NR 505 Week 3 Quality Healthcare Nursing Practice Performance Paper

Purpose

The purpose of this assignment is to have students research the measurement tools of NP performance.  Through the use of quality patient outcomes, student will list and discuss three different patient interventions and how they would specifically measure the outcomes and h o w these primary care interventions result in improved patient outcomes and cost savings for the practice.  In addition, students will discuss how these interventions result in improved patient ratings.

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Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

1. Employ strategies to impact the development, implementation, and consequences of holistic healthcare policies using evidence-based practice principles (CO1)
2. Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
3. Demonstrate professional and personal growth concerning the advocacy role of the advanced practice nursing in fostering policy within diverse healthcare settings (CO3)
4. Analyze social, historical, ethical and political contexts of healthcare policies and advanced practice leadership (CO4)
5. Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO5)

Requirements:

The National Committee for Quality Assurance (NCQA) was formed to ensure quality of patient care and measurement of patient outcomes with set standards.

Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:

1. Effectiveness of Care.
2. Access/Availability of Care.
3. Experience of Care.
4. Utilization and Risk Adjusted Utilization.
5. Health Plan Descriptive Information.
6. Measures Collected Using Electronic Clinical Data Systems

You may access the 6 domains of care by clicking this link:

HEDIS

(NCQA, n.d. https://www.ncqa.org/hedis)

As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients and has a method of measuring quality of care.

Write a formal paper in APA format with title page, introduction, the four required elements below, conclusion and reference page.

1. You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal and Postpartum care, etc.
2. Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.
3. How would these primary care interventions result in improved patient outcomes and health care cost savings?
4. How can these interventions result in improved NP patient ratings?

Category	Points	%	Description
List and discuss three different patient interventions and how you would specifically measure the outcomes.	60	30%	From the National Committee for Quality Assurance (NCQA) website, discuss three patient interventions for the one performance measure. Develop a measurement tool to track patient outcomes.
How would these primary care interventions result in improved patient outcomes and cost savings for the practice?	60	30%	Discuss how the interventions can result in improved patient outcomes and cost savings for the practice.
How can these interventions result in improved patient ratings?	60	30%	Discuss how these interventions can result in improved patient ratings (an NP’s patient scorecard).

NR 505 Week 3 Quality Healthcare Nursing Practice Performance Sample

Policy and Leadership

High blood pressure (hypertension) is the leading cause of the increased risk of heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC, 2021), heart disease and stroke are the leading causes of mortality in the United States. For instance, hypertension is the principal causal factor for more than 500000 deaths in the United States in 2019. Further, hypertension-related ramifications like the increased prevalence of heart disease and stroke cost the country about $131 billion each year. As a result, controlling high blood pressure emerges as a profound measure of the care effectiveness domain. While effective hypertension management signifies effective and quality care, this paper expounds on three patient interventions for preventing and managing high blood pressure, strategies for measuring outcomes, how these interventions result in improved patient outcomes and healthcare cost savings, and how they result in improved NP patient ratings.

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Three Patient Interventions for Addressing High Blood Pressure

Controlling high blood pressure is an essential approach to promoting people’s health and well-being. The National Committee for Quality Assurance (NCQA, 2018) presents hypertension as a “silent killer,” considering its association with adverse health consequences and conditions such as heart disease, stroke, and kidney disease. In the same breath, the committee proposes three proven approaches for preventing and managing hypertension. These approaches include encouraging low-sodium diets, increased physical activity, and smoking cessation.

Encouraging Low-sodium Diets by Educating People About Healthy Diets

Unhealthy eating habits are among the leading causes of hypertension. According to the Centers for Disease Control and Prevention (CDC, 2020), choosing healthy meals and snack options can help people avoid high blood pressure and its subsequent complications. Eating plenty of fresh fruits and vegetables instead of foods with high sodium concentration or unsaturated fats can lower blood pressure and protect people against heart disease and stroke (CDC, 2020). However, some sections of the at-risk populations lack knowledge and awareness of healthy diet options. As a result, implementing nutrition education programs care improving people’s knowledge of healthy diet plans. In a study by Lee et al. (2020), the researchers revealed a significant decrease in sodium intake after implementing a nutrition education program. Therefore, it is valid to argue that involving vulnerable people in education initiatives can promote their health and protect them from hypertension.

Involving Patients in Physical Exercise

Physical inactivity exacerbates the situation by resulting in multiple health, including overweight, obesity, and hypertension. The Centers for Disease Control and Prevention (CDC, 2020) contends that physical activity can play a significant role in facilitating healthy weight and lowering blood pressure. Further, the CDC recommends 2 hours and 30 minutes for moderate-intensity exercise such as brisk walking and bicycling for adults every week. On the other hand, children and adolescents can participate in 1 hour of daily physical activity to prevent the risk of obesity, hypertension, and cardiovascular conditions such as heart disease and stroke.

Apart from enabling people to maintain a healthy weight and lowering blood pressure, physical exercise can lead to improved body fitness levels, reduce stress, and facilitate cognitive functions. According to Rego et al. (2019), physical exercise (PE) can play a protective role in response to the cognitive damage associated with hypertension. Further, the researchers recommend PE as an approach for increasing the cognitive ability of hypertensive people. As a result, it is a profound measure for improving outcomes and preventing hypertension-related ramifications.

Smoking Cessation

The current literature links cigarette smoking or tobacco use with increased blood pressure and heart disease. According to Tsai et al. (2021), cigarette smoking can influence cardiovascular parameters, including systolic blood pressure, increasing an individual’s susceptibility to high blood pressure and subsequent heart attack and stroke. As a result, involving tobacco users in cessation programs can improve their health and avert the risks of hypertension. Equally, smoking cessation programs resonate with the determination to address other chronic conditions such as chronic obstructive pulmonary disease (COPD) and different types of cancer.

How to Implement These Interventions and Assess the Outcomes

Notably, the three interventions for controlling high blood pressure are patient-centered because patients play an active role in deciding schedules and participating in these programs. For instance, it is essential to involve hypertensive patients in planning, implementing, and evaluating the effectiveness of nutrition education, physical exercise (PE), and smoking cessation. As a nursing practitioner (NP), I would embrace various strategies to implement these interventions, including face-to-face educational sessions, moderate-intensity exercise such as bicycling, and group therapies to assist people to quit smoking. When evaluating the interventions’ outcomes, I would assess people’s willingness to adhere to self-management approaches such as diet plans, the ability of smokers to transform behaviors, and the overall impacts of physical exercises in reducing the body mass index (BMI).

How the Interventions Result in Improved Patient Outcomes and Care Costs Savings

Undoubtedly, implementing the three interventions improves health outcomes and curtails the costs of compensating hypertension-related ramifications. For instance, physical exercise, smoking cessation programs, and nutrition education initiatives are fundamental in controlling high blood pressure and reducing the prevalence of heart disease and stroke (Centers for Disease Control and Prevention, 2020). Further, it is essential to note that hypertension-related consequences such as heart diseases and cardiovascular conditions are the leading causes of increased care costs in the US and globally. Finally, the three patient-centered interventions lead to other health benefits, including enhancing patients’ cognitive functions, preventing cancer and respiratory conditions, and preventing obesity. Collectively, smoking cessation, nutrition education, and physical exercise are universally accepted interventions for improving public health and curtailing the costs of different health concerns such as hypertension, obesity, diabetes, cancer, and depression.

How These Interventions Result in Improved NP Patient Ratings

Patient ratings reflect their satisfaction and conformity to nurse practitioner-led interventions. Although hypertensive patients can experience difficulties in participating in smoking cessation programs, nutrition education sessions, and physical exercise due to the prevailing social determinants of health such as age and neighborhood factors, it is essential to note that these approaches can result in patient satisfaction by enabling patients to control hypertension and prevent cardiovascular diseases (CVDs). According to the National Committee for Quality Assurance (NCQA, 2018), encouraging low-sodium diets, emphasizing physical activities, and smoking cessation are vital steps for controlling high blood pressure and preventing heart attack, kidney disease, and stroke. As a result, patients are willing to participate in these programs to avert adverse consequences of hypertension.

Conclusion

Undeniably, controlling high blood pressure is beneficial in preventing multiple health concerns, including heart disease, stroke, and kidney disease. The universally accepted strategies for preventing and controlling hypertension are physical exercise, smoking cessation, and nutrition education programs targeting at-risk populations. Undeniably, these approaches are consistent with positive health outcomes because they address potential causative and contributing factors for high blood pressure and cardiovascular diseases (CVDs), including tobacco use, physical inactivity, and unhealthy diet plans. Hypertensive patients are willing to embrace these measures due to their contribution to promoting health and controlling blood pressure. Therefore, the interventions can improve NP patient ratings.

References

Centers for Disease Control and Prevention. (2020, January 22). Prevent high blood pressure. https://www.cdc.gov/bloodpressure/prevent.htm

Centers for Disease Control and Prevention. (2021, September 27). Facts about hypertension. https://www.cdc.gov/bloodpressure/facts.htm#

Lee, Y.-S., Rhee, M.-Y., & Lee, S.-Y. (2020). Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults. Nutrition Research and Practice, 14(5), 540. https://doi.org/10.4162/nrp.2020.14.5.540

National Committee for Quality Assurance. (2018). HEDIS measures and technical resources. NCQA. https://www.ncqa.org/hedis/measures/

Rêgo, M. L., Cabral, D. A., Costa, E. C., & Fontes, E. B. (2019). Physical exercise for individuals with hypertension: It is time to emphasize its benefits on the brain and cognition. Clinical Medicine Insights: Cardiology, 13, 1-10. https://doi.org/10.1177/1179546819839411

Tsai, S.-Y., Huang, W.-H., Chan, H.-L., & Hwang, L.-C. (2021). The role of smoking cessation programs in lowering blood pressure: A retrospective cohort study. Tobacco Induced Diseases, 19(October), 1–9. https://doi.org/10.18332/tid/142664