NURS-FPX4900: Assessing the Problem: Quality, Safety, and Cost Consideration

Assessing the Problem: Quality, Safety, and Cost Consideration

HIV remains a pressing issue in the United States. Over 1.2 million people live with the condition with about 13% unaware of their status. Disproportionate impact on individuals, families, and communities explains the need for evidence-based strategies for responding to the needs of racial and ethnic minorities and others vulnerable to the condition. Focusing on quality, cost, and safety makes stakeholders among them policymakers and healthcare providers aware about challenges that undermine successful prevention and treatment (Areri et al., 2020). The three enhance efforts toward overcoming health disparities witnessed in underserved and under-resourced communities. Vulnerable populations, largely young people get the opportunity to access essential diagnosis, prevention, and treatment services. Similarly, addressing costs, safety, and quality of HIV care makes stakeholders aware of the factors associated with delayed or postponed care across the continuum. This way, the different stakeholders dedicate time and energy toward identifying resources and allocating them in ways that help reduce health disparities.

This capstone highlights the need for increased commitment to engaging patients and identifying resources that support successful self-management. The findings address calls for evidence-based and patient-centered interventions that make essential services available and accessible by more patients. Collaborations between case managers, social workers, pharmacists, nurses, CHWs, and community-based organizations make it possible to identify challenges associated with HIV management and solutions necessary for preventing undesirable disease progress and premature deaths (Crowley & Rohwer, 2021). This project focuses on interdisciplinary collaboration as one of the pathways for addressing the burden associated with HIV.

Quality of Care, Safety, and Cost Aspects

Managing HIV requires enhanced access to health resources across the continuum. The process is expensive for patients in underserved and under-resourced communities affected by low incomes, limited access to primary care providers, and specialists, and poor infrastructure. The cost of HIV care is about $1,800 to $4,500 every month. The lifetime medical costs for those infected at the age of 35 is about $326,500 (Ritchwood et al., 2017). Costly ART medications make up 60% of the costs. The absence of financial incentives for drugs and therapies make treatment complicated for vulnerable low-income populations. Patients face challenges accessing medical and non-medical resources such as antiretroviral drugs, healthy food, and therapies designed to prevent undesirable prognosis (Crowley & Rohwer, 2021). Focusing on high out-of-pocket costs makes the care team and relevant stakeholders committed to identifying alternatives such as consistent self-management. The interventions allow patients to take charge of their health and well-being through lifestyle modifications, exercise, and adherence to recommended medications. Similarly, healthcare providers, policymakers, community-based organizations, and other players address individual vulnerability to unsafe clinical practices. Notably, unsafe treatment triggered by stigma, negligence, and ineffective collaboration with patients jeopardizes continuation of HIV treatment.

Patients are likely to discontinue drugs or choose pathways that expose them to severe complications and premature deaths. The effects of unsafe HIV treatment reveals the consequences of disparities and the need for sustainable efforts for making self-management an essential component of prevention and treatment (Krentz & Gill, 2021). On quality of care, patients need accurate and complete information on evidence-based strategies for controlling symptoms. The process entails proactive education and promotion to make individuals aware about nutrition, exercise, lifestyle changes, and other interventions necessary for avoiding severe complications and premature deaths. Quality considerations also remind stakeholders about the need for available and accessible care to promote adherence to recommended treatment. However, patients in under-resourced communities are vulnerable to reduced quality of HIV management due to limited access to primary care providers, specialists, ARV, and other resources.

Nurse Practice Standards and Health Policies Associated with HIV Management

Quality, safe, and affordable HIV management depends on nurses’ commitment to improving outcomes. Nurse practice standards remind the care team about their roles and responsibilities in adhering to policies, procedures, and initiatives associated with evidence-based and patient-centered care. Among priorities identified is delivering services in ways that eliminate discrimination and stigma (Rouleau et al., 2019). Nursing practice requires professionals to coordinate with colleagues, patients, and families to provide quality formal and informal care across the continuum. The process empowers nurses to identify and eliminate barriers that undermine adherence to treatment and timely diagnosis. Nurses should also advocate for equity to ensure that low resource communities where HIV prevalence is high access resources and programs for preventing high morbidity and mortality rates (Rouleau et al., 2019). In this case, nurses advocate for drivers of quality, safe, and affordable care such as adequate staffing and ARVs that prevent transmission and ineffective treatment. Compassion and empathy should influence the care team’s commitment to strengthening community-based health systems and other initiatives associated with successful HIV management.

The Affordable Care Act (ACA) is the right legislation for addressing quality, safety, and cost issues associated with HIV management. Key highlights of the policy include assured coverage for people with pre-existing conditions, expanded Medicaid coverage, reduced cost of prescription drugs, and access to preventive services such as HIV testing (Ginossar et al., 2019). ACA also supports coordinated care for people with HIV. Thus, patients and families benefit from a healthcare system that streamlines access to critical medical and non-medical services. Patients are free from denied coverage that prevented them from getting recommended prevention and treatment services. Broader Medicaid eligibility is another consideration that allow low-income populations to access services that safeguard them from a damage immune system (Satre et al., 2020). In this case, affordable coverage makes preventive services accessible to more patients. Similarly, there are opportunities to initiate and sustain coordinated care for those with HIV and related complications. In the end, more patients benefit from expanded access to essential health services designed to improve the quality, cost, and safety of care.

Improving Quality, Safety, and Cost of HIV Care

Addressing quality, safety, and cost aspects strengthens commitment to reducing morbidity and mortality rates associated with HIV. One viable approach is expanding community health centers to make preventive and primary care services available to more patients (Ritchwood et al., 2017). The facilities align with national strategies for integrating testing, prevention, and treatment services into primary care. Delivering culturally competent care is another consideration. In this context, stakeholders focus on strengthening training to reduce health disparities in populations heavily affected by HIV. The care team acquire knowledge, skills, and experiences for handling patients’ values and preferences across the continuum. Further, successful HIV management outcomes depends on safe staffing levels. Adequate physicians, nurses, and other healthcare providers make services more accessible by vulnerable populations (Ward et al., 2020). The strategy also includes having a diversity of primary care providers and specialists to respond to the needs and expectations of patients in underserved communities. Thus, evidence-based interventions should focus more on programs that support access to prevention and treatment services without additional costs. Significant expansion of community health centers and safe staffing levels will reduce the risk of delayed or postponed care common in under-resourced and under-served communities.

Part Two

This part describes the two hours practicum experience. I had a conversation with a patient living with HIV. The interaction provided insights into the need for improvements that make quality, safe, and affordable care accessible to patients living with HIV. The patient from a low-resource setting agreed that it is challenging coping with quality, safety, and cost concerns evident in under-resourced and underserved communities. Challenges such as inadequate staffing, inconveniences in accessing ARVs, and low income that denies individuals from accessing healthy foods and other self-care measures prevent patients from living longer and healthier lives.

The patient expressed optimism in accessing better services by enrolling for Medicaid and Medicare programs. The patients also expressed desire to access primary care providers and specialists conveniently for education and counseling on tailored interventions for improving quality of life. Limited access to financial aid programs is a serious challenge that limits access to prescription drugs and other services appropriate for preventing escalating symptoms. Challenges accessing private insurance also undermine access to comprehensive care. However, the patient appreciated existence of the Affordable Care Act that facilitates access to emergency services, mental health counseling, talk therapies, prescription drugs, and overnight stays at hospitals. Qualifying for Medicaid and Medicaid is a significant step for patients living with HIV and from low-income settings to live healthier lives.