Ethical and Policy Factors in Care Coordination for Maternal Substance Use

Capella University NURS-FPX 4050 Assessment 3 asks you to develop a 10-minute PowerPoint presentation and 3–4 page narrative script analyzing ethical standards and policy issues that affect care coordination for Candace, a pregnant client with substance use disorder. You will examine how governmental policies shape community health and safety, explore national and state-level ethical dilemmas, and assess how the ANA Code of Ethics guides nursing practice. The assignment requires APA citations, a Kaltura video, and evidence from 4–5 peer-reviewed sources published between 2018 and 2026.

Brief Overview and Assignment Scope

Capella University NURS-FPX 4050 Assessment 3 requires students to examine ethical standards and policy issues that affect care coordination for a pregnant client with substance use disorder through a 10-minute PowerPoint presentation and narrative script.

Develop a 10–12 PowerPoint slide presentation with narrative Stript on your Safety concern/care coordination from assessment #2.

Students should frame Candace’s case around the tension between maternal autonomy and fetal safety, since current federal policy continues to shift toward family-centered care rather than punitive reporting.

Safety Concern from Assessment # 2: Pregnant Client (Candace) with Substance Use Disorder

• The presentation should be 10 minutes in length.
• The intended audience can be a healthcare organization—you are NOT presenting this live.
• The focus of the presentation is on ethical standards and relevant policy issues that impact the coordination of care at a healthcare organization.

Contemporary healthcare organizations increasingly rely on asynchronous video presentations to train interprofessional teams, so clarity and brevity in both slides and script matter more than ever.

• Create a detailed narrative script for your presentation on a Word document.
• The script should be 3–4 pages in length.

A well-structured script allows you to articulate transitions between slides while embedding APA citations naturally into spoken content.

Governmental Policies and Community Health

In your presentation:

• Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.
• Provide examples of a specific policy affecting your site.

The Child Abuse Prevention and Treatment Act (CAPTA) and its 2016 Comprehensive Addiction and Recovery Act (CARA) amendments directly shape how hospitals notify child protective services about substance-exposed infants, which affects Candace’s care plan (Darlington et al., 2024).

National State Local Policy Provisions

• Explain how national, state, and local policy provisions raise ethical questions or dilemmas for care coordination.
• What are the implications and consequences of specific policy provisions? Consider the impacts at the national, state, and local levels.
• What evidence do you have to support your conclusions?

State-level variability in mandatory reporting laws means that Candace’s provider in one state might face criminal prosecution threats, while a provider in another state would connect her to a Plan of Safe Care; these differences create profound ethical tension for nurses (Darlington et al., 2024).

Nursing Code of Ethics Impact

• Assess the impact of the code of ethics for nurses on the coordination and continuum of care. Consider the factors that contribute to health, health disparities, and access to services specific to your patient population.
• Include any evidence you have to support your conclusions.

The American Nurses Association Code of Ethics for Nurses with Interpretive Statements (2015) obligates nurses to practice with compassion and respect for inherent dignity, but nurses must also manage mandatory reporting requirements that may fracture trust with patients like Candace (Franco-Rowe et al., 2025).

Communicating Ethical Policy Issues

• Communicate key ethical and policy issues affecting the coordination and continuum of care for a healthcare organization. Make sure both narrative written script and a Kaltura video showing your PowerPoint with are included in your presentation.
• Present a concise overview.
• Support your main points and conclusions with relevant and credible evidence.

Effective presentations often open with a concise patient vignette, then move to policy analysis, and close with evidence-based recommendations that align with the ANA non-punitive treatment position (Ellick et al., 2024).

Scoring Guide and Assessment Criteria

The requirements outlined above correspond to the grading criteria in the Ethical and Policy Factors in Care Coordination scoring guide, so be sure to address each point.

Read the performance-level descriptions for each criterion to see how your work will be assessed.

Reviewing the distinguished-level descriptions on the scoring guide reveals that evaluators reward specific policy examples, explicit ethical analysis, and seamless integration of scholarly sources.

Presentation Format Requirements

• Title slide.
• Presentation title.
• Your name.
• Date.
• Course number and title.
• Slides should include APA references and/or in-text citations. You cannot have a reference slide without citing those references within the presentation.

Many students overlook the requirement to cite sources directly on individual slides, and omitting these citations violates academic integrity standards for visual presentations.

• References (at the end of your presentation).

Append your reference list to the narrative script rather than treating it as a standalone document.

Your slide deck should consist of 10–12 slides, not including a title and reference slide.

Create a detailed narrative script for your presentation in APA format with proper citation of supporting evidence.

This would be the script of what you would say in an actual presentation.

You do not need to present to an organization.

Kaltura recordings should display the slides in full-screen mode while your voice narrates the content; test your audio levels before final submission to avoid technical penalties.

Supporting Evidence Guidelines

Supporting Evidence

Cite 4–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation.

Include your source citations on a references page appended to your narrative script.

Use Academic Writer for guidance in citing sources in proper APA style.

See the Writing Center for more APA resources specific to your degree level.

Peer-reviewed sources from 2018 to 2026 carry more weight in this assessment than older textbooks, so prioritize recent nursing ethics and policy scholarship (Franco-Rowe et al., 2025).

Course Competencies and Learning Outcomes

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 2: Apply the code of ethics for nursing to care coordination decisions.
  • Assess the impact of the code of ethics for nurses on the coordination and continuum of care, including access to services.

Nurses working with pregnant patients who have substance use disorders frequently encounter moral distress when organizational policies conflict with patient advocacy goals (Darlington et al., 2024).

• Competency 3: Explain how health care policies affect the coordination of patient centered care.
  • Explain how governmental policies related to the health and/or safety of a community affect the coordination of care.
  • Explain how national, state, and local policy provisions raise ethical questions or dilemmas for care coordination. Include evidence to support ideas.

Recent CDC data indicate that states with non-punitive reporting policies and extended postpartum Medicaid coverage achieve higher rates of treatment retention among pregnant women with opioid use disorder (Ellick et al., 2024).

• Competency 5: Apply professional, scholarly communication strategies to lead patient centered care.

Scholarly communication in this context means translating complex regulatory language into actionable clinical guidance that frontline nurses can apply during discharge planning (Ellick et al., 2024).

Patient Profile and Clinical Context

Note on the patient, Candace.

Candace represents a growing population of pregnant women who face structural barriers to treatment, including intimate partner influences and limited access to medication-assisted therapy (Franco-Rowe et al., 2025).

She is pregnant, living at home with 2 kids.

Her boyfriend goes out and brings substances that both can use.

This raises serious health concern for both the baby and the mother.

Please use Candace as the patient when developing the PowerPoint Presentation.

Also refer to the Preliminary Care Coordination developed in Assessment 2.

Candace’s household dynamics illustrate how environmental triggers and relationship patterns compound the physiological challenges of pregnancy and substance use, making coordinated, multi-sector interventions essential for safe outcomes (Franco-Rowe et al., 2025).

Sample Response Excerpt

A strong response opens with a concise overview of Candace’s situation, noting that she is a pregnant mother of two living in a home where substance use is readily accessible through her boyfriend. The presentation then identifies the federal Child Abuse Prevention and Treatment Act (CAPTA) and the 2016 Comprehensive Addiction and Recovery Act (CARA) as the primary policies shaping her care coordination, particularly the requirement for Plans of Safe Care for substance-exposed infants. Students should explain how state-level mandatory reporting laws create ethical dilemmas for nurses who must balance patient advocacy with legal obligations, citing the ANA Code of Ethics for Nurses with Interpretive Statements (2015) to support non-punitive, compassionate care. The script evaluates how health disparities, including limited access to medication-assisted treatment and stable housing, restrict Candace’s continuum of care and increase her risk of preterm birth or neonatal abstinence syndrome. Evidence from recent peer-reviewed literature, as demonstrated in BMC Pregnancy and Childbirth (Franco-Rowe et al., 2025), shows that integrated care coordination improves perinatal outcomes for pregnant patients with substance use disorders. Finally, the presentation closes with actionable recommendations for the healthcare organization, including trauma-informed screening protocols and interprofessional collaboration with social services, to ensure patient-centered care without stigmatization.

Why do ethical and policy factors create barriers in care coordination for pregnant patients with substance use disorders?

Ethical and policy factors create barriers because federal mandates such as CAPTA require child welfare notifications for substance-exposed infants, yet state laws vary widely in how they define abuse, which forces nurses to manage contradictory obligations while trying to maintain patient trust. Darlington et al. (2024) found that maternity providers experience significant moral distress when mandatory reporting laws conflict with patient advocacy goals. State-level variations mean that Candace might encounter supportive care coordination in one jurisdiction and punitive prosecution in another, directly affecting her willingness to seek prenatal care. Recent evidence from Ellick et al. (2024) indicates that states with extended postpartum Medicaid coverage and non-punitive reporting achieve better treatment retention for pregnant women with opioid use disorder. Healthcare organizations can reduce these barriers by implementing trauma-informed protocols and interprofessional teams that align with the ANA Code of Ethics.

Key Considerations for Care Coordination

• Review your state’s specific CAPTA implementation guidelines, since notification requirements for substance-exposed infants vary significantly between jurisdictions and affect how nurses document positive screenings (Centers for Disease Control and Prevention, 2019).
• Integrate the ANA Code of Ethics for Nurses (2015) by emphasizing patient advocacy and nonjudgmental care when discussing Candace’s treatment plan with interprofessional team members (Darlington et al., 2024).
• Include at least one peer-reviewed source published after 2022 that addresses medication-assisted treatment barriers or ethical dilemmas in maternal substance use reporting (Franco-Rowe et al., 2025).
• Align your recommendations with the CDC’s state strategies for opioid use disorder in pregnancy, prioritizing extended postpartum coverage and trauma-informed provider training (Ellick et al., 2024).

Specialist Terminology for Care Coordination

Term	Definition
CAPTA	The Child Abuse Prevention and Treatment Act, federal legislation requiring states to establish child abuse reporting procedures and safe care plans for substance-exposed infants
CARA	The Comprehensive Addiction and Recovery Act of 2016, which amended CAPTA to include all substances, not just illicit drugs, in notification requirements
Plan of Safe Care	A coordinated care plan developed for infants affected by prenatal substance exposure, intended to address the health and substance use treatment needs of the infant and family
Medication-Assisted Treatment	The use of FDA-approved medications such as methadone or buprenorphine, combined with counseling, to treat opioid use disorder during pregnancy
Neonatal Abstinence Syndrome	A withdrawal condition observed in newborns exposed to opioids in utero, characterized by tremors, irritability, and feeding difficulties

Why This Matters in Practice

Healthcare leaders who understand the intersection of nursing ethics and substance use policy can design workflows that reduce stigma and keep families together. Nurses who master these concepts protect both maternal autonomy and infant safety while meeting legal obligations. Effective care coordination for Candace requires more than clinical knowledge; it demands fluency in regulatory frameworks, cultural humility, and commitment to evidence-based, non-punitive care.

Frequently Asked Questions

Which federal policies most directly shape care coordination for pregnant patients with substance use disorders?

CAPTA and CARA serve as the primary federal frameworks that require states to establish notification and safe care planning protocols for substance-exposed infants. These laws do not mandate universal drug testing, but they create administrative requirements that hospitals must follow, which directly influences how nurses coordinate care for patients like Candace (Darlington et al., 2024).

The ANA Code of Ethics provides which protections for nurses during mandatory reporting conflicts?

The ANA Code of Ethics for Nurses with Interpretive Statements (2015) requires nurses to practice with compassion and respect for inherent dignity, even when legal obligations complicate the therapeutic relationship. Nurses must balance fidelity to reporting laws with advocacy for non-punitive treatment, and they should communicate reporting requirements transparently to preserve trust whenever possible (Franco-Rowe et al., 2025).

Which interventions produce the best perinatal outcomes for pregnant patients with substance use disorders?

Medication-assisted treatment with methadone or buprenorphine, combined with trauma-informed behavioral health services and care coordination, produces better maternal and infant outcomes than punitive approaches. States that extend postpartum Medicaid coverage and implement perinatal quality collaboratives report higher treatment retention and lower rates of neonatal abstinence syndrome (Ellick et al., 2024).

State-level policy variations generate ethical dilemmas for care coordinators in which specific ways?

State laws differ in whether they classify substance use during pregnancy as child abuse, which determines whether providers must report positive screens to child protective services. These variations create ethical dilemmas because nurses in punitive states may face pressure to report patients who would otherwise engage in treatment, while nurses in supportive states can focus on family-centered care coordination (Darlington et al., 2024).

References

Darlington, C. K., Compton, P., Clark, R., & Ulrich, C. M. (2024). Maternity providers’ moral experiences addressing drug use among pregnant and postpartum women: A systematic review. Nursing Ethics. https://pmc.ncbi.nlm.nih.gov/articles/PMC12550207/

Franco-Rowe, C. Y., Lee-Winn, A. E., Williams, V. N., Lopez, C., Tung, G. J., & Allison, M. A. (2025). Perinatal healthcare experiences of pregnant and parenting people with a history of substance use disorder: A qualitative study. BMC Pregnancy and Childbirth, 25, Article 369. https://doi.org/10.1186/s12884-025-07473-8

Ellick, K. L., Kroelinger, C. D., Chang, K., McGown, M., McReynolds, M., Velonis, A. J., Bronson, E., Riehle-Colarusso, T., Pliska, E., Akbarali, S., Mueller, T., Dronamraju, R., Cox, S., & Barfield, W. D. (2024). Increasing access to quality care for pregnant and postpartum people with opioid use disorder: Coordination of services, provider awareness and training, extended postpartum coverage, and perinatal quality collaboratives. Journal of Substance Use and Addiction Treatment, 154, Article 209208. https://doi.org/10.1016/j.josat.2023.209208

Centers for Disease Control and Prevention. (2019). State strategies to address opioid use disorder among pregnant and postpartum women and infants prenatally exposed to opioids. Morbidity and Mortality Weekly Report, 68(36), 777–783. https://www.cdc.gov/mmwr/volumes/68/wr/mm6836a1.htm

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Compose a 10–12 slide PowerPoint presentation with a 3–4 page narrative script for Capella NURS-FPX 4050 Assessment 3, analyzing ethical standards and policy issues in care coordination for Candace, a pregnant client with substance use disorder. (275 words)

Write a 3–4 page APA narrative script and develop a 10-minute PowerPoint presentation exploring governmental policies, nursing ethics, and care coordination barriers for a pregnant patient with substance use disorder in a healthcare organization setting.

Develop a PowerPoint presentation and script examining ethical and policy factors in care coordination for a pregnant client with substance use disorder.

Assignment Preview

Assessment 4 (Week 6): Final Care Coordination Plan

Build upon your preliminary plan from Assessment 2 and your policy analysis from Assessment 3 by developing a comprehensive, patient-centered care coordination plan for Candace. In a 5–7 page paper, identify multidisciplinary team members, community resources, and measurable goals that address her substance use disorder, pregnancy, and parenting needs. Include a detailed timeline for interventions, anticipated barriers, and evaluation strategies, with at least five current peer-reviewed sources in APA format.

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Sample PPT

Ethical and Policy Factors in Care Coordination for Pregnant Patients with Substance Use Disorders: The Case of Candace

Slide 1: Title Slide

• Title: Ethical and Policy Factors in Care Coordination for Maternal Substance Use
• Subtitle: Analysis for Candace, a Pregnant Client with Substance Use Disorder
• Presenter: [Your Name]
• Course: NURS-FPX 4050
• Date: [Current Date]
• Capella University

Slide 2: Candace’s Clinical Profile

• Pregnant woman living at home with two young children.
• Boyfriend introduces and shares substances, creating an unstable household environment.
• Risks include preterm birth, neonatal abstinence syndrome (NAS), and disrupted family dynamics.
• Key barriers: Limited access to medication-assisted treatment (MAT), stigma, and environmental triggers.

Slide 3: Overview of Safety Concern

• Substance use during pregnancy compounds physiological and psychosocial challenges.
• Household substance availability heightens risks for both mother and fetus.
• Care coordination must address immediate safety while supporting long-term recovery.
• Tension arises between maternal autonomy and fetal/infant well-being.

Slide 4: Federal Policies – CAPTA and CARA

• Child Abuse Prevention and Treatment Act (CAPTA), amended by the 2016 Comprehensive Addiction and Recovery Act (CARA).
• Requires notification to child protective services for substance-exposed infants and development of Plans of Safe Care (POSC).
• Expands to all substances (not just illicit).
• Aims to support family-centered care rather than purely punitive measures.

Slide 5: Impact of Governmental Policies on Care Coordination

• Policies shape hospital notification protocols and interagency collaboration.
• Hospitals must balance reporting requirements with building patient trust.
• Positive effects include structured POSC that coordinate services for mother, infant, and family.
• Challenges arise when policies lead to fragmented care or deter prenatal engagement.

Slide 6: National, State, and Local Policy Provisions

• National: CAPTA/CARA set baseline notification and planning standards.
• State variability: Some states treat substance use as child abuse with mandatory reporting; others emphasize supportive Plans of Safe Care.
• Local implications: Providers in punitive jurisdictions face prosecution risks, while others facilitate treatment access.
• Consequences include inconsistent care quality and ethical conflicts for nurses.

Slide 7: Ethical Dilemmas Raised by Policies

• Conflict between maternal autonomy and fetal safety obligations.
• Mandatory reporting can erode trust and discourage care-seeking.
• Moral distress for providers balancing advocacy with legal duties.
• Evidence shows non-punitive approaches improve treatment retention.

Slide 8: ANA Code of Ethics and Nursing Practice

• Provision 1 emphasizes compassion and respect for dignity.
• Guides nurses to advocate for patients while fulfilling reporting requirements transparently.
• Supports trauma-informed, nonjudgmental care.
• Helps mitigate health disparities in access to services for vulnerable populations.

Slide 9: Health Disparities and Continuum of Care

• Factors like housing instability, intimate partner influences, and limited MAT access exacerbate risks.
• Coordinated care improves perinatal outcomes and reduces NAS severity.
• Interprofessional teams address medical, social, and behavioral needs.
• Evidence links extended postpartum coverage to better retention.

Slide 10: Recommendations for Healthcare Organizations

• Implement trauma-informed screening and universal protocols.
• Foster interprofessional collaboration with social services.
• Develop clear policies aligning with ANA ethics and CAPTA/CARA.
• Prioritize family-centered Plans of Safe Care.

Slide 11: Evidence-Based Outcomes

• Integrated care models reduce stigma and improve engagement.
• States with supportive policies report lower NAS rates and higher treatment success.
• Organizations benefit from reduced moral distress among staff.
• Focus on equity ensures better long-term family outcomes.

Slide 12: Conclusion and References

• Summary: Policies and ethics must align to support Candace through coordinated, compassionate care.
• Call for organizational commitment to non-punitive frameworks.
• References (APA on slides and full list in script).

(Total: 12 slides, including title and references. Slides use clean visuals, bullet points, minimal text, and embedded in-text citations. Use Kaltura for 10-minute narration with full-screen slides.)

Narrative Script (Approximately 3–4 Pages When Formatted in APA, Double-Spaced, 12-pt Font)

Introduction (Slides 1–3)

Candace presents as a pregnant woman raising two young children in a household where her boyfriend regularly introduces substances. This environment exposes both her and the developing fetus to significant health risks, including potential preterm delivery and neonatal withdrawal. Healthcare organizations face the challenge of coordinating care that protects infant safety without undermining maternal trust or autonomy. Federal and state policies directly influence how nurses approach such cases. The presentation examines these policy and ethical dimensions to guide effective coordination.

Governmental policies such as the Child Abuse Prevention and Treatment Act, strengthened by the Comprehensive Addiction and Recovery Act of 2016, require healthcare providers to notify child protective services about substance-exposed infants and create Plans of Safe Care. These measures promote family support rather than automatic separation. In practice, the policies compel hospitals to establish protocols that connect families to resources while fulfilling legal obligations. For Candace, a POSC could outline prenatal treatment, housing support, and parenting resources, thereby addressing immediate safety concerns.

Policy Analysis (Slides 4–6)

National frameworks set expectations, yet state-level implementation creates variability. In some jurisdictions, providers risk legal repercussions for delayed reporting, while others emphasize voluntary engagement through supportive plans. These differences generate practical consequences for care continuity. A nurse coordinating Candace’s care in a supportive state might focus resources on medication-assisted treatment and counseling. Conversely, stricter locales could prioritize documentation over relationship-building, potentially reducing her willingness to attend appointments.

Local healthcare organizations translate these provisions into daily workflows. Hospitals develop internal guidelines for screening and referral that must comply with both federal notification rules and state mandates. Evidence indicates that coordinated responses improve outcomes when they pair reporting with tangible services. Data from state collaboratives show higher treatment retention where postpartum Medicaid extensions accompany non-punitive reporting.

Ethical Dimensions and ANA Code (Slides 7–8)

Policy provisions raise ethical questions about balancing competing interests. Nurses experience moral distress when mandatory reporting threatens the therapeutic alliance essential for Candace’s engagement. The American Nurses Association Code of Ethics directs practitioners to uphold patient dignity and advocate compassionately. Provision 1 calls for respect for inherent worth, even amid legal complexities. Nurses fulfill this by communicating requirements transparently and prioritizing trauma-informed approaches that preserve trust.

The Code further obligates attention to health disparities. Candace faces barriers rooted in relationship dynamics and access limitations. Coordinated care that incorporates social services helps bridge these gaps. Providers who integrate ethical principles reduce stigma and encourage continued prenatal visits, which directly benefits maternal and fetal health.

Recommendations and Synthesis (Slides 9–11)

Organizations strengthen care coordination by adopting standardized, trauma-informed protocols. Interprofessional teams that include nurses, social workers, addiction specialists, and obstetric providers develop individualized Plans of Safe Care. These plans target measurable goals such as stable housing, MAT adherence, and parenting support. Evidence from recent studies demonstrates that integrated models lower neonatal complications and support family unity.

Healthcare leaders advance equity by training staff on unconscious bias and policy nuances. Extended postpartum coverage and quality collaboratives further enhance retention. For Candace, such strategies translate policy mandates into practical support that safeguards her children while honoring her recovery journey.

Conclusion (Slide 12)

Ethical standards and policy frameworks shape care for pregnant patients like Candace. When organizations align practices with the ANA Code and evidence-based coordination, they mitigate barriers and promote healthier outcomes. Frontline nurses who navigate these factors effectively contribute to systems that value both maternal autonomy and infant safety.

(Script word count ~950–1100 spoken words for ~10 minutes at natural pace. Include pauses for slide transitions. Full APA reference list appended below.)

References (APA 7th; Harvard-style list as requested)

Darlington, C. K., Compton, P., Clark, R., & Ulrich, C. M. (2025). Maternity providers’ moral experiences addressing drug use among pregnant and postpartum women: A systematic review. Nursing Ethics. https://doi.org/10.1177/09697330251333368

Franco-Rowe, C. Y., Lee-Winn, A. E., Williams, V. N., Lopez, C., Tung, G. J., & Allison, M. A. (2025). Perinatal healthcare experiences of pregnant and parenting people with a history of substance use disorder: A qualitative study. BMC Pregnancy and Childbirth, 25, Article 369. https://doi.org/10.1186/s12884-025-07473-8

Ellick, K. L., Kroelinger, C. D., et al. (2024). Increasing access to quality care for pregnant and postpartum people with opioid use disorder. Journal of Substance Use and Addiction Treatment, 154, Article 209208. https://doi.org/10.1016/j.josat.2023.209208

Kroelinger, C. D., et al. (2019). State strategies to address opioid use disorder among pregnant and postpartum women. Morbidity and Mortality Weekly Report, 68(36), 777–783. https://www.cdc.gov/mmwr/volumes/68/wr/mm6836a1.htm

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. (Updated provisions referenced in 2025 guidance).

Additional credible source (2025): Jose, A., et al. (2025). Addressing the needs of infants with prenatal substance exposure. PMC article. https://pmc.ncbi.nlm.nih.gov/articles/PMC11979226/