Ethical and Policy Issues in Nursing


Government policy and ethical considerations have a significant impact on care coordination. They indicate the types of care that must be provided and the minimum conditions that must be met by healthcare organizations (Rajamohan et al., 2019). Nurses working at nursing homes depend on the policies and code of conduct to work effectively. Failure to apply the policies and follow the provisions may lead to suspension from duty and poor care to patients. As a result, regulations and codes addressed in this presentation will inform the healthcare providers at nursing homes to provide high-quality care while adhering to ethical standards. Therefore, government policy, ethical considerations, and the nurses’ code of ethics exist to promote care coordination among nurses at nursing homes.

The Impact of Government Policies On Nursing Homes

One of the community organizations impacted by government policies is the nursing home. Several state and federal regulations safeguard nursing home residents while promoting their well-being and health results (Cohen & Mello, 2018). All nursing facilities that participate in federal programs are required by the Centers for Medicare and Medicaid Services (CMS) to follow the rules. One of the most important is keeping accurate, accessible, and full records of each nursing home resident. The other policy affecting nursing home operations is the Nursing Home Reform Act of 1987 (Rajamohan et al., 2019). The policy influences nursing homes by ensuring the prompt and correct maintenance of clinical records for all patients and thereby directs the expectations of nursing home healthcare staff.

The Health Insurance Portability and Accountability Act (HIPAA) is applicable to nursing homes and has an impact on how people are cared for during care. According to Cohen and Mello (2018), HIPAA provides guidelines for safeguarding patient medical records and other protected health information. In addition, it governs how personal health information can be accessed, utilized, and released while maintaining patient privacy and security. Therefore, to avoid penalties and any legal action, nursing home care providers must be familiar with the privacy and security rules. As a result, this policy emphasizes the responsibility of the healthcare provider to protect the patient’s health information from unauthorized access and breach.

The Policies that Raise Ethical Dilemmas

There are several policies that raise ethical dilemmas during the coordination of care. The first policy is the health insurance policy in the US which supports the application of managed care plans (Eguia et al., 2018). One of the main purposes of managed care plans is to reduce the cost of healthcare. However, the priority is given to the payment of healthcare insurance rather than the care given to patients. The second policy is the Affordable Care Act (ACA), which is designed to improve care provision (Eguia et al., 2018). Despite its existence, healthcare is not affordable to Americans. In addition, the fines charged create an ethical dilemma due to their impact on care coordination. Excess fines may interfere with the effectiveness of care coordination by lowering resources at the nursing home.

The Impact of the Code of Ethics on Nurses

The Implications

Code of ethics is an important tool for nurses because it guides daily practice. Provision 4 aids in acknowledging the patient’s responsibility and accountability through nursing practice and delegation (Weis & Schank, 2017). The nurse is responsible for delegating the appropriate responsibilities to the appropriate staff. Provision 7 of the code encourages nurses to participate in healthcare policy and stay involved (Weis & Schank, 2017). This involves mentoring new nurses and taking on leadership roles. Other methods to keep active include serving on a committee and helping the next generation of nurses. These provisions ensure that nurses working in a nursing home work together with others to provide quality healthcare services.

The code of ethics has an impact on the coordination of care at nursing homes. According to provision 3 of the code, a nurse should defend, promote, and advocate for the rights and safety of patients (Weis & Schank, 2017). In addition, this care coordination guideline implies that the nursing home care provider should query the authorization of specific individuals to access patient information. For instance, when coordinating care with third parties, the nurse must promote the privacy of information. However, they are authorized to share information and what information they can communicate with the third party. Therefore, this code of ethics ensures that nurses working at nursing homes avoid mistakes while providing healthcare services to patients.

The Consequences of the Provisions

The provisions may lead to suspension from work if they are not followed. Nurses operating in nursing homes are required to adhere to the code of conduct for the provision of quality healthcare services. However, they are prone to suspension from work when the codes are not followed. According to Brent (2019), in the case of Leach v. Iowa Board of Nursing, the nurse involved was punished and had to repeat a Health Insurance Portability and Accountability Act learning module after being suspended for two 12-hour shifts. The nurse represents one of the nurses who experienced the negative impacts of the provisions.

The Social Determinants of Health Identified in Healthy People 2020

This is critical in coordinated care since it gives everybody exposure to the patient’s care plans and intervention. The Protection Act establishes guidelines for preventing unauthorized access to care (Schroeder et al., 2019). Although it protects patient information, it hiders coordinated care, considering that some important parties may be denied access to information while they are integral in the development of collaborative care. One social determinant that mostly influences this law is the lack of awareness of the strategies to protect restricted data (Schroeder et al., 2019). A data breach is possible when there is ignorance of ways to protect it, considering that simple mistakes such as sharing information with other unauthorized experts may result in a violation of the law while this practice of sharing and interpersonal cooperation is based on sharing.

One of the essential pillars of continuum-based care is care coordination. Nurses must work with interdisciplinary teams to address the patient’s requirements in order to provide safe and effective treatment (Schroeder et al., 2019). However, various hindrances affect interpersonal collaboration in healthcare provision, including the social determinants of health, such as poverty and lack of education about the importance of coordinated care. Rigid federal statutes such as ACA and HIPAA also affect the proper implementation of coordinated care since they provide exclusive ultimatums, which may result in poor coordination. Ethical considerations such as inclusivity, while the law does not accommodate such a setup, significantly hinder promoting adequate change.


The effectiveness of coordination of care largely depends on healthcare policy and nursing ethics. Healthcare policies lay forth the procedures that health facilities must follow to achieve improved health results. For instance, HIPAA policies safeguard patient data and information from illegal access. In the same way, codes of ethics outline how nurses should conduct themselves when coordinating care in various circumstances. Care coordination in nursing homes should, in general, increase residents’ well-being while also improving care outcomes and care ethics. The appropriate processes and safeguards that should be undertaken to protect patients’ safety and improve their outcomes are defined by healthcare policy and code of ethics.


Brent, J. M. N. S. (2019). RN breaches patient confidentiality policy to check work schedule. Nurse.Com Blog.

Cohen, I. G., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st century. Jama, 320(3), 231-232.

Eguia, E., Cobb, A. N., Kothari, A. N., Molefe, A., Afshar, M., Aranha, G. V., & Kuo, P. C. (2018). Impact of the Affordable Care Act (ACA) Medicaid expansion on cancer admissions and surgeries. Annals of Surgery, 268(4), 584.

Rajamohan, S., Porock, D., & Chang, Y. P. (2019). Understanding the relationship between staff and job satisfaction, stress, turnover, and staff outcomes in the person-centred care nursing home arena. Journal of Nursing Scholarship, 51(5), 560-568.

Schroeder, K., Garcia, B., Phillips, R. S., & Lipman, T. H. (2019). Addressing social determinants of health through community engagement: An undergraduate nursing course. Journal of Nursing Education, 58(7), 423-426.

Weis, D., & Schank, M. J. (2017). Development and psychometric evaluation of the nurse’s professional values scale-3. Journal of Nursing Measurement, 25(3), 400-410.

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