NURS 500 Assignment: Healthcare System, Policies, and Theories

This assignment, designed for a NURS 500 course, examines the distinctions between healthcare protocols, standards of care, and policies at practice, state, and federal levels. It explores the perspectives of patients, providers, payers, and policymakers within the healthcare system. The assignment also requires the discussion of a relevant nursing theory, specifically focusing on Virginia Henderson's 'Need's theory', and its implications on nursing administration, management, or education. The solution provides detailed explanations of each concept, supported by academic references, and offers insights into how these elements impact nursing practice and patient care. The assignment provides a comprehensive overview of healthcare systems and nursing theories.

Running head: NURSING AND HEALTHCARE SERVICES
NURSING AND HEALTHCARE SERVICES
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1NURSING AND HEALTHCARE SERVICES
Question 1
A protocol is an established framework dictating standards of clinical care for the
purpose of delivering quality services to patients within a particular area of practice. While a
protocol may not provide exact details on the methods underlying the performance of procedure,
protocols establish the place, the clinical situation, the reason and the designation personnel
responsible for deliverance of the protocol. For example: The Food and Nutrition Service (FNS),
as part of the United States Department of Agriculture (USDA), provides protocols for the
delivering nutritious meals to patients with allergies by outlining frameworks for avoiding cross
contamination and labelling the food trays with the specific allergies, name, room number and
bed number of the patient (Morphet, Clarke & Bloomer, 2016). Standards of Practice are
frameworks, formulated at the national or state level, and dictates expected outcomes, duties and
responsibilities from health professionals. For example: the Nursing Standards of Practice are
implemented at the national level where every state has its own set of guidelines which dictate
nurses on the responsibilities they must follow to obtain licensure and successful implement
quality nursing services (McMullen et al., 2015). Policies are written statements dictating
standards of healthcare to be implemented at the federal level and hence, is governed solely by
federal legislation. For example: the Patient Protection and Affordable Care Act (PPACA) has
been implemented by the federal government in order to ensure that every state overlooks
availability of subsidized insurance coverage and healthcare services for required patient
communities (Sommers et al., 2015).
The multiple stakeholders who are involved in the healthcare delivery system include,
patients, providers, policy makers and payers, each of whom perceive the system in varied ways.

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Patients perceive that the healthcare system must not only provide them with services which are
accessible, affordable and efficient but must also provide accessible information on the details
underlying their care, via documentation and healthcare records (Piña et al., 2015). Providers
perceive the healthcare system as a platform to coordinate their services with additional
providers to deliver best quality care for overall benefit of patient communities (Norris et al.,
2017). Policy makers perceive the healthcare system as a practice which must be standardized by
protocols and laws to ensure deliverance of superior clinical services. Payers perceive the
healthcare system as one which required sustainable and stable resources for adequate
functioning hence resulting in their function of procuring financial resources for healthcare
policies (Bastian, Munoz & Ventura, 2016).
Question 2
The key nursing theory which is essential for guidance in nursing academics and clinical
professional practice is the ‘Need’s theory’ by Virginia Henderson. According to this theory,
nurses must strive to ensure that a patient achieves independence in conducting their self-care
strategies even after treatment and hospitalization (Ahtisham & Jacoline, 2015). Implementation
of such a theory can be strongly observed to affect nursing administration and management, via
the need for nurses to practice patient centered care - which necessitates incorporation of needs
of the patient in the care plan through direct patient discussion and involvement. This theory also
dictates nursing education via teaching nurses on strategies of follow up valuation and referral
recommendations to the patient to ensure his or her independence and guidance in self-care post
treatment (McDonald et al., 2019).

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References
Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice;
Virginia's Henderson Need Theory. International Journal of Caring Sciences, 8(2).
Bastian, N. D., Munoz, D., & Ventura, M. (2016). A mixed-methods research framework for
healthcare process improvement. Journal of pediatric nursing, 31(1), e39-e51.
McDonald, K. M., Singer, S. J., Gorin, S. S., Haggstrom, D. A., Hynes, D. M., Charns, M. P., ...
& Axon, R. N. (2019). Incorporating theory into practice: Reconceptualizing exemplary
care coordination initiatives from the US Veterans health delivery system. Journal of
general internal medicine, 1-6.
McMullen, T. L., Resnick, B., Chin-Hansen, J., Geiger-Brown, J. M., Miller, N., & Rubenstein,
R. (2015). Certified nurse aide scope of practice: State-by-state differences in allowable
delegated activities. Journal of the American Medical Directors Association, 16(1), 20-
24.
Morphet, J., Clarke, A. B., & Bloomer, M. J. (2016). Intensive care nurses’ knowledge of enteral
nutrition: a descriptive questionnaire. Intensive and Critical Care Nursing, 37, 68-74.
Norris, J. M., White, D. E., Nowell, L., Mrklas, K., & Stelfox, H. T. (2017). How do
stakeholders from multiple hierarchical levels of a large provincial health system define
engagement? A qualitative study. Implementation Science, 12(1), 98.
Piña, I. L., Cohen, P. D., Larson, D. B., Marion, L. N., Sills, M. R., Solberg, L. I., & Zerzan, J.
(2015). A framework for describing health care delivery organizations and systems.
American journal of public health, 105(4), 670-679.

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Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported
insurance coverage, access to care, and health under the Affordable Care Act. Jama,
314(4), 366-374.