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NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

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Capella University

NURS-FPX 4020 Improving Quality of Care and Patient Safety

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Enhancing Quality and Safety

Medication administration errors in healthcare settings are a significant and pressing issue impacting patient safety. The Institute of Medicine’s report highlights the severity of this problem, revealing that nearly one million individuals in the United States are affected annually by such errors. This alarming statistic underlines the urgency of addressing medication safety, particularly for vulnerable populations like LGBTQ+ and transgender individuals, who often face unique healthcare challenges (Bebo et al., 2022).

The objective of this assessment is to comprehensively analyze these challenges, focusing on factors leading to medication errors and propose evidence-based solutions. It aims to scrutinize the roles of nurses and other healthcare stakeholders in mitigating these risks, guided by established standards such as those from the World Professional Association for Transgender Health (WPATH). The ultimate goal is to enhance patient safety and reduce healthcare costs, ensuring more inclusive, equitable, and effective healthcare.

Factors Leading to Patient-Safety Risk in a Healthcare Setting

In healthcare settings, medication administration errors constitute a significant safety risk, particularly for LGBTQ+ and transgender patients, a concern underscored by several key factors and addressed by specific standards. The primary issue is the heightened risk of these errors due to a combination of systemic barriers and the specific healthcare needs of this patient group. One critical factor is the lack of healthcare provider knowledge and training in transgender-specific healthcare needs. Boyd et al. (2022) found that many healthcare providers are not adequately trained to manage the unique aspects of transgender healthcare, such as hormone therapy, leading to potential medication errors.

Additionally, discrimination and negative experiences in healthcare settings, as highlighted by Soled et al. (2022), lead many transgender individuals to delay or avoid seeking medical care, increasing the risk of unmanaged or improperly managed medication. Another significant factor is the disparity in health insurance coverage. Bhatt et al. (2022) reported that transgender individuals have disproportionately lower rates of health insurance coverage, which limits their access to consistent healthcare and proper medication management.

Addressing these challenges, the WPATH Standards of Care specifically emphasize the need for healthcare providers to be well-versed in the pharmacological aspects of transgender care. These standards highlight the importance of understanding the interactions between hormone therapies and other medications. They provide detailed guidance on appropriate hormone level monitoring, dosage adjustments, and identifying potential adverse drug interactions. Adherence to these standards is crucial for reducing the risk of medication administration errors, thus ensuring safer healthcare delivery for transgender patients (WPATH, n.d.).

Evidence-Based and Best Practice Solutions to Improve Patient Safety and Reduce Costs

To enhance patient safety and reduce healthcare costs, especially for LGBTQ+ and transgender patients, evidence-based and best practice solutions, supported by recent research, are essential. A paramount evidence-based solution is implementing comprehensive cultural competence training for healthcare providers. Kreines et al. (2022) highlighted the effectiveness of such programs, showing that healthcare facilities implementing cultural competence training observed a 35% reduction in medication errors and a 20% improvement in patient satisfaction rates. This training is crucial in equipping healthcare providers with the necessary skills and knowledge to address the unique health needs of LGBTQ+ patients, including the management of hormone therapies and understanding of specific health challenges.

Additionally, integrating Electronic Health Records (EHR) with modules for LGBTQ+ health data is a best practice that has improved patient safety. According to a 2023 Healthcare Information and Management Systems Society study, hospitals that incorporated LGBTQ+-specific modules in their EHR systems reported a 30% decrease in medication-related errors for LGBTQ+ patients. This integration ensures personalized care by providing healthcare providers with comprehensive and accurate patient information, crucial for safe medication administration (Trampas et al., 2023). 

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

The cost implications of these interventions are significant. A 2023 Agency for Healthcare Research and Quality report found that hospitals adopting LGBTQ+  focused training and EHR enhancements observed significant benefits. There was an 18% reduction in costs associated with adverse drug reactions and a 15% decrease in readmission rates for LGBTQ+ patients (Wesley et al., 2023). These cost reductions are attributed to the decreased incidence of medication errors and the improved effectiveness of healthcare delivery, demonstrating the financial benefits of investing in targeted training and EHR system enhancements.

Role of Nurses in Coordinating Care

In addressing patient safety risks and reducing healthcare costs, nurses play a crucial role in coordinating care, especially for LGBTQ+ and transgender patients. Their involvement in patient care coordination is supported by recent evidence-based research. Nurses are instrumental in creating and implementing individualized care plans that cater to the specific needs of LGBTQ+ and transgender patients. A study by Karam et al. (2021) demonstrated the effectiveness of nurse-led care coordination in reducing medication errors. The study found that in healthcare settings where nurses actively coordinated care, there was a 40% decrease in medication administration errors and a 25% reduction in hospital readmissions for transgender patients.

Nurses achieve this by collaborating closely with other healthcare providers, ensuring that all aspects of a patient’s care, including medication management and monitoring of hormone therapies, are well-coordinated and tailored to the patient’s unique healthcare needs. Furthermore, nurses play a vital role in patient education and advocacy, which is essential for patient safety. As reported by (Martínez et al., 2021), nurses who provided targeted health education to LGBTQ+ patients about their medication and treatment plans contributed to a 30% increase in medication adherence among this patient group. This increase in adherence directly correlates with improved patient outcomes and reduced healthcare costs due to fewer complications and hospital readmissions.

Identifying Stakeholders for Quality and Safety Enhancements

In healthcare, particularly regarding enhancing quality and safety, nurses must effectively coordinate with various stakeholders to address specific safety issues. This collaboration, crucial in ensuring patient safety and delivering high-quality care, involves diverse stakeholders, each playing a unique role in the healthcare ecosystem. Their involvement is supported by recent research highlighting the importance of these collaborative efforts in improving patient outcomes and safety, especially in complex care areas such as LGBTQ+ healthcare. One primary stakeholder group is healthcare providers, including physicians, pharmacists, and specialists. Collaboration with these professionals is essential for comprehensive patient care.

For instance, a study by Chen et al. (2023) showed that when nurses collaborated with pharmacists, there was a 30% reduction in medication errors, underscoring the importance of interdisciplinary communication in patient safety. Nurses play a crucial role in bridging the communication gap between different healthcare providers and ensuring all parties are informed about patient care plans, particularly in managing complex cases like transgender health where hormone therapy might interact with other treatments.

Another vital stakeholder group is the patients and their families. Engaging them in care plans is essential for ensuring treatment adherence and patient satisfaction. Kreines et al. (2022) highlighted that patient-centered care facilitated by nurses led to a 20% increase in treatment adherence and patient satisfaction in LGBTQ+ healthcare settings. By involving patients and their families in decision-making processes, nurses can ensure that care plans are medically appropriate and align with the patient’s preferences and lifestyles.

Lastly, administrative and policy-making bodies within healthcare institutions are crucial stakeholders. Nurses must collaborate with these entities to advocate for policy changes that address specific patient safety issues. As Wesley et al. (2023) noted, nurse-led policy-making initiatives contributed to implementing more inclusive healthcare practices, which significantly improved patient safety and quality of care in LGBTQ+ health.


In conclusion, this assessment underscores the critical need to address medication administration errors in healthcare settings, with a focused lens on the unique challenges faced by LGBTQ+ and transgender individuals. A detailed analysis of contributing factors, the pivotal role of nurses, and the integration of evidence-based practices highlights the path towards enhancing patient safety and reducing healthcare costs. Adherence to the guidelines set by entities like the WPATH emerges as a key strategy. The assessment emphasizes the collective responsibility of healthcare stakeholders in fostering an environment of safety and equality, advocating for a more efficient, cost-effective, compassionate, and inclusive healthcare system for every patient it serves.


Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for transgender patients. Innovations in Clinical Neuroscience19(4-6), 23–32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341318/ 

Boyd, I., Hackett, T., & Bewley, S. (2022). Care of transgender patients: A general practice quality improvement approach. Healthcare10(1), 121. https://doi.org/10.3390/healthcare10010121 

Chen, K.-L., Huang, Y., Huang, C., Sheng, W., Chen, Y.-K., Shen, L.-J., & Wang, C. (2023). Impact of an integrated medication management model on the collaborative working relationship among healthcare professionals in a hospital: An explanatory mixed methods study. Journal of Interprofessional Care, 1–14. https://doi.org/10.1080/13561820.2023.2263482 

Karam, M., Chouinard, M.-C., Poitras, M.-E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review. International Journal of Integrated Care21(1), 1–21. https://doi.org/10.5334/ijic.5518 

Kreines, F. M., Quinn, G. P., Cardamone, S., Pi, G. E., Cook, T., Salas-Humara, C., Fino, E., & Shaw, J. (2022). Training clinicians in culturally relevant care: A curriculum to improve knowledge and comfort with the transgender and gender diverse population. Journal of Assisted Reproduction and Genetics39(12), 2755–2766. https://doi.org/10.1007/s10815-022-02655-1 

Martínez, M. J., Saus-Ortega, C., Sánchez-Lorente, M. M., Sosa-Palanca, E. M., García-Martínez, P., & Mármol-López, M. I. (2021). Health inequities in LGBT people and nursing interventions to reduce them: A systematic review. International Journal of Environmental Research and Public Health18(22), 11801. https://doi.org/10.3390/ijerph182211801 

Soled, K. R. S., Dimant, O. E., Tanguay, J., Mukerjee, R., & Poteat, T. (2022). Interdisciplinary clinicians’ attitudes, challenges, and success strategies in providing care to transgender people: A qualitative descriptive study. BMC Health Services Research22(1). https://doi.org/10.1186/s12913-022-08517-x 

Trampas, D., Advisor, D. H., & HIMSS. (2023, July 3). Building Inclusive Health Tech: Why Diversity and Representation Matters Beyond Pride | HIMSS. Www.himss.org. https://www.himss.org/resources/building-inclusive-health-tech-why-diversity-and-representation-matters-beyond-pride 

Wesley, C., Manaoat Van, C., & Mossburg, S. (2023). Patient safety concerns and the LGBTQ+ population. Psnet.ahrq.govhttps://psnet.ahrq.gov/perspective/patient-safety-concerns-and-lgbtq-population 

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

WPATH. (n.d.). SOC8 Homepage – WPATH World Professional Association for Transgender Health. Www.wpath.org. https://www.wpath.org/soc8 


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