NUR 495 Health Care Delivery Systems Discussion

In complex healthcare environments, an awareness of how consumer relations affect the provision of nursing care is essential. Consumers are faced with many changes and challenges as they navigate the healthcare delivery system. When clients enter the system, they lose a significant amount of control and their families may experience stress due to changes in relationships with their loved ones and the burden of additional responsibilities.

The Code of Ethics for Nurses requires nurses to maintain a primary commitment to clients and their families and to involve them as they develop and implement individualized plans for care. Client-centered care requires relationships of mutuality and reciprocity, which results in respectful and effective communication and establishes a dynamic that promotes optimal care.

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Upon successful completion of the course material, you will be able to:

Explore the characteristics of organizations with high ethical standards.
Analyze perceptions of and challenges for nurses and clients in the provision of client-centered health care.

Textbook: Leading and Managing in Nursing
Web Article: Creating a Culture of Ethical Practice in HealthCare Delivery Systems
Website: American Nurses Association (ANA) Nursing World

Background Information
In the assigned readings this week, you will explore ethical practices associated with healthcare delivery systems. You will identify and analyze similarities and differences in perceptions of nurse leaders and clients related to the complex system and the provision of care. The activities are designed to assist you in discovering how nurse leaders facilitate ethical client-centered care and promote positive experiences with healthcare.

As you develop the discussion response below, consider a common client population associated with your capstone project.


Review the rubric to make sure you understand the criteria for earning your grade.
Read Chapter 3, 12, and 22 in the textbook: Leading and Managing in Nursing.
Read the following article from Online Campus Library Services (OCLS). The link takes you to the article in the online library. Log in to the database using your MYIWU Portal User Name and Password. If you have any trouble accessing the article, please contact OCLS by filling out the OCLS Request Form.
Creating a culture of ethical practice in health care delivery systems.
Visit the American Nurses Association (ANA) Nursing World website’s section entitled, “Ethics” at
Briefly review the “Code of Ethics for Nurses with Interpretive Statements” by clicking on the link for that article.
Navigate to the threaded discussion and respond to the following while considering a common client population associated with your capstone project:
Describe three ways the health care organization of your capstone project creates or could create a culture of ethical practice.
Identify one factor that you as a nurse leader can use to facilitate ethical patient-centered care to promote a positive health care experience.
What tenets of the ANA Code of Ethics for Nurses (2001) can be applied to your capstone project to facilitate ethical patient-centered care?

For your Capstone Project this week, you will complete an outline of your plan/proposal and describe the stakeholder audience to whom you will present your draft project.

A key element of your Capstone Project is presenting your project to a stakeholder audience and obtaining their feedback on your plan or proposal. In Week 6, you will informally present your draft project plan or proposal to a relevant stakeholder audience – an administrator, staff member, or faculty member at the institution you are targeting for your project, and/or an employer, alumni, or community representative. You may present your project to an individual, several individuals separately, or to a small group. Consider that the more people with whom you share your project, the more useful feedback you are likely to receive on the value and appropriateness of your project for that institution.

Using feedback from your colleagues and Instructor, revise your problem statement and rationale (submitted in Week 1), add your literature review, and develop an outline of your project plan or proposal. Your outline should include the following major elements:

Goals for the project
Description of the local context
Activities, initiatives, or strategies to be used
Deliverables or outcomes – what the project should accomplish
How the project, if implemented, could be evaluated or assessed
A proposed timeline that could be followed to implement the project
A list of budgetary items – financial, human, or other resources – that would be needed to support the project
The stakeholder audience to whom you plan to present your project plan/proposal, and reasons for their interest in the project

2. Introduction to your proposed problem:

– Significance of the Practice Problem: Discuss the identified Practice Problem.

-Introduce the topic of the paper.

-Describe the health problem. Don’t type “Introduction.” OR “PICOT”

-Present PICOT in a paragraph format

-Using data and statistics, support your claim that your selected issue is a problem.

– Include your purpose statement and what specifically you will address in your proposed program.

-Be sure your proposed outcome is realistic and measurable.

3. PICOT- Should be discussed in detail. This section should include your PICOT question but also should provide thorough descriptions of your population, intervention, comparison intervention, outcome, and timing (if appropriate to your question).

The word PICOT is a mnemonic derived from the elements of a clinical research question – patient, intervention, comparison, outcome, and (sometimes) time. The PICOT process begins with a case scenario, and the question is phrased to elicit an answer. P – Patient/Problem I – Intervention C – Comparison O – Outcome T – Timeframe

4. Describe the vulnerable population

-Discuss the impact of social determinants on health for your selected population.

-What are the risk factors that make this a vulnerable population?

-Use evidence to support the risk factors you have identified.

5. Research should be from scholarly journals of evidence-based interventions that address the problem.

-Peer-reviewed research articles not older than five years (all articles must be used in your paper)

6. Proposal

-Propose addressing the selected health problem using an evidence-based intervention in your literature search to address the problem in the selected population/setting.

-Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role.

-Be sure to include a timeline for the intervention proposed.

7. Theoretical Framework/Nursing Theory- This section should include the theoretical framework which supports your project. Describe a theory or model to serve as the foundation for your project.

– Overall, you should be able to introduce the problem and why this is significant to the healthcare system. For example: What impact does it have on the patient, community, cost of care, quality of life, readmissions and so forth

-Use appropriate APA 7th Ed. format along with Syllabus outline

-Scholarly, peer-reviewed, and research articles cited should be within the last five years.

-This section should be 3-4 pages long (not including the title and reference page).

-Use proper in-text citations with a properly formatted reference list.

-All papers must be written in the 3rd person.


1. Review of Literature

– Review and discuss literature: Synthesize at least 10 primary research studies and/or systematic reviews; do not include summary articles. This section is all about the scientific evidence rather than someone else’s opinion of the evidence. Do not use secondary sources; you need to get the article, read it, and make your own decision about quality and applicability to your question even if you did find out about the study in a review of the literature. This is a synthesis rather than a study by study review. Address the similarities, differences, and controversies in the body of evidence.

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