NR 300A Week 5 Evidence Summary Draft Section Example

Draft Section 3 of the Evidence Summary: What the Admission Checklist Asks and Why

Student Name

College of Nursing, Chamberlain University

NR 300A: Directed Independent Study

Instructor Name

Month Day, Year

Draft Section 3 of the Evidence Summary: What the Admission Checklist Asks and Why

Note to the Sponsor

This is Section 3 of the six-page evidence summary, drafted at final wording. I chose it first because Sections 1, 2 and 4 either lead into it or depend on it: if the reasoning here does not hold, the rest of the summary has nothing to stand on. Sections 1 (the problem on our unit) and 2 (what the literature shows) will be condensed from the Week 3 literature summary. Section 4 (how the checklist performed) waits for the usability trial, which started this week as you approved. Two open decisions are marked in the text in capitals where they sit. Please look first at the hearing aid item and the fallback step, which make the strongest claims.

3. What the Checklist Asks and Why

The checklist adds six questions to the admission property form that nurses on the unit already complete. The existing form asks only whether a patient has glasses, hearing aids or dentures. It does not ask whether the patient is using them, whether they work, where they are, or whether the next nurse will know. Those four gaps are what the six questions address. Each question is followed by the reason it is there and the strength of the evidence behind it.

3.1 Glasses

The nurse asks whether the patient uses glasses for reading, for distance or both, whether they are with the patient now, and whether the case is labeled and on the bedside table. The reason is practical: a patient who cannot read the menu, the whiteboard or the discharge sheet cannot take part in their own care in the ways the unit expects. The evidence on glasses in hospital is thin. The only source found was a commentary and survey arguing that inexpensive reading glasses are often missing on geriatric psychiatry inpatient units (Barnes & Sewell, 2014). The checklist therefore makes no claim about outcomes for this item; it asks the question because the answer is needed at the bedside.

3.2 Hearing Aids

The nurse asks whether the patient uses hearing aids, in which ear, whether they are in and turned on now, whether the patient can hear the nurse clearly with them, whether batteries or a charger came in with them, and whether the case is labeled. This item carries the strongest evidence in the summary. A systematic review of 13 studies found that hearing loss harmed communication between hospitalized patients and their providers in every study, and that simple amplification improved it (Shukla et al., 2019). A randomized trial found that providing hearing augmentation on admission raised scores on a standard cognitive screen by about 2 points on average (MacDonald et al., 2012), which means that a patient assessed without their hearing aids may be recorded as more impaired than they are. The item asks whether the aids are working, not only present, because an aid with a dead battery gives no benefit and is easily missed.

OPEN DECISION: WHETHER TO ASK THE PATIENT TO CONFIRM THEY CAN HEAR THE NURSE, OR TO USE A SIMPLE TEST SUCH AS REPEATING A SHORT SENTENCE. The first is quicker; the second is more reliable. I lean toward the first for the trial and will report how often it was completed.

3.3 Dentures

The nurse asks whether the patient has upper, lower or partial dentures, whether they are with the patient now, and whether they are kept in a labeled denture cup rather than on a meal tray or wrapped in a tissue. The reason is loss prevention. Across 11 English hospital trusts, 695 lost dentures were logged in a five-year period (Mann & Doshi, 2017), and our unit's property log records two lost upper dentures in the past three months. None of the sources found here measured what going without dentures does to a patient's meals, speech or recovery, so the checklist claims nothing about those outcomes.

3.4 When Hearing Aids Are Missing

If a patient who uses hearing aids does not have them, or they are not working, the nurse fetches the pocket amplifier kept at the charge station. If that device is in use or not working, the nurse uses the reverse stethoscope method: the earpieces go into the patient's ears and the nurse speaks quietly into the diaphragm. In a study of 109 older medical inpatients, this method increased the number of short sentences patients could repeat correctly (Hodson et al., 2024). It costs nothing and every nurse carries a stethoscope, which makes it the one step that can always be taken at 3:00 a.m. It is also the item most likely to feel awkward the first time, and the trial will record whether nurses actually use it or skip to writing the patient notes on paper instead.

3.5 Whiteboard and Handoff

The last two items are the ones most likely to be skipped and the ones the summary argues matter most. The nurse writes the aids in use on the patient's whiteboard, for example "Glasses (reading), hearing aids R and L," and says them at handoff. The reason comes from the only published study of a sensory aid checklist found in this project: on a UK geriatric ward, a separate bedside checklist was completed only 18% of the time, but a combination of approaches cut the share of patients with unknown needs by roughly 32% (Arifaj et al., 2025). The lesson taken here is that the information has to travel to where the next nurse will see it, not stay on a form.

OPEN DECISION: WHETHER THE WHITEBOARD WORDING SHOULD BE STANDARDIZED. A standard phrase would be easier to scan across rooms; free text is quicker to write. I propose a standard phrase, printed at the bottom of the checklist for copying.

3.6 What the Checklist Does Not Do

The checklist does not screen for hearing or vision loss in patients who have no aids, and it does not claim to prevent delirium. Sensory protocols were one of six components of the program that lowered delirium in older medical patients in the study most often cited for this purpose (Inouye et al., 1999), but that study cannot show what glasses and hearing aids achieve on their own. The checklist's claim is narrower: that patients who already depend on these aids should have them, working, and that the nurses caring for them should know.

References

Arifaj, B., Shakeel, A., Nyam, L., & Sansom-Ninnes, K. (2025). Improving staff awareness of sensory aid needs and dementia status in an old age ward. BMJ Open Quality, 14(4), Article e003369. https://doi.org/10.1136/bmjoq-2025-003369

Barnes, S. S., & Sewell, D. D. (2014). The value and underutilization of simple reading glasses in geropsychiatry inpatient settings. American Journal of Alzheimer's Disease & Other Dementias, 29(8), 657-659. https://doi.org/10.1177/1533317514539034

Hodson, A., Clancy, N., & Foo, I. (2024). The reverse stethoscope technique: A rapid intervention for old age hearing loss. Hospital Practice, 52(1-2), 23-28. https://doi.org/10.1080/21548331.2024.2320067

Inouye, S. K., Bogardus, S. T., Jr., Charpentier, P. A., Leo-Summers, L., Acampora, D., Holford, T. R., & Cooney, L. M., Jr. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients. New England Journal of Medicine, 340(9), 669-676. https://doi.org/10.1056/NEJM199903043400901

MacDonald, A. A., Joyson, A., Lee, R., Seymour, D. G., & Soiza, R. L. (2012). The effect of hearing augmentation on cognitive assessment scales at admission to hospital. American Journal of Geriatric Psychiatry, 20(4), 355-361. https://doi.org/10.1097/JGP.0b013e3182107e88

Mann, J., & Doshi, M. (2017). An investigation into denture loss in hospitals in Kent, Surrey and Sussex. British Dental Journal, 223(6), 435-438. https://doi.org/10.1038/sj.bdj.2017.728

Shukla, A., Nieman, C. L., Price, C., Harper, M., Lin, F. R., & Reed, N. S. (2019). Impact of hearing loss on patient-provider communication among hospitalized patients: A systematic review. American Journal of Medical Quality, 34(3), 284-292. https://doi.org/10.1177/1062860618798926