NR 538 Week 4 Trend Analysis Write-Up Example

Course	NR 538 Population Health I: Assessment and Analysis of Data
Week	4
Paper type	Trend analysis write-up
Length	About 1,120 words, 3 pages
Format	APA 7 student paper
School	Chamberlain University
Program	MSN, Population Health
Updated	September 2026

Free sample paper for NR 538 Week 4

Trend Analysis Write-Up: Seven Years of Fall Hospitalizations and Lift-Assist Calls Among a Rural County's Older Adults, a Rate That Fell Because the Denominator Grew and a Count That Jumped Because a Form Changed

Student Name

College of Nursing, Chamberlain University

NR 538: Population Health I: Assessment and Analysis of Data

Instructor Name

Month Day, Year

What this page is doingThe title reports two apparent trends and names the artifact behind each before claiming any direction of travel, which is what a trend write-up is graded on. Student APA 7 title page.

Purpose

This write-up examines seven years of data, 2019 through 2025, for two of the indicators selected for our county's assessment of serious fall risk among adults aged 65 or older: fall-related hospitalizations and lift-assist calls to the county ambulance service. The purpose is to report the direction of travel for each and, before doing so, to test whether any apparent change reflects the problem itself or something about how the numbers were produced. A rate that falls for three years running can mean the problem eased, or it can mean a form changed. Both kinds of change appear in these data.

The Data

Table 1 sets out the counts, the older adult population and the resulting rates.

Table 1

Fall Hospitalizations and Lift-Assist Calls, Adults Aged 65 or Older, 2019 to 2025

Year	Residents aged 65 or older	Fall-related hospitalizations	Rate per 10,000	Lift-assist calls, age 65 or older
2019	12,900	171	132.6	94
2020	13,150	148	112.5	88
2021	13,400	166	123.9	102
2022	13,600	163	119.9	241
2023	13,800	161	116.7	276
2024	14,000	160	114.3	297
2025	14,200	171	120.4	318

Hospitalizations: What the Rate Shows

Read on its own, the hospitalization rate fell from 132.6 per 10,000 in 2019 to a low of 112.5 in 2020, rose in 2021 and then fell for three consecutive years to 114.3 in 2024, before rising again in 2025. A report that showed only the rate might conclude that fall injuries among older adults had declined by about a tenth over the period.

Two things explain most of that apparent decline, and neither is a reduction in falls. The first is the 2020 dip, which coincided with the pandemic. Hospital admissions for many conditions fell that year as people avoided hospitals and elective care was suspended, and fall admissions were likely affected in the same way. The 2020 figure should be treated as an outlier rather than part of a trend. The second is the growth in the denominator. The county's older adult population grew by about 10% over the period, from 12,900 to 14,200, as residents aged and some retirees moved in. The count of hospitalizations barely changed: 171 in both 2019 and 2025. A stable count spread across a larger population produces a falling rate. But a larger population of older adults is also, on average, an older one, and fall risk rises steeply with age. A crude rate that holds steady while the population ages may in fact conceal a slight improvement, or may not; the data cannot tell without age adjustment.

The honest conclusion is that fall-related hospitalizations have been roughly flat in number over seven years, that the crude rate declined slightly because the population grew, and that the direction of the underlying risk is uncertain. National data show that falls remain common and deadly among older adults (Kakara et al., 2023), and nothing in our county data suggests we are an exception.

Lift-Assist Calls: What the Count Shows

Lift-assist calls more than doubled between 2021 and 2022, from 102 to 241, and have risen each year since. A reader might conclude that falls at home rose sharply. The explanation is a change in the form. In 2022, the ambulance service moved to a new version of its electronic patient care record to meet the state's adoption of an updated national EMS data standard. The new version added a specific disposition for assisting a patient who needed no treatment or transport. Before the change, crews had recorded most lift assists as a refusal of transport or as no patient contact, which the old count did not capture. A description of the national EMS data set shows how its standard fields for disposition shape what can be counted from agency records (Mann et al., 2015).

The jump from 2021 to 2022 is therefore mostly a measurement artifact. The rise after 2022, from 241 to 318 over three years, is more likely to be real, since the form has not changed since then. It may reflect more falls, more older adults living alone, greater willingness to call or the growth of the older population. The per-person rate rose from about 17.7 per 1,000 in 2022 to 22.4 per 1,000 in 2025, which is larger than population growth alone would explain.

Checking the Explanations

Both explanations were checked, because an artifact that is assumed but not tested is only another guess. For the hospitalizations, I calculated rates excluding 2020 and found the same pattern. I asked the state for age-specific counts to allow age adjustment, which will be available next quarter. For the lift-assist calls, I reviewed a sample of 30 records from 2021 coded as refusal or no patient contact and found that 19 described a lift assist in the narrative, which confirms that the old coding hid most of these calls. Applying that proportion to all such 2021 records suggests that the true number of lift assists in 2021 was around 230, similar to 2022.

Conclusions for the Assessment

Three conclusions follow. First, fall-related hospitalizations among older adults have not fallen in number, and the modest decline in the crude rate should not be reported as progress. Second, lift-assist calls have risen since 2022 by more than population growth, which is a real signal of increasing need, while the jump from 2021 to 2022 is an artifact of the form. Third, any future report of these indicators should include counts alongside rates, should mark 2020 as a pandemic year, note changes in forms or coding, and, once available, use age-adjusted rates. Research on lift-assist calls found most calls coming from a small share of homes, often again within a month (Cone et al., 2013), so the rise in calls may also reflect a growing group of repeat callers, which the next analysis will examine. The write-up also has a lesson for the rest of the assessment. Each of the two indicators looked, at first glance, like it told a clear story: fall injuries declining, falls at home soaring. Neither story survived a question about how the numbers were made. The same question will be asked of every other indicator before its trend is reported to partners.

What this page is doingEach apparent trend is tested for artifacts, one from a growing denominator and one from a changed form, and both explanations are checked against the data before any direction of travel is reported.

References

Cone, D. C., Ahern, J., Lee, C. H., Baker, D., Murphy, T., & Bogucki, S. (2013). A descriptive study of the "lift-assist" call. Prehospital Emergency Care, 17(1), 51-56. https://doi.org/10.3109/10903127.2012.717168

Kakara, R., Bergen, G., Burns, E., & Stevens, M. (2023). Nonfatal and fatal falls among adults aged ≥65 years: United States, 2020-2021. MMWR. Morbidity and Mortality Weekly Report, 72(35), 938-943. https://doi.org/10.15585/mmwr.mm7235a1

Mann, N. C., Kane, L., Dai, M., & Jacobson, K. (2015). Description of the 2012 NEMSIS public-release research dataset. Prehospital Emergency Care, 19(2), 232-240. https://doi.org/10.3109/10903127.2014.959219

What the NR 538 Week 4 assignment asks for

Analyzing trends in your population's indicators is this week's work. Prompts generally ask you to present data over several years, describe the direction and size of change, consider explanations and discuss implications for the assessment. Before reporting any direction, ask how the numbers were produced in each year. Look for changes in the denominator, such as population growth or aging, and in the numerator's recording, such as new forms or codes. Treat unusual years, like a pandemic year, separately. Check each explanation with the data if you can. Report counts beside rates. Say what the trend cannot show without age adjustment or other data. Cite sources in APA 7 and present the years in a table.

How the NR 538 Week 4 example is put together

The write-up states its purpose and the warning that a falling rate can reflect a changed form. Table 1 gives seven years of population, hospitalizations, rates and lift-assist calls. The hospitalization section shows the rate falling while the count stays near 170, explains the pandemic dip and the growing denominator, and notes that aging could hide a change either way. The lift-assist section traces the 2022 jump to a record system change and shows that calls rose faster than population afterward. A checking section reports rates without 2020, a request for age-specific counts and a sample of old records showing hidden lift assists. Three conclusions and a lesson for other indicators close the paper.

NR 538 Week 4 rubric: what full points look like

Trend analysis rubrics typically reward accurate presentation of data over time, correct calculation of rates, appropriate description of change, consideration of alternative explanations and sound conclusions. Graders favor write-ups that test whether a change is real before interpreting it. Identifying denominator growth and recording changes as artifacts shows sophistication with population data. Checking explanations against the data, rather than asserting them, demonstrates rigor. Reporting counts with rates and noting the need for age adjustment show statistical care. Conclusions that separate real signals from artifacts give the assessment a sound basis. A clear table and correct citations support the grade in most sections.

Common NR 538 Week 4 mistakes, and how to avoid them

The most common mistake is reporting a rising or falling rate as a change in the problem without asking whether the denominator or the recording changed. Check both. Another is treating a pandemic year as part of a trend. Mark it. Students also calculate rates without showing counts, which hides whether a change rests on a few events. Show both. Avoid overstating certainty when age adjustment is not available. Do not ignore changes in forms, codes or record systems, which are common in local data. Test your explanation with whatever data you have, even a small sample. Finally, carry the lesson forward, applying the same questions to every indicator in the assessment.

Get a NR 538 Week 4 example written to your instructions

Give us the prompt, the rubric, and whatever chart or table format your classroom expects, plus the measure and years you are working with. We write a custom NR 538 example against that material and return it inside 24-48h, with the first one free. If the series comes from an employer report, send the published version rather than an internal file.

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NR 538 Week 4 questions, answered

How many years does a trend need?

More than two, and enough that one unusual year cannot carry the story. Prompts differ and some name a span, so read yours first. Where only a short run is published, the honest write-up says so and reports the movement as provisional rather than inventing a longer series from sources that count different things in different years.

Should the write-up include a chart?

Usually yes, and on its own it earns very little. A chart with a labeled axis, a stated source and the full range of years supports the reading; a chart pasted in without a source line invites the marker to check it and find nothing. Some classrooms want figures numbered and captioned in the required style, so confirm the formatting expected in your section.

What if the number has barely moved?

That is a result and often a better one to write about. A flat series in a problem everyone assumes is worsening is genuinely interesting, and the write-up then argues about why nothing shifted despite attention and spending. The weak version is a writer who forces a slope out of noise; the strong version reports stability, sizes it, and asks what has been holding the number in place.

Where can I find a free NR 538 Week 4 sample paper?

The seven-year falls trend write-up above is the whole NR 538 Week 4 sample and is shared openly. If your indicators come from other sources, send us the years of data you have and an analysis testing each trend can be written.

Why might an NR 538 trend be misleading?

Because a rate can change when its denominator grows or when the way events are recorded changes. The sample shows a falling rate caused by population growth and a rising count caused by a new record code.