| Course | NR 528 Leading and Managing Evidence-Based Change in Nursing |
|---|---|
| Week | 4 |
| Paper type | Implementation plan |
| Length | About 1,120 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NR 528 Week 4
Implementation Plan: The Head-of-Bed Rollout Scheduled Step by Step, With a Role and a Week Against Each Step and Nothing Dated Before What It Depends On Exists
Student Name
College of Nursing, Chamberlain University
NR 528: Leading and Managing Evidence-Based Change in Nursing
Instructor Name
Month Day, Year
Implementation Plan: The Head-of-Bed Rollout Scheduled Step by Step, With a Role and a Week Against Each Step and Nothing Dated Before What It Depends On Exists
The Rule the Plan Follows
This plan schedules the introduction of the head-of-bed practice for every patient on a running tube feed on our 24-bed progressive care unit. It follows one rule: a step is dated only after everything it depends on already exists. The first attempt at this change broke that rule. Teaching happened before angle indicators were available, and nurses were taught to hold 30 degrees without any way to see it. Each step below lists its owner, the week it happens and what must be in place before it can start. Week 1 is the week the plan was approved by the unit practice council.
The Schedule
Table 1 lists the steps in order.
Table 1
Implementation Schedule
| Week | Step | Owner | Depends on |
|---|---|---|---|
| 1 | Submit request to forms and order set committee for a head-of-bed flowsheet field and a contraindication order | Project lead (me) | Practice brief approved |
| 1 | Submit purchase request for 24 bed angle indicators | Nurse manager | Cost quote from supply chain |
| 2 | Meet wound care nurse; agree repositioning and mattress guidance | Project lead, wound care nurse | None |
| 3 | Draft teaching content, including night routine and pressure injury guidance | Project lead, unit educator | Week 2 meeting |
| 4 | Forms committee approves field and order; informatics begins build | Committee chair; informatics analyst | Week 1 request on agenda |
| 5 | Angle indicators delivered and installed on all beds | Biomedical engineering | Week 1 purchase approved |
| 6 | Flowsheet field and order live in the record | Informatics analyst | Week 4 approval |
| 7 | Teaching: two day-shift sessions and two night-shift sessions at 0200 | Unit educator (days), project lead (nights) | Indicators installed; field live; content drafted |
| 7 | Nursing assistant huddle teaching on returning beds to 30 degrees | Charge nurses | Content drafted |
| 8 | Practice goes live; charge nurse checks every tube-fed patient on the safety round | Charge nurses | Teaching complete for at least 80% of staff |
| 8 to 16 | Weekly audit at four set times; results posted every Monday | Project lead; two volunteer audit nurses | Go-live |
Why the Order Matters
The schedule looks slow at the start. Nothing visible happens on the unit for six weeks, and the temptation is to begin teaching in week 2 while enthusiasm is high. The plan resists that because teaching in week 2 would repeat the first attempt's mistake: nurses would be asked to maintain an angle they cannot see and document it in a field that does not exist. The six weeks are spent building the conditions that make the practice possible, the indicators, the documentation and the pressure injury guidance, so that when staff are taught, everything they are taught to use is already on the unit.
The critical path runs through two external calendars. The forms committee meets monthly, so the request must be submitted in week 1 to be approved in week 4. The informatics build takes about two weeks after approval, placing the live field in week 6. The indicators need purchase approval and delivery, placing installation in week 5. Teaching is set for week 7, the educator's first open slot, one week after both prerequisites are due, leaving a week of margin.
Night Shift, Planned Separately
The baseline audit found 28% compliance on nights compared with 52% on days, and the aspiration event that triggered the project happened at night. Night shift therefore gets its own teaching sessions, held at 0200 when the unit is quietest, led by the project lead rather than by a day educator who has not worked nights. The teaching covers the night routine in detail: pause the feeding before lowering the bed for repositioning or linen changes, return the bed to 30 degrees, then restart the feeding. The nursing assistants on nights receive the same content in their huddle.
Keeping Staff Informed Before They Are Taught
Six weeks of preparation can look like inaction to staff who heard about the aspiration event. To prevent the project being written off before it starts, the charge nurses will give a one-sentence update at every shift huddle from week 2: what has been done that week and what comes next, for example "the angle indicators are ordered and arrive in week 5." The project lead will post the schedule in the break room and mark off completed steps. Night staff, who were left out of the first attempt, will be told directly that their sessions will be at night and led by someone who works nights. These updates cost a few seconds a shift and keep the project visible while its foundations are laid.
What Could Delay the Plan, and the Response
If the forms committee defers the request, teaching will proceed with a temporary paper checklist at the bedside for documentation, and the flowsheet field will follow; the angle indicators, which are the more important prerequisite, would still be in place. If the indicators are delayed, teaching will be postponed, not held without them, since seeing the angle is the heart of the practice. If fewer than 80% of staff have completed teaching by week 8, go-live will move one week and makeup sessions will be added.
How the Plan Connects to the Evidence
The practice follows nutrition support guidance that places tube-fed adults with high aspiration risk at 30 to 45 degrees (McClave et al., 2016) and a practice alert from critical care nurses advising a minimum of 30 degrees where no contraindication exists (American Association of Critical-Care Nurses, 2016). Where a head-of-bed protocol was tested against usual care, nearly nine in ten protocol patients were kept at 30 degrees or more, against 38% of usual-care patients (Metheny et al., 2010). That result shows that high adherence is achievable, and the unit's target of 85% on both shifts is set with it in mind.
If the Schedule Slips
Some steps depend on people outside the unit. If the bed angle indicators arrive late, go-live week will not start without them, because the practice depends on staff seeing the angle at a glance; teaching will continue and the date will move. If the flowsheet field is not built in time, nurses will record the angle in the existing positioning comment until the field goes live. A slip of more than two weeks will be reported to the nurse manager with a revised date rather than absorbed quietly.
References
American Association of Critical-Care Nurses. (2016). Prevention of aspiration in adults [Practice alert]. Critical Care Nurse, 36(1), e20-e24. https://doi.org/10.4037/ccn2016831
McClave, S. A., Taylor, B. E., Martindale, R. G., Warren, M. M., Johnson, D. R., Braunschweig, C., McCarthy, M. S., Davanos, E., Rice, T. W., Cresci, G. A., Gervasio, J. M., Sacks, G. S., Roberts, P. R., & Compher, C. (2016). Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Journal of Parenteral and Enteral Nutrition, 40(2), 159-211. https://doi.org/10.1177/0148607115621863
Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18-25. https://doi.org/10.1097/NNR.0b013e3181c3ba05
What the NR 528 Week 4 assignment asks for
For Week 4 you write the plan for putting your practice change into place. Prompts usually ask for the steps in sequence, a timeline, responsible roles, resources, communication and education, and how you will handle obstacles. Many include a table or Gantt-style chart. The quality of the plan depends on its order. Before you date a step, ask what must exist first, such as equipment, a documentation field or an education slot, and who controls it. Plan the shift or group that is hardest to reach on its own. Say what staff will hear while preparation is under way. Link the approach to the evidence behind the practice and to implementation literature in APA 7, and keep within your section's page limit.
How the NR 528 Week 4 example is put together
The plan starts by stating its governing rule and recalling that the first attempt failed because teaching came before tools. A table lists the steps from committee request and purchase through teaching, go-live and audits, each with a week and an owner. A section explains why the order looks slow and why that is intended. Night shift gets its own sessions at 0200 and its own checks. A section on communication describes one-sentence huddle updates from week 2. Another lists likely delays with a response to each, such as a paper checklist if the flowsheet field is deferred. The paper ties the practice to nutrition support guidance and a critical care alert, then closes with what moves if the schedule slips.
Where the points sit in the NR 528 Week 4 rubric
The rubric for the implementation plan usually rewards a logical, complete sequence of steps, a realistic timeline, clear responsibilities, attention to resources and education, and plans for barriers. Graders favor schedules where dependencies are visible, because that is what makes a timeline realistic. A table the grader can read at a glance often supports the organization points. Plans that treat groups with different needs, such as night shift, separately tend to score higher on feasibility. Contingencies stated as specific responses show leadership judgment. Evidence should support both the practice and the implementation approach. Professional writing and APA 7 formatting, including a properly labeled table, make up the smaller share of the grade in most versions.
Common NR 528 Week 4 mistakes, and how to avoid them
The plan most often loses credit when it starts teaching before the tools or documentation exist, which trains staff on a practice they cannot yet perform. Check each date against its prerequisites. Another common gap is a timeline that ends at go-live, leaving out audits and follow-up. Students also assign steps to the unit or to staff instead of a named role. Avoid planning one education session for everyone; different shifts and float staff need different approaches. Say how you will keep staff informed during preparation, or the project will look abandoned. Contingency plans should say what you will actually do, not that you will adjust as needed. Finally, check that the table and the prose agree on every date.
Get a NR 528 Week 4 example written to your instructions
Send the Week 4 instructions along with any template your classroom supplies and a short account of the change and the unit, and a custom example is written to that template and returned inside 24 to 48 hours. The first one is free. Real dates out of your own calendar drop in afterwards without disturbing anything.
More NR 528 papers and MSN samples
- NR 528 Week 1: Discussion on a Stalled Change
- NR 528 Week 2: Practice Problem Brief
- NR 528 Week 3: Stakeholder Analysis
- NR 528 Week 5: Change Model Application
- NR 528 Week 6: Measurement Plan
- NR 528 Week 7: Barrier Mitigation Brief
- NR 528 Week 8: Sustainability Plan
- NR 527 Week 4: Interprofessional Case Analysis
- NR 520 Week 4: Ways of Knowing Essay
- NR 519 Week 4: Medication Review Read Backward
- NR 518 Week 4: Study Design Comparison
NR 528 Week 4 questions, answered
How far past go-live should the plan run?
Far enough to cover the weeks where a change is actually abandoned, which is rarely the first one. Four to six weeks of dated activity after the start reads as complete in most classrooms: the repeat teaching, the first reading, the point where extra help comes off. A plan ending on the go-live date has scheduled the easy part and stopped.
What if I have no idea how long a system build takes?
Write the step, give it a range, and label the range an estimate. Then say what happens at each end of it, which is the sentence that matters. A build arriving late usually means starting on paper, and a plan that has already worked out its paper version reads far better than one assuming the screen will be ready.
Does everything have to start on the same day?
Almost never, and choosing otherwise is part of the work. One shift, one area or one group of patients first, with the reason for that choice written down and a stated date for the rest, gives you somebody to learn from before the change is everywhere. Where a classroom asks for a single start, keep the dry run anyway.
Where can I find a free NR 528 Week 4 sample paper?
The dependency-ordered rollout above is the complete NR 528 Week 4 sample, with its schedule table, and it can be read free. Students planning a different practice change can outline their steps on the request page for a plan scheduled to their own unit.
Should the NR 528 Week 4 plan include a timeline table?
Yes, most sections expect a table or chart. The sample lists each step with a week and an owner, and the prose explains why no step appears before what it depends on is in place.