| Course | NR 556 The Nurse Leader and Health Policy |
|---|---|
| Week | 6 |
| Paper type | Position statement |
| Length | About 1,100 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Healthcare Policy |
| Updated | September 2026 |
Free sample paper for NR 556 Week 6
Position Statement: The Nursing Practice Council's Position That Non-Violent Restraint for Delirium Must Be Tested by a Documented Release Trial Every Shift Before It Is Renewed
Student Name
College of Nursing, Chamberlain University
NR 556: The Nurse Leader and Health Policy
Instructor Name
Month Day, Year
Position Statement: The Nursing Practice Council's Position That Non-Violent Restraint for Delirium Must Be Tested by a Documented Release Trial Every Shift Before It Is Renewed
Issuing Body
This statement is issued by the Nursing Practice Council of our community hospital, the shared governance body of staff nurses, managers and clinical specialists that advises the chief nursing officer on nursing practice standards. It was drafted by the council's patient safety workgroup, adopted by council vote at its monthly meeting and is scheduled for review in two years or sooner if the hospital's restraint policy changes. It speaks for the council, not for the hospital's medical staff or administration, though it has been shared with both.
Position
For adult inpatients restrained to protect medical devices, most often because of delirium, no restraint should be renewed unless a release trial has been documented within the preceding shift, and the restraint should be discontinued whenever the trial shows it is no longer needed.
Grounds, Strongest First
Federal regulation requires it in substance. Hospitals taking part in Medicare must remove restraint at the first safe moment and may use it only to keep people physically safe (Condition of Participation: Patient's Rights, 2024). A restraint renewed without testing whether it is still needed cannot show that it is being ended at the earliest safe point. A documented release trial is the most direct evidence that the requirement is being met.
Restraint carries real risk. Pooled studies of restraint devices have linked them to patient injury, sometimes severe, and doubted that they reliably do what they are used for (Evans et al., 2003). Every unnecessary hour in restraint is an hour of avoidable risk.
Restraint can worsen delirium. Delirium in older hospitalized patients is common and associated with poor outcomes, and physical restraint is recognized as a factor that can precipitate or worsen it (Inouye, 2006). Keeping a delirious patient restrained longer than necessary may prolong the condition the restraint was meant to manage.
Our own data show the gap. A review of 30 restraint episodes on one medical unit found that in 12, a renewal was signed with no trial on record for the day before, and that the median episode lasted 41 hours.
Wide variation suggests room to improve. A multi-hospital study found up to tenfold variation in restraint rates within and between institutions, with preventing disruption of therapy the most common reason given (Minnick et al., 2007), which suggests that local practice, not patient need alone, drives restraint use.
The Strongest Objection
The strongest objection comes from night nurses and hospitalists, and it deserves to be stated as they would state it. "A release trial on a delirious patient at 3 a.m. risks the patient pulling out a central line or a feeding tube in seconds. Reinserting a central line exposes the patient to a procedure, infection risk and delay in treatment. One nurse with five patients cannot sit at the bedside for 15 minutes. Requiring a trial every shift will either be ignored or will cause the harm restraint is meant to prevent."
The objection is serious and partly correct. A release trial without enough staff is unsafe.
Response
The council's position requires a trial each shift, not at any particular hour. A trial can be timed when the patient is most alert and when a family member, sitter or second staff member is present, for example during morning care or a family visit. Where a trial is judged unsafe because of staffing or the patient's condition, the nurse documents why, and that documentation itself becomes data the council can use to argue for sitters or virtual monitoring. The position does not require nurses to take unsafe risks; it requires them to test and record, and it makes visible when the system does not give them the means to do so. The risks of line removal are real, but so are the risks of prolonged restraint, and a documented trial is the only way to weigh them for each patient.
What the Council Asks
The council asks the nursing policy committee to amend the restraint policy to define a release trial and require it each shift before renewal; asks the chief nursing officer to fund sitters or virtual monitoring for patients whose trials cannot be done safely; and asks unit managers to review restraint duration and trial documentation quarterly. The council will report on adoption and on restraint duration at its meeting six months after the policy change.
Why the Council Is Taking a Position
Shared governance councils take positions on practice when an issue crosses individual units and affects how nurses exercise their professional judgment. Restraint meets both tests. The practice gap was found on one unit, but the policy governs all adult inpatient units, and the renewal decision rests on a nursing assessment of whether the patient still needs restraint. The council's standing comes from its role in the hospital's professional practice model, which gives staff nurses a voice in setting practice standards. A position statement records that voice formally and gives the nursing policy committee a clear signal about what staff will support.
The council also recognizes that its position has costs. Release trials take time, and some will be judged unsafe. The statement is written to make those costs visible rather than to ignore them, so that the hospital can decide what support nurses need to meet the standard.
Scope and Limits
The position applies to non-violent restraint for adult inpatients. It does not address restraint for violent or self-destructive behavior, which follows different rules, or restraint in the behavioral health unit, the emergency department or pediatric units, where the council has not reviewed practice. It rests on evidence that is strongest for harms of restraint and weaker for the benefits of specific release trial protocols, and the council will revise it if local data show harm from trials.
The council recognizes that some patients will still need restraint for days, particularly those with severe delirium and critical lines. For them, the position asks only that the need be tested and recorded each shift, so that continuing is an active choice and not a default. That standard is achievable, respects nurses' judgment and gives the hospital the evidence federal rules expect.
The council will publish its review of these data.
References
Condition of Participation: Patient's Rights, 42 C.F.R. ยง 482.13 (2024).
Evans, D., Wood, J., & Lambert, L. (2003). Patient injury and physical restraint devices: A systematic review. Journal of Advanced Nursing, 41(3), 274-282. https://doi.org/10.1046/j.1365-2648.2003.02501.x
Inouye, S. K. (2006). Delirium in older persons. New England Journal of Medicine, 354(11), 1157-1165. https://doi.org/10.1056/NEJMra052321
Minnick, A. F., Mion, L. C., Johnson, M. E., Catrambone, C., & Leipzig, R. (2007). Prevalence and variation of physical restraint use in acute care settings in the US. Journal of Nursing Scholarship, 39(1), 30-37. https://doi.org/10.1111/j.1547-5069.2007.00140.x
What the NR 556 Week 6 assignment asks for
This week asks you to write a position statement on a practice or policy issue. Instructions commonly request the issuing organization, the position, supporting evidence, counterarguments and recommendations. Name the issuing body first, with its role and adoption and review dates, since standing distinguishes a position from an opinion. State the position in one sentence that could be quoted on its own. Order the grounds with the strongest first, including regulation, professional standards, research and local data. State the strongest objection as its holders would, with their best reasons, and respond without dismissing it. List specific requests of named decision makers. State the scope and limits of the position. Cite regulation, standards and research in APA 7.
How this NR 556 Week 6 example is built
The statement opens by naming the nursing practice council, its membership, how the statement was adopted and when it will be reviewed. A one-sentence position follows. Grounds are ordered: the federal requirement to end restraint promptly, evidence of restraint injury, the link between restraint and delirium, local chart review data and national variation in restraint rates. The objection from night staff and hospitalists about line removal is stated in their words. The response explains timing trials when help is available and documenting unsafe trials as data. The statement asks the policy committee, the chief nursing officer and managers for specific actions and closes with scope and limits.
Where the points sit in the NR 556 Week 6 rubric
Readers of position statements reward clear standing, a quotable position, well-ordered evidence, fair treatment of objections, specific requests and honest limits. Naming the issuing body and its dates at the start establishes authority. A position written to be quoted out of context shows discipline. Ordering grounds from strongest to weakest reads as persuasive. Stating the objection as its holders would, and responding without dismissing it, shows respect and earns credit. Requests directed to named decision makers make the statement actionable. Honest scope and limits increase credibility. Regulation, professional evidence and local data, cited in APA 7, support the position. Plain, confident language suits the genre.
NR 556 Week 6 help: mistakes that cost points
Position statements often build toward the position over several pages, so readers do not know what is claimed until the end. State it first. Another weakness is failing to say who issues the statement, which makes it read as personal opinion. Name the body and its standing. Some students present a weak version of the opposing view; state it at full strength. Avoid vague requests such as improve practice; name who should do what. Include scope, so readers know where the position does not apply. Keep the statement concise, and make sure each ground actually supports the position rather than the general topic. Date the statement and set a review date, since positions age as evidence and policy change.
Get a NR 556 Week 6 example written to your instructions
Send the Week 6 instructions, the rubric and the issue plus the organization your section named, or say if the choice is yours. A custom position statement is written to those materials and returned inside 24-48h, first one free, laid out in published form rather than as an essay about the topic.
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NR 556 Week 6 questions, answered
Am I writing as a real organization or an invented one?
Sections handle this differently, so the instructions decide it. Where a real body is named, write what that body could credibly adopt given the positions it already holds, and never copy wording from a statement it has published. Where the organization is invented or left to you, define it in a line at the top, because the scope of who it speaks for changes what the statement is allowed to claim.
How long should a position statement actually be?
Shorter than most people expect, and your rubric sets the ceiling. These documents work by being readable in one sitting by somebody with no stake in the topic, which usually means a couple of pages with the position visible on the first. If the page count required feels large for the form, put the extra length into grounds and limits rather than into a longer introduction.
Can I take a position that some nurses would disagree with?
Yes, and a statement nobody could object to is generally the weaker submission. The requirement is that disagreement is acknowledged inside the document rather than ignored, usually in the limits section or in a short paragraph handling the strongest counterargument on its own terms. What costs points is pretending consensus exists where it does not, since the colleagues being committed will know.
Where can I find a free NR 556 Week 6 sample paper?
The restraint release trial position statement is the NR 556 Week 6 sample shown above, fully readable. If your issue calls for a different position, send us the topic and issuing body and a statement can be written.
How should the NR 556 Week 6 statement handle objections?
By stating the strongest objection as its holders would and responding to it directly. The sample voices night nurses' concern about line removal and answers it.