NURS FPX 4900 Assessment 2
Phillip September 17, 2023 No Comments

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

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

Student Name

Capella University

NURS-FPX4900: Capstone Project for Nursing



Assessing the Problem: Quality, Safety, and Cost Considerations

In this capstone project analysis, we will delve deeply into the case of John, a 10-year-old clinically obese patient, to understand the widespread implications of obesity on the quality of care, patient safety, and costs incurred by the patient and the healthcare system. The primary goal of this assessment is to scrutinize obesity from multiple dimensions, such as quality, safety, and economic viewpoints. Furthermore, we will explore the standards of nursing practice and organizational or governmental policies that influence obesity’s impact on care, safety, and financial considerations. It is imperative to grasp how these standards and policies shape the treatment provided to patients like John and the problems they might pose. Lastly, we will propose purposeful strategies to enhance the quality of care, escalate patient safety, and diminish costs for the patient and the healthcare organization, hoping to address cases similar to John’s better. By providing comprehensive, evidence-based care to our patients, we aim to improve their health outcomes and quality of life significantly.

The Impact of Obesity on Care Quality, Patient Safety, and Costs

John’s clinical obesity significantly impacts the quality of care, patient safety, and costs to the healthcare system and his expenses. Indeed, let us delve into a more detailed analysis of this. 

Quality of Care

John’s clinical obesity challenges healthcare providers to deliver high-quality care. Obesity often comes with comorbidities such as hypertension, diabetes, and heart disease, requiring a specialized care approach and more comprehensive management strategies (Safaei et al., 2021). This complexity can lead to inconsistencies or delays in care. Furthermore, obesity is often linked to psychosocial issues, including depression and anxiety, inhibiting medical care effectiveness. Research also highlights barriers to accessing care for obese patients, including stigma, discrimination, and inadequately equipped medical facilities (Talumaa et al., 2022). These factors can impede regular check-ups, early diagnosis, and preventive care vital for optimal health. 

Patient Safety

 Patient safety is significantly compromised with obesity. Obese individuals like John have a higher risk for adverse events such as misdiagnosis due to physical examination limitations, inaccurate drug dosing, complications from surgeries, and increased susceptibility to falls (Appeadu & Bordoni, 2023). A concrete example would be the issues around correct medication dosing. An obese patient may receive an inaccurate dosage due to complexities accounting for body fat, potentially leading to overdosing or underdosing. 

System and Individual Costs 

 The economic burden of clinical obesity is enormous on both healthcare systems and individual patients. Direct medical costs tied to obesity include preventive, diagnostic, and treatment services (Ling et al., 2022). Obesity-related illnesses increase hospital admissions and extended hospital stays, straining healthcare resources. Individually, patients like John bear the burden of high out-of-pocket expenses, including medication costs, additional co-pays, and surcharges on premiums for their increased risk status.

Nursing Practice Standards and Policy Impact on Quality of Care, Safety, and Costs: A Literature Synthesis

The Board of Registered Nursing (BRN) in California has outlined comprehensive standards that significantly influence the quality of care, patient safety, and the costs associated with healthcare. BRN emphasizes the active involvement of registered nurses in preventing and managing diseases in collaboration with other healthcare teams. In the context of obesity, for instance, BRN suggests that nurses maintain ongoing nutrition and weight management education. Still, it also highlights the need to detect obesity-related complications like diabetes or cardiac issues competently (Backstrom, 2019). These standards thus aim to improve the quality of care provided to obese patients while ensuring safety by preventing or managing potential complications. Financial costs can also be maintained, avoiding expensive procedures arising from unmanaged complications. 

The Affordable Care Act (ACA) has significantly reduced the financial burdens associated with obesity-related diseases by focusing more on preventive care and chronic disease management. It mandates that insurance covers preventative services, lightening patients’ financial load. ACA also promotes healthy living in individuals, which can prevent the development of severe conditions linked to obesity. Focusing on preventive care directly impacts cost reduction by averting expensive treatments and hospitalizations later (Rdesinski et al., 2023). Research supports these policies’ effectiveness; Mylona et al. (2020) documented a decline in obesity-related healthcare costs after ACA implementation, underscoring the benefits of concentrating on preventative care and management. 

This policy shift has influenced nursing practice by providing a cornerstone for a more comprehensive, cost-effective patient care strategy. Considering a patient like John, this could entail regular health monitoring, mental health support, patient education on self-management, and preventive measures to improve care quality and safety and reduce costs. These standards and policies help shape nursing practice by guiding patient relationships, enforcing competency standards, and regulating clinical decision-making. The standards set by Nurse’s Practice Act dictate the scope of practice, while federal laws, such as ACA, influence the delivery of preventive care, reimbursement rates and respect patient rights, all of which have a profound impact on the quality of care, patient safety, and the cost to the system and the individual. These combined influences provide a direction for nurses to offer patients efficient, preventive, and sustainable healthcare.

Effective Strategies for Enhancing Care Quality, Patient Safety, and Cost Efficiency

The strategies that can improve the quality of care, enhance patient safety, and reduce costs to the system and individual for John’s clinical obesity could include:

Personalized Care 

The concept of Personalized Care plays a critical role in improving patient care, safety, and cost-effectiveness in the healthcare system. Combating patient problems, like obesity in John’s case, requires a multifaceted approach involving individualized weight loss goals, dietary changes, a structured and safe physical activity plan, and psychological support. As the American Heart Association emphasizes, personalized care plans consider each individual’s unique health circumstances and requirements. For a non-communicable disease like obesity, this approach could include recommendations for a dietary shift towards lower saturated fats and higher fruits and vegetables.

Regular and progressive physical activity recommended by a physical therapist could be a crucial component of the care plan. This approach can target weight loss without raising the risk of bodily injury. Recognizing that obesity often coexists with mental health issues like depression and anxiety involving a psychologist or a counselor in the care plan can be advantageous (Lavallee et al., 2021). For personalized care, studies reveal improved patient engagement and adherence to lifestyle changes, as it considers individual preferences and capabilities. In obesity management, a customized approach could include tailored diet plans, exercise regimens, and behavioral therapies, which can all lead to significant and sustainable weight loss (Wadden et al., 2020). This comprehensive approach embodies facets that enhance patient safety, ensure the quality of care, and empower the patient toward better health outcomes. 

Telehealth services

Telehealth services are becoming incredibly important in managing obesity, facilitating crucial elements such as remote patient monitoring, nutrition counseling, mental support, and physical activity strategies. In the case of John, an individual struggling with obesity, telehealth can deliver varied advantages. Frequent virtual meetings allow healthcare experts to remotely track patients’ weight and critical health indicators, adjusting treatment plans when needed. This can lead to superior health management, decreasing the chance of complications associated with obesity, such as diabetes and heart disease. In addition to monitoring medical conditions, telehealth can offer John nutritional counseling services. Accredited dieticians can remotely evaluate his eating habits, design personalized food plans, and provide nutritional education. This guidance can be instrumental in helping John pick healthier food options and comprehend the relationship between nutrition and overall health.

Comprehensive physical activity programs can be accessible to John through telehealth, modifying workouts based on his capabilities and likings. Exercise sessions or physiotherapy can be done virtually, which removes the need for a gym membership or transportation. Additionally, telehealth can connect John with psychologists or therapists to help him deal with any mental or emotional challenges linked with obesity. Telehealth presents itself as a feasible and adjustable approach to delivering personalized care. A study by Houser et al. (2019) demonstrated that weight management programs via telehealth led to weight reduction and improved health behaviors amongst obese individuals. Consequently, telehealth provides a well-rounded approach to managing John’s obesity, which can improve his health results and enhance his quality of life.

 Evidence is steadily growing support,g strategies such as personalized care and telehealth services for managing obesity, guided by research and relevant benchmark data. Sources such as the Centers for Disease Control and Prevention (CDC), which offers information on obesity prevalence and related health outcomes, and the American Telemedicine Association, which provides data on the scalability and effectiveness of telehealth services, can serve as benchmark data. Trends, products, and the impact of interventions can be gleaned from data collected over time from these sources. Comparing John’s progress with these benchmarks can provide invaluable insight into both his health journey and the effectiveness of the personalized telehealth services he is using. Overall, evidence suggests that customized care and telemedicine services show promise in managing obesity, offering a multifaceted, accessible, and adaptable approach to care. 

Practicum Experience Hours

To track the practicum hours spent aiding John with obesity management, I’ll meticulously log data on Capella’s Academic Portal Volunteer Experience Form. This will contain records of session dates and times, the nature of our interaction, interventions employed, and John’s progress. This will include changes in his weight, diet, exercise habits, and his response to different strategies. I might also record changes in his mood, motivation, and commitment to his obesity management program. I would also document any challenges encountered during the sessions and how they were addressed. If any consultations with the subject matter and industry experts were done during these hours, those should also be documented. I demonstrate accountability, commitment, and professionalism by meticulously registering these data. Moreover, it allows for an objective review of the efficacy of interventions and helps inform future approaches, making the overall process more evidence-based and person-centered.


As we conclude our deep dive into assessing the quality, safety, and cost considerations within healthcare, particularly in the context of John’s clinical obesity, it is critical to reflect on the complexity of this pervasive health challenge. Obesity is not just an individual problem; it goes beyond touching every corner of our healthcare system. The downstream effect on quality of care, patient safety, and cost to the individual and the system is profound. In the face of it, strict adherence to the standards set forth by entities such as the Board of Registered Nursing (BRN) and legislation like the Affordable Care Act (ACA) can significantly mediate these effects.

As healthcare providers, we can take these as a guiding force, directing our approach towards prevention, proactive management of complications, and fostering a more comprehensive care system that is financially easier for everyone involved. Most importantly, let us not lose sight of the human at the center, our patient John, and many others like him agitating under the burden of obesity. Combining empathic, clinically excellent care, effective policies and standards, and personalized preventive strategies can significantly improve their healthcare experience. Our collective efforts should bend towards making their journey toward health not just a possibility but a reality. It is about more than just our professional standards. Still, it is the very core of why we became part of the healthcare system, to begin with – to help individuals like John live healthier, happier, and more fulfilling lives.


Appeadu, M., & Bordoni, B. (2023). Falls and fall prevention. PubMed; StatPearls Publishing. 

Backstrom, L. (2019). Weighty problems: Embodied inequality at a children’s weight loss camp. Rutgers University Press.

Houser, S., Joseph, R., Puro, N., & Burke, D. (2019). Use of technology in the management of obesity: A literature review. Perspectives in health information management, 16(Fall). 

Lavallee, K. L., Zhang, X. C., Schneider, S., & Margraf, J. (2021). Obesity and mental health: A longitudinal, cross-cultural examination in Germany and China. Frontiers in Psychology, 12(712567.). 

Ling, J., Chen, S., Zahry, N. R., & Kao, T. A. (2022). Economic burden of childhood overweight and obesity: A systematic review and meta‐analysis. Obesity Reviews, 24(2). 

Mylona, E. K., Benitez, G., Shehadeh, F., Fleury, E., Mylonakis, S. C., Kalligeros, M., & Mylonakis, E. (2020). The association of obesity with health insurance coverage and demographic characteristics: A statewide cross-sectional study. Medicine, 99(27), e21016. 

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

Rdesinski, R., Chamine, I., Valenzuela, S., Marino, M., Schmidt, T., Larson, A., Huguet, N., & Angier, H. (2023). Impact of the Affordable Care Act Medicaid expansion on weight loss among community health center patients with obesity. The Annals of Family Medicine, 21(Supplement 1). 

Safaei, M., Sundararajan, E. A., Driss, M., Boulila, W., & Shapi’i, A. (2021). A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity. Computers in Biology and Medicine, 136(104754). 

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

Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022). Effective strategies in ending weight stigma in healthcare. Obesity Reviews, 23(10). 

Ufholz, K., & Bhargava, D. (2021). A review of telemedicine interventions for weight loss. Current Cardiovascular Risk Reports, 15(9).

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

Wadden, T. A., Tronieri, J. S., & Butryn, M. L. (2020). Lifestyle modification approaches for the treatment of obesity in adults. American Psychologist, 75(2), 235–251. 


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