| Course | NR 452 Capstone Course |
|---|---|
| Week | 8 |
| Paper type | Capstone final paper |
| Length | About 1,130 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 452 Week 8
A Pump That Is Not Running Prevents Nothing: Restarting Compression Devices After Every Return to Bed on a Surgical Unit
Student Name
College of Nursing, Chamberlain University
NR 452: Capstone Course
Instructor Name
Month Day, Year
A Pump That Is Not Running Prevents Nothing: Restarting Compression Devices After Every Return to Bed on a Surgical Unit
The Argument
This paper argues one thing: on a surgical unit where patients are ordered intermittent pneumatic compression to prevent venous thromboembolism, the moment that decides whether the device works is the moment a patient returns to bed, and a single nursing check at that moment, restarting the pump and confirming it is cycling, is the smallest change likely to close the gap between devices ordered and devices working. The paper assembles the work of this session, the observation from the first week, the problem statement, the appraised evidence, the proposal and its implementation and evaluation plans, in revised wording, and it marks the sentence where the evidence ends and the recommendation begins.
The Problem, Revised
During eight day shifts on a composite 30-bed surgical unit, the writer repeatedly saw patients whose compression sleeves were on their calves while the pump beside them sat silent, switched off or with its tubing hanging loose. The first-week post described this as happening on most hourly checks of the writer's own two or three patients during the first half of four shifts. That wording has been revised here, because an informal check of the writer's own small assignment is not a rate, and the problem statement should not have implied one. What the writer can claim is narrower: the pattern was observed repeatedly, it clustered after patients returned from a chair or the bathroom, and staff confirmed it without surprise. The expectation it falls short of is published. The American College of Chest Physicians guidance on thromboprophylaxis in surgical patients recommends mechanical prophylaxis with intermittent pneumatic compression for patients at moderate or high risk, particularly when anticoagulants are contraindicated, and notes that its benefit depends on correct and consistent use (Gould et al., 2012).
What the Evidence Supports
Three sources carry the evidence, each at a different strength. The strongest is a large randomized trial in immobile stroke patients, in which patients assigned to compression developed fewer proximal clots in the leg veins than patients assigned to none (CLOTS Trials Collaboration, 2013). Stroke patients differ from surgical patients, so the trial supports the device rather than its use on this unit, but it establishes that the device works when it is worn and running. The second source is an observational study in which investigators checked compression devices at the bedside in intensive care and found frequent errors in how they were applied and operated (Elpern et al., 2013). Its setting differs, and its design cannot show that errors cause clots, but it shows that the problem the writer observed is not unique to one unit. The third is a pooled review of studies measuring whether mechanical prophylaxis was actually used after surgery, which found that adherence was often incomplete across studies (Craigie et al., 2015).
Taken together, the evidence supports two claims with reasonable confidence: that compression prevents thrombosis when it is used, and that it is often not in use when it is supposed to be. It does not show that any particular nursing check restores use, and no source located tested a check at the return to bed. The evidence ends there, and the recommendation that follows goes one step beyond it: it proposes a check at the moment the observation identified, on the reasoning that a device cannot help if it is not running, not on a trial that tested the check. A reader who disagrees with this paper should disagree with that step.
The Recommendation
Every time a patient with an order for intermittent pneumatic compression returns to bed from a chair, the bathroom or a walk, the staff member who settles the patient reconnects the sleeves to the tubing, restarts the pump and watches it complete one inflation cycle before leaving the room. The check is added to the unit's existing return-to-bed routine, which already includes the call light, the bed alarm and the bed height. It is the same moment the writer observed the device being left off, and it is owned by whoever is already there.
How It Would Be Carried Out
The implementation plan written in the sixth week assigns ownership to the unit's nurse manager and its clinical nurse educator, because this writer's placement ends with the session. The educator adds the check to the unit's existing return-to-bed card, posted in every room, and teaches it in a five-minute huddle segment over two weeks to nurses and nursing assistants on both shifts. The nurse manager asks supply chain whether portable battery-powered pumps, which can travel with the patient, could be trialed for patients who walk often, a question the writer cannot answer and the unit can. Nothing in the plan requires a new meeting or form.
The plan also names what the unit should watch for in the first weeks. Nursing assistants may find that restarting a pump takes longer than expected when tubing has been disconnected and tangled, and the educator's huddle segment will include a thirty-second demonstration of reconnecting the tubing so that the check does not become a reason to leave the pump off.
How Anyone Would Know
The evaluation uses a count the unit already produces. The unit's monthly skin and safety rounds, performed by the charge nurse on a random sample of patients, already record whether ordered devices are applied. The plan asks that the rounds record one additional fact for patients with compression orders: whether the pump is running at the time of the check. The first reading would come three months after the change, after this session ends, and the unit would compare the percentage of running pumps with the first month's rounds. The paper does not propose to measure thromboembolism, which is too uncommon on one unit to change detectably and depends on many other factors.
Limits of This Project
The project rests on one student's observations on one unit over eight shifts, on evidence from populations that only partly resemble surgical patients, and on a recommendation that no study has tested directly. Its strength is that the recommended change is small, costs almost nothing, fits an existing routine and addresses a moment where the problem was seen repeatedly. Its weakness is that the size of the benefit is unknown. Those are the conditions under which a pre-licensure capstone can responsibly recommend a change: modestly, with its reasoning exposed and with a plan for the unit to find out whether it helped.
References
CLOTS Trials Collaboration. (2013). Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): A multicentre randomised controlled trial. The Lancet, 382(9891), 516-524. https://doi.org/10.1016/S0140-6736(13)61050-8
Craigie, S., Tsui, J. F., Agarwal, A., Sandset, P. M., Guyatt, G. H., & Tikkinen, K. A. O. (2015). Adherence to mechanical thromboprophylaxis after surgery: A systematic review and meta-analysis. Thrombosis Research, 136(4), 723-726. https://doi.org/10.1016/j.thromres.2015.06.023
Elpern, E., Killeen, K., Patel, G., & Senecal, P. A. (2013). The application of intermittent pneumatic compression devices for thromboprophylaxis. American Journal of Nursing, 113(4), 30-36. https://doi.org/10.1097/01.NAJ.0000428736.48428.10
Gould, M. K., Garcia, D. A., Wren, S. M., Karanicolas, P. J., Arcelus, J. I., Heit, J. A., & Samama, C. M. (2012). Prevention of VTE in nonorthopedic surgical patients: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2, Suppl.), e227S-e277S. https://doi.org/10.1378/chest.11-2297
NR 452 Week 8 instructions, in plain terms
The final NR 452 paper asks you to present your capstone project as a complete scholarly paper. The checklist generally covers the problem, the evidence, the recommended change, implementation, evaluation, limitations and a conclusion, in APA. State your single argument in the opening paragraph so the reader knows what the project was for. Revise earlier work rather than pasting it, and say what changed and why. Carry the evidence at the strength each source allows, and say plainly what it does and does not support. State the recommendation as an action. Summarize implementation and evaluation with their owners and data. Tie the limits back to the argument instead of listing disclaimers.
Inside the NR 452 Week 8 example
The argument section claims that the moment a patient returns to bed decides whether compression prevents anything. The problem section revises the Week 1 observation and corrects wording that implied a rate. The evidence section reports the CLOTS 3 trial in immobile stroke patients as the strongest source, then adherence data and device application findings, concluding that compression works when used and is often not in use. The recommendation asks whoever settles the patient, nurse or assistant, to reconnect and restart the pump every time. The implementation section assigns ownership to the nurse manager and educator and names early problems to watch. The evaluation section uses the monthly skin and safety rounds already done. The limits section closes the paper.
NR 452 Week 8 rubric: what full points look like
Capstone paper rubrics in NR 452 typically score a clear argument, a refined problem statement, synthesis of evidence, a specific recommendation, implementation and evaluation plans, limitations, organization and APA. The argument is the row that separates a paper from a collection of sections, and this one earns it by stating the claim in the first paragraph and returning to it throughout. The problem is credited for honest revision of earlier work. Evidence scores when each source's strength is stated. The recommendation earns points as one action at one moment. Implementation and evaluation are credited for owners and existing data. Limits score because they are tied to the argument. Four references complete APA.
NR 452 Week 8 help from the desk
The most expensive capstone paper has no argument, only sections, with each earlier assignment under its own heading and no claim joining them. Another loss is pasting earlier work without revising it, which carries forward mistakes. Students also overstate the evidence, recommend a change no one owns or list limitations as boilerplate. You can reuse earlier work if you revise it and say so. Mentioning what you would do differently strengthens the limits section. Write about a setting you have left in the past tense for observations and the present for recommendations. Send your earlier assignments and an NR 452 final paper can be built around one argument.
Get a NR 452 Week 8 example written to your instructions
Send the Week 8 instructions with any required section list, along with the assignments already submitted this session, and a custom example is assembled to those requirements and returned inside 24 to 48 hours. The first one is free. Clinical hours and the evaluation your preceptor completes are records of your own work and not things a sample would attempt.
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NR 452 Week 8 questions, answered
How much of my earlier work can I reuse?
Follow whatever your section says about reusing your own submitted writing, since the rules on that vary and are worth reading before you start. Setting that aside, the useful move is rewriting rather than pasting: eight weeks of feedback usually means the problem should be narrower and the evidence claim more careful than they were when first written.
Should the paper mention what I would do differently?
Only where the instructions ask for it, and keep it tied to one decision rather than to the experience overall. A paragraph saying the problem should have been narrowed a week earlier, with what that cost the evidence work, reads as judgment. A general account of how much was gained from the course reads as filler and is marked that way.
How do I write about a setting I have left?
In the past tense, at the level of detail you genuinely have, with the assumptions marked. Say the observations came from a placement of a stated length and describe the service by type. A paper claiming current knowledge of a floor the writer has not stood on for months is making a claim it cannot support, and the hedged version costs nothing.
Where can I find a free NR 452 Week 8 sample paper?
This page shows the complete Week 8 capstone paper on restarting compression devices after every return to bed, with the argument, the revised problem, the evidence, the recommendation, implementation, evaluation, limits and four references.
What does the NR 452 Week 8 paper recommend?
That every time a patient with a compression order returns to bed from a chair, the bathroom or a walk, the staff member who settles the patient reconnects the sleeves and restarts the pump.