Assessing the Problem: Quality, Safety, and Cost Considerations

Chemotherapy-induced nausea and vomiting (CINV) is a significant concern in oncology nursing. It impacts the quality of care, patient safety, and costs for both individuals and healthcare systems. In this assessment, we explore the multifaceted effects of CINV on patient outcomes and healthcare delivery.

We examine the influence of nursing practice standards, policies, and strategies on addressing CINV to improve care quality, enhance patient safety, and reduce costs (Cristina et al., 2023). By understanding these dynamics, nurses can develop effective interventions to mitigate the impact of CINV and optimize patient care.

Impact of Patient Problems on Quality of Care, Patient Safety, and Costs

Chemotherapy-induced nausea and vomiting (CINV) profoundly impacts the quality of care, patient safety, and costs for both individuals and healthcare systems. For instance, consider an individual patient undergoing chemotherapy for lung cancer. Despite advancements in antiemetic medications, the persistent experience of CINV can lead to decreased treatment adherence and compromised symptom management (Gupta et al., 2021). This, in turn, affects the overall quality of care by impeding the patient’s ability to tolerate chemotherapy regimens optimally, potentially compromising treatment efficacy and disease outcomes.

CINV poses significant safety risks to patients. For example, severe vomiting episodes may lead to dehydration, electrolyte imbalances, and nutritional deficiencies, exacerbating existing health issues and potentially necessitating hospitalization for supportive care. Additionally, CINV-induced nausea can impact a patient’s ability to perform daily activities safely, increasing the risk of falls and other accidents, further compromising patient safety and well-being.

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality, Safety, and Cost Considerations

The financial burden associated with managing CINV can be substantial for individuals and healthcare systems. Individually, patients may incur additional expenses related to antiemetic medications, supportive care interventions, and hospitalizations for symptom management. On a broader scale, healthcare systems face increased costs associated with emergency department visits, hospital admissions, and prolonged hospital stays due to severe CINV complications (Juan Felipe Rico et al., 2023). Additionally, the decreased treatment adherence resulting from poorly managed CINV may lead to suboptimal treatment outcomes, potentially necessitating more intensive and costly interventions in the long run.

CINV significantly impacts the quality of care, patient safety, and costs by compromising treatment adherence, exacerbating safety risks, and imposing financial burdens on individuals and healthcare systems. Addressing CINV effectively requires comprehensive strategies prioritizing evidence-based symptom management, interdisciplinary collaboration, and patient-centered care to mitigate these detrimental effects.

Effect of Nursing Practice Standards and Policies

State board nursing practice standards and organizational or governmental policies play a pivotal role in shaping the landscape of healthcare delivery and influencing patient outcomes. These standards and policies establish the framework within which nurses operate, impacting various aspects of care, including quality, safety, and costs (Oldland et al., 2020).

Firstly, adherence to state board nursing practice standards ensures nurses deliver care consistent with recognized best practices and guidelines. These standards often outline patient assessment, treatment, and documentation protocols, promoting standardized care delivery approaches. By adhering to these standards, nurses can enhance the quality of care by ensuring patients receive evidence-based interventions tailored to their needs.

Organizational or governmental policies set the tone for healthcare practices within specific settings or jurisdictions. For instance, policies related to staffing ratios or nurse-to-patient ratios can significantly impact patient safety by influencing the workload and availability of nursing staff (Phillips et al., 2021).

Adequate staffing levels contribute to improved patient outcomes by reducing the risk of adverse events and errors, as mandated by policies. Additionally, policies related to reimbursement and payment models can affect healthcare costs at the systemic and individual levels (Reindersma et al., 2022). For example, policies promoting value-based care or incentivizing preventive measures may save costs by reducing hospitalizations and complications.

The scope of nursing practice is intricately linked to regulatory policies established by state boards and governing bodies. Changes in the scope of practice regulations can expand or restrict the range of services nurses are authorized to provide, thereby influencing access to care and patient outcomes (Flaubert et al., 2021).

By understanding and navigating these policies effectively, nurses can advocate for interventions that align with their scope of practice while maximizing the impact on quality, safety, and costs. In summary, state board nursing practice standards and organizational or governmental policies are essential guides that inform nursing interventions, ultimately shaping care delivery and its outcomes for patients, families, and populations.

Strategies to Improve Care Quality, Patient Safety, and Reduce Costs

Several strategies can be implemented to improve the quality of care, enhance patient safety, and reduce costs to the healthcare system and individuals.  (Flaubert et al., 2021). For example, using clinical pathways for managing common conditions like heart failure or pneumonia has reduced hospital length of stay, decreased readmission rates, and lowered healthcare costs. Benchmark data from organizations that have successfully implemented clinical pathways can provide valuable insights into the effectiveness of these strategies and serve as a reference for implementation in other settings.

NURS FPX 4900 Assessment 2 Assessing the Problem: Quality, Safety, and Cost Considerations

Another strategy to enhance patient safety and reduce costs is the implementation of technology-enabled solutions, such as electronic health records (EHRs) and medication management systems. EHRs allow for standardized documentation, improved communication among healthcare providers, and real-time access to patient information, reducing the risk of errors and adverse events.

Additionally, medication management systems with built-in safety features, such as barcode scanning and automated alerts for drug interactions, help prevent medication errors and improve medication adherence (Zeeland, 2023). Benchmark data from healthcare organizations implementing these technologies can demonstrate their impact on patient safety metrics, such as medication error rates, and provide insights into cost savings associated with reduced adverse events and hospitalizations.

Promoting patient and family engagement in care can improve the quality of care and enhance patient outcomes while reducing costs. Encouraging patients to participate actively in decision-making, self-management, and care planning can lead to better treatment adherence, improved health outcomes, and decreased healthcare utilization.

For instance, shared decision-making tools and patient education materials empower patients to make informed choices about their care, leading to more efficient use of healthcare resources and reduced costs associated with unnecessary procedures or treatments. Benchmark data on patient engagement initiatives, such as patient satisfaction scores and healthcare utilization metrics, can help organizations assess these strategies’ effectiveness and identify areas for improvement.

Documentation of Practicum Hours

In documenting the practicum hours spent implementing these strategies, nurses can contribute valuable data to benchmarking and quality improvement initiatives. By recording their experiences and outcomes in the Capella Academic Portal Volunteer Experience Form, nurses can help identify successful interventions, share best practices, and drive continuous improvement in patient care and safety.

Introduction

Chemotherapy-induced nausea and vomiting (CINV) is a significant concern in oncology nursing, impacting the quality of care, patient safety, and costs for both individuals and healthcare systems. In this assessment, we explore the multifaceted effects of CINV on patient outcomes and healthcare delivery. Additionally, we examine the influence of nursing practice standards, policies, and strategies on addressing CINV to improve care quality, enhance patient safety, and reduce costs. By understanding these dynamics, nurses can develop effective interventions to mitigate the impact of CINV and optimize patient care.

Conclusion

Chemotherapy-induced nausea and vomiting (CINV) presents complex challenges in oncology nursing, affecting patients’ quality of life, safety, and healthcare costs. Nurses can address these challenges effectively by adhering to nursing practice standards, organizational policies, and evidence-based strategies. By implementing standardized protocols, leveraging technology-enabled solutions, and promoting patient engagement, nurses can enhance care quality, improve patient safety, and reduce costs to individuals and healthcare systems.

Documenting practicum hours spent on implementing these strategies is crucial for evaluating their effectiveness and driving continuous improvement in patient care and safety. Overall, a comprehensive approach that integrates nursing standards, policies, and evidence-based interventions is essential for mitigating the impact of CINV and optimizing patient outcomes in oncology settings. 

References

Cristina, Maria, O., Cíntia Silva Fassarella, & José, E. (2023). The impact of nursing practice environments on patient safety culture in primary health care – A Scoping Review Protocol. 3, 2(5), BJGPO.2023.0032–BJGPO.2023.0032.

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health care access and quality. In www.ncbi.nlm.nih.gov. National Academies Press (US).

Gupta, K., Walton, R., & Kataria, S. P. (2021). Chemotherapy-induced nausea and vomiting: Pathogenesis, recommendations, and new trends. Cancer Treatment and Research Communications, 26(100278), 100278.

Juan Felipe Rico, Caterino, J. M., Stephens, J. A., Abar, B., Adler, D., Bastani, A., Bernstein, S. L., Bischof, J. J., Coyne, C. J., Grudzen, C. R., Henning, D. J., Hudson, M. F., Klotz, A. D., Lyman, G. H., Madsen, T. E., Reyes, C. C., Ryan, R. J., Shapiro, N. I., Swor, R., & Thomas, C. R. (2023). Variables associated with admission rates among cancer patients presenting to emergency departments: A CONCERN group study. Emergency Cancer Care, 2(1), 790.

Oldland, E., Botti, M., Hutchinson, A. M., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare: Exploration of content validity. Collegian, 27(2), 150–163.

Phillips, J., Malliaris, A. P., & Bakerjian, D. (2021, April 21). Nursing and patient safety. Ahrq.gov.

Reindersma, T., Sülz, S., Ahaus, K., & Fabbricotti, I. (2022). The effect of network-level payment models on care network performance: A scoping review of the empirical literature. International Journal of Integrated Care, 22(0), 3.

Zeeland, frotor. (2023, December 3). The impact of electronic health records (EHR) on medication management and error reduction. AltexSoft.