| Course | NU753 Transforming the Health Care Organization |
|---|---|
| Unit | Unit 5 |
| Paper type | Theory application paper |
| Length | About 1,090 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NU753 Unit 5
Three Missing Arrows: An Open Systems Theory Application Reading the Colorectal Surgery Path Through a Composite Health System as One System Whose Feedback Loops Have Been Cut
[Student Name]
Purdue University Global
NU753: Transforming the Health Care Organization
Unit 5 Theory Application Paper
[Instructor Name]
[Date]
The system, units and figures are composite; numbers are bracketed.
Why One Theory
A theory application paper can apply several theories briefly or one theory thoroughly. I chose one, open systems theory, because the problem on 5 West is not inside the unit. It sits in the connections between the unit and the clinic before it, the operating suite beside it and the patient's home after it. Open systems theory is built to describe exactly those connections.
The Theory in Brief
Open systems theory grew from Ludwig von Bertalanffy's general system theory, which proposed that living systems, unlike closed physical systems, survive by exchanging energy, material and information with their environments (von Bertalanffy, 1968). Daniel Katz and Robert Kahn applied that idea to organizations, describing them as open systems that take in inputs, transform them through internal processes and return outputs to the environment, and that depend on feedback to stay in balance (Katz & Kahn, 1978).
Six of their concepts are used throughout this paper, each defined once here. Input is what enters the system, such as patients, information and resources. Throughput is the transformation inside it, here the care patients receive. Output is what leaves, such as patients discharged home. Feedback is information about outputs that returns to the system and allows it to adjust. A boundary separates a system or subsystem from its environment and regulates what crosses it. And equifinality is the principle that a system can reach the same end state by different paths.
The System Drawn
The colorectal surgery path can be drawn as four linked subsystems: the preoperative clinic, the operating suite, 5 West and the patient's home. Patients flow from each to the next in one direction, and the arrows for patient flow are all present. Information should also flow between subsystems, in both directions, so that each can adjust to what the others do. When the information arrows were traced, three were missing.
The first missing arrow runs from 5 West back to the preoperative clinic. The clinic instructs every elective colorectal patient to fast from midnight, and patients arrive on 5 West after surgery dehydrated, hungry and slow to eat. Nobody on the unit has told the clinic what these instructions do after surgery, and the clinic has never asked. In Katz and Kahn's terms, the clinic's output, a prepared patient, is an input to the next subsystems, and without feedback the clinic cannot know that its preparation is making the throughput harder.
The second missing arrow runs from the operating suite to 5 West. Intraoperative decisions about fluids, opioids and whether to leave a nasogastric tube shape a patient's first postoperative day, but 5 West nurses learn them only from the record, often hours later. The boundary between the operating suite and the unit lets the patient through but filters out most of the reasoning behind their care.
The third missing arrow runs from the home back to 5 West. After discharge, patients' recovery, complications and readmissions are recorded, if at all, in clinic notes and readmission reports that the unit does not receive. 5 West does not know how its outputs fare. Without that feedback, it cannot tell whether a change it makes helps or harms patients after they leave.
Each subsystem is working correctly by its own information, and the system as a whole is slow because none of them can see what the others see.
Throughput Without Feedback
The unit's throughput is measured mainly by falls and length of stay. Without feedback from home, 5 West optimizes what it can see, such as keeping patients safely in bed, rather than what matters after discharge. A system that lacks feedback tends to continue what it has always done, because nothing tells it that its outputs are falling short. The unit's median stay of [5.9] days has not changed in [four] years. Katz and Kahn noted that open systems move toward disorder unless they import more energy and information than they spend, and a unit cut off from information about its own outputs is, in their language, running down rather than adapting.
Equifinality and the Two Hospitals
The concept of equifinality helps explain why the community hospital in the same system reaches better mobility results by a different route. It has the same goal but a different structure, with mobility technicians reporting to nursing. The system as a whole can reach early walking by more than one path, which means the flagship does not have to copy its sister hospital's model exactly. It has to restore the information flows that let any model work.
How an Enhanced Recovery Pathway Restores the Arrows
The ERAS Society's colorectal recommendations treat perioperative care as a continuous process from before admission to after discharge, with elements in each phase and an emphasis on auditing compliance and outcomes (Gustafsson et al., 2019). Read through open systems theory, that design restores the missing arrows. Preoperative education and carbohydrate loading change the clinic's output, so patients arrive better prepared. A shared pathway document, written for all four subsystems, carries intraoperative decisions across the boundary to the unit. And an audit of outcomes after discharge sends feedback from home back to every subsystem.
The theory also predicts where the pathway will fail. If one subsystem, such as the operating suite, adopts the pathway and another does not, the system will not reach its goal, because each subsystem's output becomes the next one's input.
Limits of the Theory
Open systems theory describes flows and boundaries well, but it says little about power, culture or motivation. It cannot explain why the clinic has never asked what happens to its patients, or why the anesthesia group has no forum with nursing. Those questions belong to the political and cultural analyses in other units. Used alone, as here, the theory's strength is that it makes invisible connections visible.
Conclusion
Reading the colorectal path as a single open system shows that 5 West's slow recovery times are not a unit problem but a system problem caused by three missing feedback loops. An enhanced recovery pathway, understood as a way to restore them, has a better chance of success than any change confined to the unit itself.
References
Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., Hill, A. G., Soop, M., de Boer, H. D., Urman, R. D., Chang, G. J., Fichera, A., Kessler, H., Grass, F., Whang, E. E., Fawcett, W. J., Carli, F., . . . Ljungqvist, O. (2019). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World Journal of Surgery, 43(3), 659-695. https://doi.org/10.1007/s00268-018-4844-y
Katz, D., & Kahn, R. L. (1978). The social psychology of organizations (2nd ed.). Wiley.
von Bertalanffy, L. (1968). General system theory: Foundations, development, applications. George Braziller.
What the NU753 Unit 5 assignment asks for
The Unit 5 assignment asks you to apply an organizational theory to a problem at your site. Most versions want the theory's origins and key concepts, a diagram or description of the site through those concepts, an analysis of the problem, and implications, including the theory's limits. Around 2,200 words is common. Faculty reward papers that choose a theory suited to where the problem lies, define each concept before using it, apply every concept to specific features of the site, and use the theory to predict as well as to explain. Cite the original theorists wherever you can rather than a textbook summary, and say what the theory leaves out, since no single theory explains power, culture and flow at once.
How this NU753 Unit 5 example is built
The paper explains why one theory was chosen and why open systems theory suits a problem at the boundaries between departments. It traces the theory's lineage and defines six concepts. The system is drawn as four subsystems with patient flows present and three information flows missing: from the unit back to the clinic, from the operating suite to the unit, and from home back to the unit, with the highlighted sentence on subsystems that cannot see each other. Sections explain throughput without feedback and apply equifinality to the two hospitals. The enhanced recovery pathway is read as a way to restore the missing arrows, the theory predicts partial adoption will fail, and limits and a conclusion close.
Reading the NU753 Unit 5 grading rubric
Theory application papers are typically assessed on understanding of the theory, application to the site, analysis, use of sources and critique. Understanding earns credit when concepts are defined accurately and the theory's origins are stated. Application rewards concepts tied to specific features of the site, not general illustrations. Analysis is judged on whether the theory reveals something not obvious without it and supports a prediction. Sources are credited when original theorists are cited. Critique scores well when the paper states what the theory cannot explain and where other theories would be needed. A diagram that shows flows and gaps clearly usually strengthens the application criterion considerably.
NU753 Unit 5 help from the desk
A frequent weakness is summarizing several theories briefly and applying none in depth. Another is defining concepts without tying each to a specific feature of the site. Some papers use a theory to describe a problem but never draw implications from it. Others treat the theory as complete, ignoring what it cannot address, such as power or culture. Many cite textbook summaries rather than original works. And diagrams are often decorative rather than analytic. Choose one theory that fits where your problem sits, define each concept, apply it to something you can point to, predict what would happen under a proposed change, and state the theory's blind spots.
Get an NU753 Unit 5 example written to your instructions
If your prompt names the theory, say which; if it leaves the choice open, mention the setting so the sample can pick one that fits. Include the rubric. The first custom sample is free and back within 24-48h, one theory applied in depth to a composite site, its predictions stated so they can be checked. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU753 Unit 5 questions, answered
Which systems theory works best for a nursing site?
It depends on what the site's problem is. Open systems theory suits problems at boundaries between departments, complexity science suits problems of adaptation and emergence, and sociotechnical theory suits problems where technology and work design collide. The sample chose open systems because its central problem is information failing to cross from one department to another.
Should the paper cite the original theorists or a textbook summary?
The original, wherever possible. Faculty at this level generally expect Katz and Kahn's own text, or the primary source for whichever theory you apply, with secondary sources used for later developments and critiques. A paper built on a textbook paragraph tends to define concepts loosely, and loose definitions weaken every application section that follows.
How does this paper connect to the rest of the term?
In many sections the theory paper feeds the gap analysis and the business case that follow, so its predictions become the problems later units try to solve. The sample's missing feedback loops reappear as rows in its gap table. Predictions stated in testable form give those later assignments something concrete to build on.
Where can I find a free NU753 Unit 5 sample paper?
The complete NU753 Unit 5 theory application paper appears on this page, with the theory's lineage, six concepts, a four-subsystem model, three missing flows, equifinality, how a pathway restores feedback, a prediction of failure and limits, plus three references. A paper applying a theory to your own site can be drafted.
What are the three missing arrows in NU753 Unit 5?
Information from 5 West back to the preoperative clinic about the effects of fasting, from the operating suite to 5 West about intraoperative decisions, and from patients' homes back to the unit about recovery and readmissions.