Quality, Safety, and Cost Considerations

Topic: Healthcare Research
Words: 1494 Pages: 20

Hypertension is a significant health concern, especially in developed countries like the USA. According to Al Khodor et al. (2017), 1.3 billion people are affected by the condition globally. In the United States alone, approximately 30% of the adults, 75 million, are hypertensive. The prevalence of obesity in the USA is around 18%, and the condition has already affected 13 million children and adolescents. There is a high correlation between obesity and hypertension, but not all obese kids and adolescents are hypertensive. Hypertension affects the quality of care provided to patients, their safety, and the costs incurred by these patients and their families.

Globally, hypertension is among the leading causes of death among people. Egan et al. (2019) showed that in 2016, the deaths because of non-communicable diseases accounted for around 41 million global deaths. They linked approximately 18 million of these deaths to cardiovascular diseases, with hypertension the leading cause. Examining the condition’s risk factors requires a careful clinical approach from the health care provider, which entails adherence to the stipulated clinical guidelines and monitoring the patient’s behavior. Monitoring the patient’s behavior entails creating awareness about the condition, monitoring the lifestyle and medication, and practitioners’ follow-up.

Various hindrances affect the quality of care given to hypertensive patients. According to Omboni (2019), a patient’s failure to adhere to the intended therapeutic plans dramatically affects the quality of healthcare services that hypertensive patients get. Poor economic background and low levels of education may cause failure to comply with the medication. Some patients, out of ignorance, tend not to adhere to the set antihypertensive medications, affecting the quality of care.

Clark et al. (2010), in a systemic review and meta-analysis study, showed that nurse-led interventions in hypertension management are essential in hypertension management. Still, sufficient evidence lacks to demonstrate the widespread use of nurses in high blood pressure management. Thus, it shows that many nurses globally are not updated with incorporating nursing practice in hypertension management, which is a barrier to global hypertension control.

Challenges in lifestyle behavior modification by hypertensive individuals affect the quality of care they receive. Buda et al. (2017) conducted a study on hypertensive patients’ behavior modification and established that only about 27% changed their lifestyles. It is a meager number considering the severity of the condition, and thus it shows how difficult it is for people to alter their mode of life. Fisher and Curfman (2018) also proved that lifestyle modifications among individuals are challenging to implement and endure. The quality of care these hypertensives receive thus declines because of the above factors. Concepts related to hypertensive care patient management stress the significance of consulting the patient and offering the right advice on good clinical care.

Various barrier factors to patient safety can affect an individual diagnosed with hypertension. Such barriers include low education status, ineffective communication, and the absence of collaborative teamwork among the nurses. Tang et al. (2017) demonstrated through their study on junior health care practitioners that effective team collaboration improves the care a patient is given. Interprofessional teamwork helps in enhancing the patient’s satisfaction, and thus, the patient feels safer in such an environment. The practitioners work in unison to ensure that the hypertensive individual recovers from her condition.

The nursing practice needs to stress intercourse collaboration in practice to improve patients’ clinical safety. The study also showed that effective communication between the nurses and physicians needs to occur to help the nurses carry out effective treatment in the desired order. Guidance from the physicians and senior nurses to junior nurses plays a vital role in ensuring that they carry out clinical practice in the designated manner.

Research has established that lack of education links to a greater risk of incurring medical errors. In their study, Wu and Busch (2019) found that lack of basic knowledge skills in health care organizations plays a significant role in hindering patient safety. Hypertensive patients need to be accorded the proper education concerning antihypertensive medication, follow-up care, lifestyle change, and resources available. As a nurse, failure to educate the patient is likely to worsen the hypertensive state, leading to heart failure ultimately.

The practitioner’s engagement with the caregivers and the patients is essential in improving the patient’s safety. Karaca and Durna (2019) claimed that nurses should explain their diagnosis, illnesses, treatment to improve the patient’s satisfaction and safety within the clinical setting. The study also stated that nurses should be courteous towards their clients and effectively communicate to improve their safety. Effective communication improves the quality of health care offered to hypertensive individuals. Jo Delaney (2018) demonstrated that incorporating patient-centered care by the nurses helps boost the quality of health provided at minimized costs. The patient-centered approach improves patient safety, as care is individualized for the hypertensive individual.

Hypertension patients and the nation incur high costs annually in managing the condition. Wang et al. (2017) documented that the indirect costs of hypertension management in the USA were approximately $27. billion in 2015, while the direct medical expenses amounted to roughly $91 billion. These are substantial financial costs imposed on a nation that would have otherwise been diverted to other economic activities.

Additionally, the study showed that hypertension-related complications, such as stroke, impose more financial costs in seeking treatment on the government and patients. Kirkland et al. (2018) showed that hypertensive patients incur a charge of over $9000 annually seeking medication. The study also established that hypertensive patients incur about $1900 more treatment cost annually than those without the disease. The research also proved that the nation suffers an approximately $130 billion budget in managing the condition.

Improving health care costs in hypertension entails the improvement of prevention, diagnosis, evaluation, and management. Bakker et al. (2018) identified that regular physical exercise reduces the chance of hypertension in healthy individuals. This prevention strategy prevents hypertension onset, thus reducing the costs a nation and an individual would incur to manage and treat the condition.

Drowos (2019) also identified that maintaining blood pressure in a healthy zone reduces health care costs. It can be done through regular exercising, avoiding alcohol intake, and practicing a healthy diet. Starting community-based programs and diverting resources early enough helps reduce the costs incurred by a nation in controlling the condition. Schwalm et al. (2019) established that these community-based programs sensitize the public, thus reducing the nation’s costs in the condition’s control. Addressing the barriers and factors that influence the management of the illness would significantly improve expenses. Improving hypertensive patients’ access to resources, support, and education improves their adherence to medication intake (Etminani et al., 2020).

The existing government’s health policies directly affect hypertensive patients. Huguet et al. (2021) showed that since its initiation, the Affordable Care Act (ACA)has positively impacted the lives of hypertensives. The former USA president Barack Obama signed the policy into law in 2010. Huguet et al.’s (2021) research dictated that there has been a decrease in undiagnosed hypertension after the signing of the act. The study also showed that patients who received the insurance had experienced a drastic reduction of undiagnosed hypertension. There were about 15% cases, while in 2012 to 6% in 2017. In this period, hypertensives also had access to antihypertensive medications.

The ACA has effectively eliminated health inequalities in the USA and provided equal access to health care for a vast population. The marginalized racial and ethnic groups have access to medical insurance at an affordable cost. The patients who did not earlier have proper health care access; has improved diagnosis, adequate follow-up care, adherence to the medical instructions, and quicker modification lifestyle behavior practices.

To assess this problem, I spoke to Mrs. Josephine Carly, a 71-year-old hypertensive patient. In discussing the obstacles she experienced, I learned that hypertension, education, financial burden, and resistance to lifestyle modification hindered her condition management. I approached her and inquired if she was ready to alter her lifestyle practices. Through showed a willingness to change to improve her life. She stated she felt like a different patient when the doctor was diagnosing her condition. I realized that ineffective communication and a lower level of education affected proper disease management.

I discussed with her leadership strategies to improve her outcome. She was pleased with it and stated that she would manage her condition better if she had proper guidelines. I implemented patient-centered care in my discussions with her, and she felt capable of handling the situation. In her treatment plan, she stated several barriers that were hindering her treatment plan. I explained to her how to overcome those barriers. After six weeks of weekly discussions, she agreed to start the intervention programs and reaffirmed that my meeting with her had intensified the need for the problem’s solution.

Patient-centered care, interprofessional teamwork, and expansion of the nurse’s role in hypertensive care improve the quality of health offered to patients. Developing a patient-centered care approach among the patients meets the patient’s needs. Educating the patient on adherence to medication and lifestyle practices improves the quality of health received.


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Contribution of Friedrich Schlemm
The Indiana State University Physician Assistant Program