Quality Healthcare: Measuring NP Performance
Quality Healthcare: Measuring NP Performance
Paige Carson
NR506 – 13653
September 2019
https://www.coursehero.com/file/54264852/NR-506-week-3-docx/
This study resource w
...
Quality Healthcare: Measuring NP Performance
Quality Healthcare: Measuring NP Performance
Paige Carson
NR506 – 13653
September 2019
https://www.coursehero.com/file/54264852/NR-506-week-3-docx/
This study resource was
shared via CourseHero.com
Quality Healthcare: Measuring NP Performance
Introduction
As a nurse, regardless of level of education completed, there is a natural instinct to go to
extreme measures for all of our patients. It is in our nature to want our patient to heal, all the
while providing comfort when the patient is in need. As a family nurse practitioner in the
primary care setting, we earn the privilege of taking control of the patient’s healthcare plan by
continuous management through office visits. The nurse practitioner is able to assess,
recommended treatment, and prescribe required tests and or medications. Although the
financial aspect may not be the first dilemma to cross the nurse practitioner’s mind, it is a real
issue in healthcare that has to be taken into consideration.
The National Committee for Quality Assurance is a committee designed to ensure quality
patient care by measuring patient outcomes against set standards (NCQA, 2019). There are
more than sixty patient outcomes that are categorized into six domains known as Healthcare
Effectiveness Data and Information (NCQA, 2019). Millions of people are enrolled in healthcare
plans that report HEDIS results to the NCQA, which are then condensed into data reports that
can then analyzed by the public (NCQA, 2019). All efforts within the NCQA such as the HEDIS
results are subject to professional audits to ensure healthcare accountability.
Controlling Hypertension
The domain Effectiveness of Care incorporates multiple subcategories such as prevention
and screening, respiratory conditions, cardiovascular conditions, diabetes, and behavioral
health (NCQA, 2019). Due to the fact the Center for Disease Control has issued data that reflects
23.5% of the total deaths within the United State to be linked to heart disease, it can be
assumed that cardiac care requires a massive amount of medical management and treatment
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(CDC, 2017). As the nurse practitioner in a per capita practice setting, it will be essential to
measure and improve patient outcomes while saving the medical practice cost. A per capita
Controlling a patient’s hypertension is an effective way to reduce the risk of a cardiac
event. The nurse practitioner can measure the patient’s hypertension and then try to
successfully keep it within an acceptable range with medication or promoting a lifestyle change.
When the patient initially comes to their appointment, the nurse practitioner can prescribe the
medications they see fit. The patient could be asked to keep a journal of their daily blood
pressure along with implementation of the suggested plan of care. The patient’s progress can be
reviewed amongst provider and patient during the scheduled follow up appointment. If an
adjustment is indicated based upon data collected, it can be done at that time.
If the patient’s hypertension were to go ignored by the provider and further damage the
heart, it could result in extensive and potentially expensive testing. Both of which would cause a
financial burden to the practice and the patient when the practice is funded through a fixed
payment from medical care groups. When a patient feels as if their health is of priority to the
provider, trust can be established that can also promote medical treatment compliance. If the
patient were to develop a complication and appropriate adjustments are made, continuous
positive patient ratings are likely to follow.
Diabetes Management
Alongside controlling hypertension within the domain of Effectiveness of Care, is the
issue of diabetes management. Diabetes is a complicated disease that is characterized by high
blood glucose levels as a result of the human body’s inability to make or utilize insulin (NCQA,
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2019). When left uncontrolled, diabetes can result in heart disease, stroke, kidney disease,
amputation, and premature death (CDC, 2014).
Due to the fact that more than 100 million Americans suffer from diabetes or
prediabetes, controlling and preventing the escalation of the disease is a common concern
when patients visit their primary care provider (CDC, 2017). As a family nurse practitioner, it is
our duty to encourage and guide a better lifestyle to our patients. Modification can be made
within the patient’s diet, level of physical activity, and amount of stress that the patient has the
ability to control within their life. As the provider, there are tests that can be ordered to track a
patient’s progress over a two to three-month span known as a hemoglobin A1c (Mayo Clinic,
2019). An initial level should be collected so there is evidence for comparison at the patient’s
follow up appointment. When the nurse practitioner is proactive in getting control of a patient’s
blood glucose levels, they are preventing future hospital stays as well as irreversible harmful
effects on the patient.
If the patient’s diabetic status were to go by the wayside, it could cost the practice
financially due to the need of increased medical intervention. If the provider were to make an
error in the correct amount of prescribed medication, it could too cause a need for more
medical intervention that was ultimately not the patient’s fault. Costing the patient, will cost the
practice. When the nurse practitioner is throughout with each patient’s individual plan of care,
error is less likely to occur. Displaying such competence will leave the patient feeling encouraged
and supported, influencing positive patient satisfaction.
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Antidepressant Medication Management
Last to be mentioned within the domain of Effectiveness of Care is the topic of
antidepressant medication management. Extreme depression can lead to a collection of
complications such as, altered sleep pattern, negative self-image, poor eating habits, and suicide
(NAMI, 2013). According to the Anxiety and Depression Association of America, major
depressive disorder effects 16.1 million Americans between the age of 15 and 44.3 years old
(AADA, 2019). With such an astonishing amount of suffers in the U.S., it is guaranteed that the
primary care nurse practitioner will encounter depression disorder whether it is the patient’s
chief complaint or a comorbidity. As a result, medication management is a necessity for the
provider while medication compliance is crucial for the patient. If the patient’s symptoms
appear to be severe, appropriate referrals should be made.
When a patient comes to the nurse practitioner with symptoms associated with
depression disorder it should be taken to a high priority. Before antidepressant medications are
prescribed, the provider should try to find the root cause of the patient’s depression. Often
times, other healthcare aliments are the culprit. Debilitating disease such as paralysis, kidney
failure, or cancer can take a toll on the patient’s mental wellbeing. In return, depression could
be the result of but not limited to inherited traits, hormone imbalance, brain chemistry,
traumatic event, and or substance abuse (Mayo Clinic, 2019).
If the source of the depression can be linked to a specific cause, it can help the nurse
practitioner in prescribing the correct medication. Each antidepressant targets a different
neurotransmitter within the brain such as serotonin, dopamine, and norepinephrine (Mayo
Clinic, 2019) Effective communication between patient and provider will determine the
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appropriate medication for the patient. The provider should then thoroughly educate the
patient on the side effects of the elected medication, for some of them are life threatening and
can require immediate intervention. In addition, the provider should elaborate on the fact that
most antidepressants do not work instantly but take weeks or even months to take effect (Mayo
Clinic, 2019). Effective communication can make a difference between a costly lawsuit and a
patient who is now able to function in their daily life. If a patient were to choose to end their life
after starting a new anti-depressant medication, the provider may be found liable if the court
were to determine the choice of medication fell below the expected standard of care
(Edersheim, J., 2009). If this situation were to occur, the practice could experience a devastating
financial loss.
There is potential for the patient to experience extreme gratitude towards the provider if
they felt as if they were cared for in an effective way. Although medications may not be the
universal answer, giving someone their life back by a simple prescription can improve not only
the patient’s life, but the satisfaction between provider and patient. The only true way to
measure the effectiveness of the intervention is to be observant of the patient’s mannerisms
and demeanor while listening to how they feel.
Conclusion
The entire domain of Effectiveness of Care and the subcategories within encompass a
huge part of the nurse practitioner’s role within healthcare. The National Committee for Quality
Assurance’s healthcare data information can answer the question of how effective we as nurse
practitioners are in providing care for our patients. Although the provider may feel as if they
were successful when the patient walks out of their office, the true test is if they come back. If
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they do come back, did the providers recommendations make a positive change in the patient’s
life. Continuous commitment from health care providers to supply data to committees such as
the NCQA well influence healthcare in a profound way.
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