paper, every patient desires to receive the best quality of care. It is also the desire of every healthcare organization to provide the best quality of care to their patients. The government and other legislative bodies are key players in informing the quality of care delivered to the patients.

Consequently, Healthcare organizations should ensure they comply with the set standards and regulations to maintain high levels of performance. As shown in this discussion, patient involvement in care and interprofessional collaboration are integral parts of patient care that contemporary health practitioners need to embrace.


  • AbuRuz M. E. (2018). Anxiety and depression predicted quality of life among patients with heart failure. Journal Of Multidisciplinary Healthcare, 11, 367–373.
  • Buawangpong, N., Pinyopornpanish, K., Jiraporncharoen, W., Dejkriengkraikul, N., Sagulkoo, P., Pateekhum, C., & Angkurawaranon, C. (2020). Incorporating the patient-centered approach into clinical practice helps improve quality of care in cases of hypertension: a retrospective cohort study. BMC Family Practice, 21(1), 1-8.
  • Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and control of hypertension: JACC health promotion series. Journal of the American College of Cardiology, 72(11), 1278-1293.
  • Gentry, S., & Badrinath, P. (2017). Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems. Cureus, 9(3), e1079.
  • Henry, M., Scholle, H. S., & French, J. B. (2018). Accountability for the quality of care provided to people with serious illnesses. Journal of Palliative Medicine, 21(S2), S-68.
  • Mueller, C., Duan, Y., Vogelsmeier, A., Anderson, R., McConnell, E., & Corazzini, K. (2018). Interchangeability of licensed nurses in nursing homes: Perspectives of directors of nursing. Nursing Outlook, 66(6), 560-569.
  • Ratna, H. (2019). The importance of effective communication in healthcare practice. Harvard Public Health Review, 23, 1-6.
  • Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4),433.
  • Spruill, T., Nazario, S. & Birenbaum, D. S. (2020). Interpersonal and communication skills and professionalism are the competencies most often noted in emergency medicine physicians judged as exemplary by their peers. Journal of Communication in Healthcare, (), 1–8. doi:10.1080/17538068.2020.1748476