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

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Capella university

NURS-FPX 4900 Capstone project for Nursing

Prof. Name

Date

Assessing the Problem: Quality, Safety, and Cost Considerations

Alcohol Use Disorder (AUD), commonly referred to as alcoholism, involves the excessive consumption of alcohol over an extended period. Alcoholism primarily impacts the brain, liver, and heart, causing issues such as cirrhosis and heightened infection risk. It results in approximately three million fatalities and 131 million disability-adjusted life years annually (Boschuetz & German, 2023). This paper aims to assess Henry’s alcoholism, a 38-year-old former smoker, and its impact on his family, who also struggle with alcohol addiction. Henry’s smoking history increases his health risks, such as respiratory issues, cancer susceptibility, and heart problems, impacting the quality of care, safety, and costs. Practical strategies will be developed for Henry and his family’s care plan to address these critical factors in his life.

Problem’s Effect on Care Quality, Patient Safety, and Care Costs

AUD is a significant factor in illness and death globally, affecting over 150 ailments and damage results. The World Health Organization (WHO) reports that 2.5 billion individuals currently consume alcohol, with around 1 billion classified as heavy episodic drinkers (Liu et al., 2021). It demands psychological, physical, and financial resources to address AUD and its outcomes on individual health. Henry’s experience includes withdrawal tremors, insomnia, and mood swings, exerting a profound influence on his well-being. His condition not only compromises his care, safety, and economic stability but extends these challenges to impact his family. For example, Henry’s alcoholism has caused financial strain on his family and emotional distress, affecting his children’s academic performance and psychological well-being.

Effect on Care Quality

Henry’s alcoholism significantly influences the quality of care. Initially, his AUD-related health concerns, such as uncertainties about liver disease and heart problems, impede his ability to participate in his healthcare actively. Consequently, following treatment plans, Cognitive Behavioral Therapy (CBT), addressing his drinking triggers and coping strategies, and seeking support becomes challenging (Kang & Kim, 2021).

Healthcare providers encounter obstacles in delivering tailored, high-quality care to meet Henry’s specific needs due to the complexities associated with managing AUD. Developing and implementing personalized care plans involving behavioral therapies, lifestyle modifications, exercise, and nutrition strategies require additional time and resources. Furthermore, the emotional distress and societal stigma faced by Henry and his family negatively impact the quality of care. Opposing thoughts and partialities from healthcare providers result in poor communication, weakened trust, and a lack of patient-centered care (Kang & Kim, 2021).

Effect on Patient Safety

AUD stems from various factors and often requires a multifaceted approach to address physical and mental health. Excessive alcohol consumption can lead to neurological dysfunction, depression, sleep deprivation, and reduced productivity, all of which contribute to several patient-associated risks (Ahn et al., 2021). These risks include medication management challenges, the potential for relapse, and social safety concerns. Henry’s AUD heightens these risks due to non-adherence with alcohol, which can lead to adverse events. The likelihood of relapse and harm from triggering situations in relationships increases the risk of accidents and broken family bonds (Kurihara et al., 2023). These factors threaten Henry’s and his family’s well-being and potentially cause severe health complications.

Effect on Care Costs

Alcoholism imposes financial strain in various ways. Recent research data suggests that excessive alcohol consumption incurs $28.2 billion in medical spending due to AUD-associated health conditions (Ozluk et al., 2022). For instance, AUD elevates healthcare costs through increased utilization, productivity losses, and the need for long-term care and support, resulting in excessive expenses. Henry’s alcoholism leads to increased expenses through frequent emergency room visits, alcohol-related complications, and the need for addiction treatment services (Macmurdo et al., 2021).

Additionally, AUD impairs Henry’s ability to work due to health challenges and absenteeism, leading to economic strain for Henry. Henry requires long-term rehabilitation without effective intervention, leading to sustained costs for healthcare providers, insurers, and individuals (Ozluk et al., 2022). These factors significantly burden Henry and his family, affecting their well-being, financial stability, and overall quality of life.

State Board of Nursing Practice Standards

The American Nurses Association (ANA) plays a crucial role in addressing AUD by advocating for evidence-based practices, patient-centered care, and interdisciplinary collaboration among healthcare experts. Through its standards and guidelines, the ANA ensures that nurses are well-prepared to deliver tailored and comprehensive care to individuals like Henry, who are affected by AUD. By upholding ethical principles outlined in its code of ethics, the ANA promotes positive treatment outcomes, prioritizing quality of life, safety, and cost-effectiveness (ANA, n.d.).

Henry’s journey toward recovery benefits from healthcare providers who are knowledgeable, skilled, and adhere to these care standards. Henry’s recovery benefits from the ANA guidelines fostering a healthcare environment, empowering him to overcome alcoholism with compassion and understanding.Similarly, various organizational policies, including those relevant to Henry, ensure enhanced and economically efficient care for individuals affected by AUD. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes sources, guidelines, and financial support for alcoholism treatment programs, including AUD, enhancing patient safety and facilitating access to evidence-based interventions (SAMHSA, 2020).

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

Additionally, the Centers for Disease Control and Prevention (CDC) emphasizes community well-being strategies, preventive measures, and data collection related to AUD, aiming to minimize harm and enhance safety (CDC, 2022). Moreover, the Food and Drug Administration (FDA) ensures patient safety and approves medications for effective AUD management for Henry and his family (Mason, 2021).Furthermore, various governmental policies contribute significantly to effectively managing AUD for individuals like Henry. For instance, the Mental Health Parity and Addiction Equity Act (MHPAEA) ensures financial aid for psychological issues, including AUD coverage for other health conditions (CMS, 2023). This legislation prohibits discriminatory practices in insurance coverage, promoting equality and impartiality.

The Affordable Care Act (ACA) also covers screening, treatment, and medical expenditures associated with AUD, offering financial security and increasing access to primary care and preventive services. The ACA’s provisions contribute to reducing the risk of mortality by facilitating timely and routine care provision (Olfson et al., 2021). The MHPAEA and ACA policies ensure that Henry and his family receive unbiased and cost-effective care as he navigates his journey toward managing AUD.

Policy Impacts on Nursing Scope of Practice

Organizations and policies significantly shape the landscape of nursing practice across all levels, delineating nurses’ roles, duties, and permissible actions within healthcare settings. These frameworks define nurses’ legal and ethical parameters, empowering them to enact suitable interventions. Moreover, policies about nursing education play a pivotal role in equipping nurses with the skills and proficiencies necessary to navigate evolving healthcare landscapes (Nehring et al., 2021).

These policies facilitate specialized training for addressing health issues like AUD in patients (Henry), encompassing a range of approaches, including pharmacotherapy, counseling, behavioral therapy, and relapse prevention strategies. Encouraging interdisciplinary collaboration, these policies foster seamless and coordinated care delivery with the invaluable support of nurses. Nurses play a critical role in implementing evidence-based, personalized care within ethical confines, ultimately benefiting patients and hospitals (ANA, n.d.).

Strategies to Improve the Quality of Care for Patient

The most important approach for managing AUD is presenting a combination of physical and mental treatment proposals. Drawing from Henry’s case and scientific research on AUD, a multifaceted approach to effective alcoholism management is planned. Embracing evidence-based pharmacotherapies such as naltrexone and acamprosate can significantly aid in managing alcoholism by curbing cravings and enhancing mood (Mason, 2021). Additionally, incorporating behavioral therapies like CBT and mindfulness techniques promotes well-being and supports recovery efforts, fostering a holistic approach to treatment. Both pharmacotherapy and CBT have demonstrated efficacy in treating AUD and equipping patients with coping skills, stress management techniques, and trigger identification for fostering healthier habits (Mason, 2021).

Personalized care plans tailored to individuals with comorbid health conditions, like Henry, are crucial for addressing specific needs, preferences, and social determinants of health, maximizing engagement and outcomes. Interdisciplinary collaboration among healthcare providers, including nurses, psychiatrists, and physicians, is essential in crafting holistic care plans and delivering comprehensive support to both Henry and his family (Kools et al., 2022).

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

Through the integration of varied expertise, the team guarantees comprehensive assistance, attending to medical provisions and societal impacts and enhancing outcomes for Henry. Research indicates that such collaborative approaches improve health outcomes, reduce errors, and improve treatment adherence (Kools et al., 2022). Empowering patients like Henry and his family with education on self-management strategies, healthy lifestyle choices, and mindfulness techniques enables them to manage their condition effectively.

 Integrating Electronic Health Records (EHR) into treatment plans facilitates targeted, collaborative, and follow-up care, allowing for continuous monitoring of health, symptoms, and progress. Furthermore, leveraging telemedicine for remote monitoring and consultations can reduce costs for Henry’s family and healthcare organizations while enhancing alcoholism management and alleviating financial burdens. Additionally, EHR integration and telemedicine utilization streamline healthcare delivery, improving accessibility and efficacy in alcoholism treatment (Metz et al., 2022).

The CDC is a benchmark for AUD management. The effectiveness of these strategies can reliably be evaluated by assessing them against organizational benchmarks, such as those established by the CDC. The CDC’s initiatives, including awareness campaigns, policy support, and community collaboration, serve as benchmarks for AUD management. CDC’s inclusive approach to AUD management incorporates behavioral therapy, enriching interventions, and addressing psychological aspects for sustained recovery from AUD (CDC, 2024). Henry and his family’s daily monitoring and patient feedback contribute to ongoing assessment and improvement efforts.

Part Two

Documentation of Practicum Hours

The documentation of the two practicum hours involves engaging with the patient, Henry, to develop and implement targeted strategies to enhance health outcomes and reduce costs. Successfully implementing evidence-based pharmacotherapies and CBT was made possible through consultation with Henry, with a collaborative healthcare approach involving his family in the agreed-upon treatment plan. In discussions with Henry and his family, I covered insurance possibilities, including MHPAEA and ACA, which aim to optimize health outcomes while easing financial burdens. These hours have significantly improved my comprehension of AUD management and underscored the crucial role of interdisciplinary collaboration and communication.

Conclusion

The paper assesses the impact of AUD on Henry, a 38-year-old former smoker, and his family, addressing care quality, patient safety, and costs. Strategies involve evidence-based treatments, interdisciplinary collaboration, and policy adherence. The multifaceted approach integrates pharmacotherapies, behavioral therapies, and personalized care plans to address Henry’s complex needs. Adherence to policy frameworks, such as the ACA and MHPAEA, ensures equitable and cost-effective care delivery for individuals affected by AUD.

References

Ahn, S., Choi, Y., Choi, W., Jo, Y. T., Kim, H., Lee, J., & Joo, S. W. (2021). Effects of comorbid alcohol use disorder on the clinical outcomes of first-episode schizophrenia: A nationwide population-based study. Annals of General Psychiatry, 20(1). https://doi.org/10.1186/s12991-021-00353-3 

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Boschuetz, N., & German, M. N. (2023). Alcohol use disorder: Recognition, testing, and initial management strategies. Clinical Liver Disease, 22(1), 18–22. https://doi.org/10.1097/cld.0000000000000062 

CDC. (2022, July 11). Excessive alcohol use. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/alcohol.htm#:~:text=CDC%20collects%20data%20that%20states 

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

CDC. (2024, May 15). Alcohol use. Alcohol Use. https://www.cdc.gov/alcohol/index.html

CMS. (2023, September 6). The Mental Health Parity and Addiction Equity Act (MHPAEA. Www.cms.gov. https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity 

Kang, K., & Kim, S. (2021). The efficacy of motivational interviewing with cognitive behavioral treatment on behavior changes in heavy drinkers. Sustainability, 13(3), 1338. https://doi.org/10.3390/su13031338

Kools, N., Dekker, G. G., Kaijen, B. A. P., Meijboom, B. R., Bovens, R. H. L. M., & Rozema, A. D. (2022). Interdisciplinary collaboration in the treatment of alcohol use disorders in a general hospital department: A mixed-method study. Substance Abuse Treatment, Prevention, and Policy, 17(1). https://doi.org/10.1186/s13011-022-00486-y 

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Macmurdo, M., Lopez, R., Udeh, B. L., & Zein, J. (2021). Alcohol use disorder and healthcare utilization in patients with chronic asthma and obstructive lung disease. Alcohol. https://doi.org/10.1016/j.alcohol.2021.03.002 

Mason, B. (2021). Alcohol use disorder: The role of medication in recovery. Alcohol Research: Current Reviews, 41(1). https://doi.org/10.35946/arcr.v41.1.07 

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

Metz, V. E., Leibowitz, A., Satre, D. D., Parthasarathy, S., Jackson-Morris, M., Cocohoba, J., & Sterling, S. A. (2022). Effectiveness of a pharmacist-delivered primary care telemedicine intervention to increase access to pharmacotherapy and specialty treatment for alcohol use problems: Protocol for the alcohol telemedicine consult cluster-randomized pragmatic trial. Contemporary Clinical Trials, 123, 107004. https://doi.org/10.1016/j.cct.2022.107004

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Olfson, M., Wall, M. M., Barry, C. L., Mauro, C., Choi, C. J., & Mojtabai, R. (2021). Effects of the ACA on health care coverage for adults with substance use Disorders. Psychiatric Services, 72(8), 905–911. https://doi.org/10.1176/appi.ps.202000377

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