| Course | NR 452 Capstone Course |
|---|---|
| Week | 7 |
| Paper type | Capstone evaluation plan |
| Length | About 1,120 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 452 Week 7
Counting What Is Already Counted: An Evaluation Plan for Delaying the First Newborn Bath
Student Name
College of Nursing, Chamberlain University
NR 452: Capstone Course
Instructor Name
Month Day, Year
Counting What Is Already Counted: An Evaluation Plan for Delaying the First Newborn Bath
The Change Being Evaluated
The change proposed in the earlier weeks of this capstone is to delay the first bath for healthy term newborns on a composite mother-baby unit from the current practice, a bath in the nursery within two hours of birth, to at least 12 hours after birth, and preferably 24, with the bath given at the mother's bedside. The rationale is that an early bath separates mother and baby during the first hours when breastfeeding is being established, can cool the newborn, and removes vernix. The World Health Organization recommends delaying the first bath until at least 24 hours after birth (World Health Organization, 2022), and a quality improvement project at a United States hospital found higher rates of exclusive breastfeeding at discharge after the first bath was delayed (DiCioccio et al., 2019).
The writer's placement ends with this session, and nobody on the unit will open a new logbook for a graduated student's project. The evaluation therefore uses one measure the hospital already reports, and it asks nothing new of staff beyond the change itself.
One Measure
The measure is the percentage of eligible newborns fed only breast milk during the entire hospital stay, which the hospital already reports as The Joint Commission's perinatal care measure for exclusive breast milk feeding (The Joint Commission, 2024). Because the hospital abstracts this measure every month for accreditation, the number exists whether or not this project does. Using it means the evaluation costs the unit nothing to collect and will continue after the writer is gone.
Why Only One Measure
It would be easy to promise more: newborn temperature on arrival to the unit, blood glucose values in the first hours, maternal satisfaction, hours to the first successful latch. Each of those is relevant, and a unit running a funded project might collect them all. This plan promises one because each additional measure is a commitment of someone's time, and no one on the unit has agreed to that commitment for a project whose author will not be present. A student evaluation that lists four measures has committed four people's time and secured none of it. The single measure chosen is the one most directly tied to the reason for the change, is already collected, and is already compared across hospitals, which gives the unit a reference point beyond its own history.
Temperature is the measure most likely to be asked about, because staff worry that delaying the bath will be blamed for hypothermia. The plan's answer is that newborn temperatures are already charted on admission to the unit and at routine intervals, so any charge nurse can look at them if a concern arises, and the unit's existing policy for a low temperature does not change. That is a check available on request rather than a new measure the plan promises.
A Definition a Stranger Could Apply
The numerator is the number of newborns in the denominator who were fed breast milk only, by breast or by bottle, from birth to discharge, with no formula or other liquids except medications. The denominator is single, term, liveborn newborns discharged from the hospital during the month, excluding the groups the measure specification excludes, such as newborns admitted to the neonatal intensive care unit, those with conditions that prevent breast milk feeding, those who died and those transferred to another hospital. The abstractor applies the exact exclusions listed in the current version of the measure specifications manual, and the plan does not add or remove any, so that the unit's figure can be compared with its own past values and with other hospitals using the same measure. A newborn who received a single supplement of formula for any reason counts as not exclusively breast milk fed, even if formula was medically indicated; the measure makes no exception, and neither does this plan.
Where the Number Comes From
The figure comes from the hospital's quality department, which abstracts the measure monthly from the electronic health record's feeding documentation and submits it to The Joint Commission. The nurse manager already receives the monthly figure in the unit's quality report. The baseline is the average of the twelve months before the change, which the quality department can supply from its records; the plan does not require anyone to collect a baseline from charts.
First Reading and What Counts as Change
The first reading will be the third full month after the change begins, which is after this session ends. That timing is deliberate. The first month after any change is noisy, and a reading taken during the writer's placement would measure novelty rather than the new routine. The unit will compare the three months after the change with the twelve-month baseline, plotted on a run chart so that ordinary month-to-month variation is visible. The plan does not set an arbitrary numeric target; instead, it defines a meaningful change as a sustained rise, six or more consecutive monthly points above the baseline median, or a single month more than ten percentage points above the baseline average.
Who Will Read It
The nurse manager will read the figure each month in the existing quality report and bring it to the unit's monthly staff meeting for the first six months after the change. The lactation consultant, who already reviews exclusive breast milk feeding each quarter as part of the hospital's breastfeeding committee, will add the bath change as a note on the committee's run chart, so that anyone reading the chart later can see when the change occurred.
What the Measure Cannot Tell
The measure cannot show that the delayed bath caused any change. Exclusive breast milk feeding is influenced by many other things, including lactation staffing, maternal education and the unit's formula supplementation practices, and a rise after the change could reflect any of them. The plan addresses this only partly, by recording other changes on the run chart as they happen. The measure also cannot show whether the delayed bath is actually being done, because bath timing is not in the abstracted data. For that, the plan relies on the one new item the change itself requires: the time of the first bath, which nurses already chart in the newborn flowsheet. The nurse manager can ask the quality department for a count of first baths charted within twelve hours of birth once each quarter, a report that uses documentation nurses already complete.
References
DiCioccio, H. C., Ady, C., Bena, J. F., & Albert, N. M. (2019). Initiative to improve exclusive breastfeeding by delaying the newborn bath. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(2), 189-196. https://doi.org/10.1016/j.jogn.2018.12.008
The Joint Commission. (2024). Specifications manual for Joint Commission national quality measures: Perinatal care. https://manual.jointcommission.org/
World Health Organization. (2022). WHO recommendations on maternal and newborn care for a positive postnatal experience. https://www.who.int/publications/i/item/9789240045989
NR 452 Week 7 instructions, in plain terms
The Week 7 evaluation plan asks how the effect of your change would be measured. Plan on covering the change, the measure or measures, definitions, data sources, timing, who reviews the results and the plan's limits, in APA. Name the constraint honestly, including that you will not be there to collect data. Choose a measure the hospital already produces where possible, and explain why you did not choose others. Write the definition, including exclusions, so a stranger could apply it. Name the department that supplies the figure. Set the first reading after the noisy first month and say what would count as a real change. Name who will read it. State what the measure cannot show.
How this NR 452 Week 7 example is built
The change section moves the first bath for healthy term newborns later than current practice and states that no one will open a new logbook. The measure is exclusive breast milk feeding during the stay, already reported to the Joint Commission. The next section explains why temperature, glucose, satisfaction and time to latch were left out, and how temperature concerns are already covered by routine checks. The definition gives the numerator, the denominator, the exclusions and the rule for a single supplement. The source section names the quality department's monthly abstraction. The timing section sets the first reading in the third full month and defines a meaningful change as six consecutive points above the baseline median on a run chart. The manager reads it monthly.
Where the points sit in the NR 452 Week 7 rubric
Evaluation plan rubrics in the pre-licensure capstone usually reward a measure linked to the change, a precise definition, a reliable data source, sensible timing, a clear threshold for change, named reviewers, acknowledged limits and APA. Feasibility of measurement is the decisive row, and this plan earns it by choosing a measure the hospital already reports. The definition is credited because a stranger could apply it. Timing scores when the first reading avoids the novelty of the first month. The threshold earns points as a run chart rule rather than an arbitrary target. Reviewers are named. Limits are credited for admitting the measure cannot show cause. DiCioccio and colleagues, the Joint Commission manual and the WHO recommendations support the plan.
NR 452 Week 7 help: mistakes that cost points
The plan that loses most asks someone to start counting something nobody counts, turning an eight-week project into an open commitment for staff who never agreed to it. Another loss is a list of five measures with no source for any of them. Students also leave definitions vague, read the first month as the result or claim the measure proves the change caused the improvement. If the unit records nothing relevant, look for a quality measure the hospital reports. A before figure helps, and an existing report usually has one. Send your change and an NR 452 evaluation plan can be built on a measure that already exists.
Get a NR 452 Week 7 example written to your instructions
Send the Week 7 instructions and whatever grid your section supplies, together with your proposed change and what you know of what that unit records, and a custom example is written around figures somebody could genuinely obtain and returned inside 24 to 48 hours. The first one is free. Audit figures held by the organization you were placed with stay theirs.
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NR 452 Week 7 questions, answered
What if the unit records nothing relevant?
Then say so and pick the smallest thing anybody could count without new paperwork. Ten minutes of tallying at one point in a shift is defensible; a monthly extract out of a system you were never given access to is not. Sections generally reward the writer who explains the limit over the one who writes straight past it.
When should the first reading be taken?
Late enough that the change has had time to become ordinary, which for most unit level changes means longer than a session allows. Say that plainly, give the date anyway, and add a later reading after it. A plan pretending the final week of the course is a meaningful measurement point makes a claim its own writer does not believe.
Does the plan need a before figure?
Where one can be had without new work, yes, and where it cannot, the plan should say how the comparison would be made instead. The same document for the same months a year earlier is often reachable when a live one is not. What matters is that both numbers come out of one definition, not that you were the person who collected them.
Where can I find a free NR 452 Week 7 sample paper?
The complete Week 7 evaluation plan for delaying the first newborn bath, with the single measure, the definition, the source, the timing, the run chart rule, the reviewer, the limits and three references, is available here.
What measure does the NR 452 Week 7 plan use?
The percentage of eligible newborns fed only breast milk during the hospital stay, which the quality department already reports under the Joint Commission perinatal care measures.