course materials

1. Assessing the Problem: Quality, Safety, and Cost Considerations
Assessing the Problem: Quality, Safety, and Cost ConsiderationsAssessing the Problem:
Quality, Safety, and Cost ConsiderationsIn a 5-7 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. Plan to spend approximately 2
direct practicum hours exploring these aspects of the problem with the patient, family, or
group you’ve chosen to work with and, if desired, consulting with subject matter and
industry experts. Report on your experiences during your first two practicum hours.
Assessing the Problem: Quality, Safety, and Cost ConsiderationsOrganizational 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.CLICK HERE TO ORDER YOUR
ASSIGNMENTAssessing Health ProblemPracticum Focus SheetThe patient that I intend to
work with in this project is Mr. X, a 40-year old male with history of recurrent asthma. The
patient is married and has two children. Mr. X was recently admitted to the hospital due to
unresponsive asthma. According to him, he has been experiencing asthma attacks for the
last five years, which he manages using prescribed inhaled corticosteroids. Mr. X was
chosen for this project because he expressed interest to learning more about asthma and its
effective management to prevent recurrences in the future. He is ready to embrace any
lifestyle or behavioral interventions to manage the disease. By working with this patient, I
intend to learn more about coordination of care. I also intend to learn the principles of
patient-centeredness and continuous quality care in practice (Ignatavicius et al., 2020). I
also intend to learn about effective evidence-based practices that can be used when working
with patients, families and groups from different ethnic backgrounds.The effective
management of asthmatic attack experienced by the patient will depend largely on the
understanding of the patient and his level of involvement in care. I will therefore use simple,
easy to understand and accurate messages to convince the patient about the significance of
disease management. I will also involve him and his family in examining the ways in which
environmental risks can be minimized to prevent recurrent attacks. I will embrace
transformational leadership style to influence the patient to embrace the desired
interventions for the effective management of asthma attacks. I will also focus on ensuring

2. that he plays an active role in exploring ways of promoting the effective management of the
condition. I will embrace open communication between the patient and the family to foster
their understanding of care process and care needs (Chung et al., 2019). I will also guide
them on the use of the various interventions for asthma management as a way of managing
change. Some of the potential barriers that might be experienced include the client’s tight
schedule and poor uptake of the interventions to be used in the management of his health
problem. I will embrace strategies such as developing a plan for meeting the client and his
family and ensuring active involvement of the patient in examining ways of managing his
health problem.Analysis of EvidenceAsthma is one of the health problems that most
patients admitted in the hospital experience. The obstruction of the airflow, hyper-
responsiveness and sensitivity to various stimuli characterize asthma. According to
statistics, about 300 million people globally are affected by the disease. The goals of
treatment in asthma is to prevent its recurrence and remodeling of the airways and hospital
admission rate (Ignatavicius et al., 2020). Generally, the treatment of asthma entails the use
of pharmacological agents and health education on the importance of avoiding
environmental allergens or triggers for asthma attacks. The pharmacological drugs used for
the treatment of asthma include short-acting beta agonists, inhaled corticosteroids, long-
acting beta agonists, leukotriene receptor agonists. Health education in the management of
asthma focuses on raising the level of awareness of the patients towards the triggers for
asthmatic attacks such as pollen, stress, tobacco smoke, upper respiratory tract infections,
and cold (Pereira, 2016).The use of evidence-based practices in asthma management has
been shown to result in treatment outcomes that include safety, quality and efficiency in
care. However, the use or consistent utilization of evidence-based practice interventions in
asthma management faces a number of barriers. One of the barriers is the poor adherence
by the patients and healthcare providers on the effective management of asthma. Ineffective
adherence to the prescribed treatment by the patients increases the risk of recurrence of
asthmatic attacks (McQuaid, 2018). Similarly, poor adherence to clinical guidelines for best
practices in asthma worsen the outcomes of treatment in asthma. The treatment outcomes
in asthma depends largely on the stage of its management. Early identification is associated
with enhanced outcomes of treatment that include management of recurrence and
symptoms of the disease. However, the effectiveness of evidence-based practices used in
asthma face the challenge of patients failing to identify and act to address the warning
symptoms of asthmatic attack. The attitude that the patients have towards traditional
methods of asthma management also affect the effectiveness of evidence-based
interventions. For example, patients have been shown to rely on the use of unorthodox
methods such as ginger, turmeric, hot water, and tea to relief symptoms of asthma. The
consequence include poor treatment outcomes due to low adherence level to treatment
(Chung et al., 2019). The use of complementary medicine also hinders the effectiveness of
evidence-based interventions, as patients substitute the recommended pharmacological
treatment methods with complementary medicine.Nurses have a critical role to play in the
management of asthma. They provide care that aligns with the stated professional and
institutional policies and standards of care. One of the nursing policies that regulate the
provision of nursing care to patients with asthma is utilizing patient-centered care to

3. promote safety in care. Nurses provide patient-centered assessment, planning,
implementation and evaluation of plans of care. The assessment aims at identifying the care
needs of the patients and their abilities to achieve independence in self-management of the
disease. The implementation and evaluation focuses on the effectiveness of the adopted
interventions in meeting the developed patient needs in care process. According to Pereira,
(2016), patient-centeredness in asthma care improves treatment outcomes such as safety,
adherence and patient satisfaction with care. In addition, patient-centered education
ensures that the treatment guidelines are adhered to for enhanced outcomes (McCabe &
Connolly, 2019). Nurses also utilize nursing theories to guide the care that they give to
patients with asthma. Nursing theories provide frameworks for assessing, planning,
implementing and evaluating care. An example of the use of theory in asthma management
is seen in the research by Mersal and El-Awady (2017) where the theory of self-care by
Orem was used to enhance self-management of asthma in school age children. The use of
self-care theory by Orem was associated with enhanced self-efficacy and utilization of
asthma management activities by school aged children. Assessing the Problem: Quality,
Safety, and Cost ConsiderationsEffect of State Board Nursing Practice Standards and
Organizational Policies Affecting Asthma ManagementState board of nursing practice
standards and government policies affect the outcomes of treatment in asthma. State board
of nursing practice standards guide the focus on the provision of patient-centered care in
asthma management to promote safety in care. The state board also develops competencies
that nurses must demonstrate in providing care to patients with asthma. The regulations
developed by the government also influence the outcomes of management in asthma. For
instance, the state implements provisions by the CDC’s National Asthma Control Programs
in the public health systems to increase the awareness, management, and control of asthma
in the population. The National Asthma Control Program (NACP) develops the public health
response to be utilized for asthma, promote sustainability of asthma control program,
strengthen the surveillance system and increase the role of healthcare providers in asthma
management and prevention (Chung et al., 2019).Nurses play critical roles policy making to
improve outcomes, prevent illness, and reduce readmissions due to asthma. Nurses
advocate the provision of effective care that promote safety, quality and efficiency in the
management of asthma. Nurses ensure that barriers to health in patients with asthma are
addressed. The barriers that influence the management and health outcomes in asthma
management include level of awareness, access, availability and affordability of asthma
care. Nurses therefore advocate the adoption of policies that eliminate health inequalities
and strengthen the provision of case-specific care to patients with asthma. Nurses also
advocate the implementation of evidence-based strategies for asthma management in their
states and health organizations. They champion the use of best practices in asthma
management that promote value in care and realization of patient outcomes. In doing these
roles, local, state and federal policies influence the scope of nurses in addressing the health
needs of the patients with asthma. Accordingly, nurses ensure that the care that they offer
to asthma patients promote the protection of safety needs and rights of the patients in the
care process. State and federal policies also stipulate the competencies that nurses should
demonstrate to provide appropriate care to asthma patients (Ignatavicius et al., 2020). For

4. example, nurses must be certified and registered by the state boards to demonstrate their
competencies in promoting safety in nursing practice. In addition, continued professional
development is needed to ensure that high quality care is given to asthma patients using
best practices.Leadership StrategiesEffective leadership is needed for the optimization of
treatment outcomes for patients with asthma. Nurse Managers and registered nurses play a
critical role in promoting lifestyle and behavioral transformation in the management of
asthma. Accordingly, nurses influence patients to embrace the needed strategies such as
treatment adherence through health education. Nurses also introduce change initiatives in
their practice to improve the treatment outcomes in asthma. For example, Onubogu (2019)
shows that nurses can utilize theories of change such as Kotter’s change model to introduce
improvement initiatives in the management of asthma. The use of change models facilitate
the incorporation of best clinical practices in asthma management to minimize recurrence
and worsening of symptoms. Therefore, nurses have a role to utilize their leadership skills
in improving the treatment outcomes and disease burden of asthma.Active stakeholder
collaboration is needed for the effective management of asthma in communities. Nurses and
other healthcare providers should work together in determining the health needs of asthma
patients, implementing strategies and evaluating their effectiveness. Effective referral
systems are also needed to ensure that optimum management of complex cases is achieved
in the state (Ignatavicius et al., 2020). Open communication between healthcare providers
and patients should therefore be promoted to build trust and enhance the treatment
outcomes. Open communication is essential to ensure that patients understand the
treatment approaches to their health problem and express their views and concerns on the
approaches to treatment. The effective management of asthma also requires the
implementation of strategies that promote continuous improvement in the management of
the disease (Pereira, 2016). For example, there is a need to offer training to healthcare
providers to equip them with the essential knowledge and skills alongside creating culture
that is characterized by learning to promote innovation. Therefore, organizational
transformation is needed for the adoption of change management strategies that improve
treatment outcomes in asthma.ConclusionIn conclusion, the effective management of
asthma in diverse populations depends on the level of patient and provider involvement in
the care process. Nurses and other healthcare providers should however explore effective
strategies to addressing barriers in the management of asthma in populations. Policy
advocacy is also needed to ensure that the interventions that are adopted promote equity in
health. Most importantly, nurses should explore the ways in which continuous
improvement in the management of asthma using evidence-based initiatives can be
achieved.CLICK HERE TO ORDER YOUR ASSIGNMENTReferencesChung, K. F., Israel, E., &
Gibson, P. G. (2019). Severe Asthma. European Respiratory Society.Ignatavicius, D. D.,
Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-Surgical Nursing – E-
Book: Concepts for Interprofessional Collaborative Care. Elsevier Health Sciences.McCabe,
E. M., & Connolly, C. (2019). From intention to action: Nurses as policy advocates for asthma
care in schools. NASN School Nurse (Print), 34(2), 113–116.
https://doi.org/10.1177/1942602X18786394McQuaid, E. L. (2018). Barriers to medication
adherence in asthma: The importance of culture and context. Annals of Allergy, Asthma &

5. Immunology, 121(1), 37–42. https://doi.org/10.1016/j.anai.2018.03.024Mersal, F., & El-
Awady, S. (2017). Evaluation of bronchial asthma educational package on asthma self-
management among school age children based on Orem’s self-care model in Zagazig city.
International Journal of Advanced Nursing Studies, 7, 8.
https://doi.org/10.14419/ijans.v7i1.8648Onubogu, U. (2019). How to Implement Change in
Asthma Management in a Developing Country. Open Journal of Respiratory Diseases, 9(1),
26–35. https://doi.org/10.4236/ojrd.2019.91003Pereira, C. (2016). Asthma: From
Childhood Asthma to ACOS Phenotypes. BoD – Books on Demand. Assessing the Problem:
Quality, Safety, and Cost Considerations