| Course | NR 599 Nursing Informatics for Advanced Practice |
|---|---|
| Week | 2 |
| Paper type | Documentation burden analysis |
| Length | About 1,110 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nursing Informatics |
| Updated | October 2026 |
Free sample paper for NR 599 Week 2
Documentation Burden Analysis: The Twelve-Hour Morse Fall Scale Reassessment on a 30-Bed Unit, Timed Under Real Conditions, Totaled With Assumptions in View and Set Against What It Returns
Student Name
College of Nursing, Chamberlain University
NR 599: Nursing Informatics for Advanced Practice
Instructor Name
Month Day, Year
Documentation Burden Analysis: The Twelve-Hour Morse Fall Scale Reassessment on a 30-Bed Unit, Timed Under Real Conditions, Totaled With Assumptions in View and Set Against What It Returns
The Item, Bounded
The item is one Morse Fall Scale reassessment on an adult inpatient: from the moment the nurse opens the "Morse Fall Scale" flowsheet group to the moment the entry is filed, including the "Fall Interventions" row when the total is 45 or more. It excludes the admission score, which is a separate entry, and excludes any physical change in fall precautions, which is care rather than documentation.
Assumptions in One Visible Block
| Assumption | Value | Source |
|---|---|---|
| Beds | 30 | unit census |
| Average occupancy | 95% (28.5 patients) | unit census, January to June 2026 |
| Reassessments per patient per day | 2 (every 12 hours) | documentation policy |
| Reassessments per day | 57 | 28.5 x 2 |
| Share with total of 45 or more | 46% | flowsheet report, June 2026 |
| Median time per reassessment | 52 seconds | observation, below |
| Days per year | 365 | |
| Registered nurse cost per hour with benefits | $52 | unit budget |
Anyone who disagrees with a value can change it and rerun the arithmetic below.
Timed in Real Conditions
Over four shifts in June 2026, two days and two nights, I observed 40 reassessments by eight nurses, with their agreement, and timed each from the flowsheet opening to filing. I did not ask anyone to work differently, and I counted interruptions, logins and repeats.
Median time: 52 seconds. Range: 22 seconds to 3 minutes 10 seconds.
Reassessments with an interruption: 14 of 40.
Reassessments that needed a fresh login on a shared workstation: 9 of 40, adding a median of 31 seconds each.
Reassessments where the total changed from the previous one: 5 of 40.
Zheng et al. (2011) note that time and motion studies done in quiet conditions understate documentation time; my own timing on a quiet test patient was 24 seconds, less than half the observed median.
The Total
57 reassessments a day x 52 seconds = 2,964 seconds, about 49 minutes a day.
49 minutes x 365 days = about 300 hours a year.
300 hours x $52 = about $15,600 a year in nurse time on one unit.
Across the hospital's nine adult inpatient units of similar size, roughly 2,700 hours a year.
Compared Against Something
Two comparisons.
Event-driven reassessment: a reassessment only after a change in condition, a new sedating or diuretic medication, a transfer or a fall. From the flowsheet report, about 12 such events occur a day on the unit. At 52 seconds each, about 10 minutes a day, about 63 hours a year.
A yes or no judgment field: "Fall risk per nurse judgment: yes or no," with the interventions row. Timed on 10 entries, median 15 seconds. At 57 a day, about 14 minutes a day.
Event-driven reassessment would return about 39 minutes a day to the unit's nurses.
The Benefit, Credited Separately
The reassessment exists for reasons, and they should be counted.
It can catch a change. In 5 of 40 observed reassessments, the total changed; in 2 of those 5, it crossed 45 and switched on fall precautions. Over a day, that suggests around 3 patients whose banner status changes at a routine reassessment. Some of those changes would also have been caught by an event-driven rule, because the cause was a new medication; some would not.
It provides a timed record of assessment for fall investigations and for any later legal review.
It feeds the unit's monthly report of fall risk documentation compliance, which the quality department tracks.
What the evidence says about the score itself: fall risk tools such as Morse have shown only moderate ability to predict who will fall, and reviews have suggested that the interventions matter more than the score (Oliver et al., 2010).
A Second Unit for Comparison
To test whether these figures are unusual, I timed 10 reassessments on a medical unit with the same record and policy. The median was 49 seconds, close to ours, and the score changed in 1 of 10. The pattern does not seem specific to one unit.
Where the Time Actually Goes
Breaking the 52-second median into parts, from my observation notes: about 8 seconds finding the flowsheet group, about 20 seconds scoring the six items, about 6 seconds filing and the remainder in logins, interruptions and re-entry after an interruption. Only the 20 seconds of scoring is the assessment itself; the rest is the cost of the record's layout and the shared workstations. That suggests a second, smaller saving from a better build, such as placing the Morse group on the nurse's default flowsheet view, whatever happens to the frequency rule.
How the Nurses Described It
After each timed entry, I asked the nurse one question: "Did this score tell you anything you did not know?" In 35 of 40 cases the answer was no. In 4 cases the nurse said the score confirmed something already suspected. In 1 case, the score prompted the nurse to put on a bed alarm. Nurses most often described the routine score as "for the record" rather than for the patient. Moy et al. (2021) call for burden studies to capture how clinicians experience documentation, not only its time; these answers are a small attempt at that.
What the Numbers Suggest
The routine reassessment costs about 300 hours a year on one unit. Its main benefit, catching a change, occurs in roughly one reassessment in eight, and some of those changes would be caught by an event rule. Its record-keeping benefit depends on the entry being an actual assessment, which the observation suggests is not always true: in 6 of 40, the nurse scored without seeing the patient walk or move.
Keeping the Score Itself
Nothing here argues for dropping the Morse score altogether. The admission score sets precautions for the first day, and event-driven scores catch the changes that matter most. It recommends only that the routine timer be replaced.
Limits
Forty observations by one observer, on one unit, in one month. Nurses knew they were being timed. The cost of a missed change is not priced, because I have no data on falls that a routine reassessment would have prevented.
Next Step
The overdue alert that enforces the twelve-hour rule is analyzed next, since it adds its own cost to this item.
References
Moy, A. J., Schwartz, J. M., Chen, R., Sadri, S., Lucas, E., Cato, K. D., & Rossetti, S. C. (2021). Measurement of clinical documentation burden among physicians and nurses using electronic health records: A scoping review. Journal of the American Medical Informatics Association, 28(5), 998-1008. https://doi.org/10.1093/jamia/ocaa325
Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26(4), 645-692. https://doi.org/10.1016/j.cger.2010.06.005
Zheng, K., Guo, M. H., & Hanauer, D. A. (2011). Using the time and motion method to study clinical work processes and workflow: Methodological inconsistencies and a call for standardized research. Journal of the American Medical Informatics Association, 18(5), 704-710. https://doi.org/10.1136/amiajnl-2011-000083
Reading the NR 599 Week 2 instructions
The Week 2 analysis is a costing and should read like one. Choose one item and bound it so two people timing it would time the same thing. Take frequency from something countable, such as a schedule, census or panel size, and state it as an assumption. Time the item as the work actually happens, interrupted and on shared machines, not in a quiet room. Total it with the arithmetic visible. Compare it with an alternative. Then credit the benefit separately, since the entry was added for a reason. Most rubrics mark down a large total with no assumptions shown, timing done in ideal conditions and an analysis that counts cost without crediting benefit.
How the NR 599 Week 2 example is put together
The sample bounds a single reassessment from opening the flowsheet group to filing. A table sets out beds, occupancy, frequency, the share scoring 45 or more, median time and nurse cost, each with a source. Forty reassessments by eight nurses are timed across day and night, with interruptions and fresh logins counted. The arithmetic gives 49 minutes a day and about 300 hours a year. Event-driven reassessment and a judgment field are compared. Benefits are credited: changes caught, a timed record and a quality report. Sections break the 52 seconds into parts, compare a second unit, report nurses' answers, state what is not recommended and list limits. Margin notes mark the assumptions block and the credited benefit.
NR 599 Week 2 rubric: what full points look like
The most expensive error is a total with no assumptions beside it, and every input here sits in a visible table with its source. Timing in laboratory conditions understates the item badly, so this analysis times real shifts and reports its own quiet-room figure for contrast. Counting cost without crediting benefit loses a row, while the score's benefits get their own section with counts. Comparing against nothing leaves the total meaningless, and two alternatives are timed. A second unit and nurses' own answers strengthen the evidence. Stating limits honestly earns the final criterion. Breaking the median into its parts shows that much of the time is the build's cost, not the assessment's.
NR 599 Week 2 help from the desk
Weak NR 599 Week 2 analyses produce an annual figure with no visible arithmetic. Others time an entry once, alone, on a fast computer. Many describe only the cost and never say why the entry exists. Few compare the item with any alternative. Interruptions and logins are rarely counted, though they often account for half the time. Bound your item, write every assumption in one place, time it on real shifts and credit what it gives back. Then compare it with something. If your item differs, share its frequency and a few of your timings, and we can set up a sample costing in this format.
Get a NR 599 Week 2 example written to your instructions
Send the Week 2 instructions, any template or table your classroom posts, and the item you want costed with whatever frequency you have been given. A custom example is written to those numbers and returned inside 24 to 48 hours, the first one free. Timing your own clinic is yours to do, and what comes back is the form the write-up takes.
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NR 599 Week 2 questions, answered
What if I have no way to time the task?
Say so and build the estimate in the open. A short set of self-timings with the count reported, a published figure cited to its source, or a range with a stated low and high all work, provided the paper never presents one of those as another. Sensitivity then does the honest labor: show the conclusion at both ends of your range and let a reader see it hold or fail.
Should the analysis recommend removing the item?
Only where the instructions ask, and only inside what the costing supports. Plenty of strong papers conclude that the item is worth its price and explain why, which is harder to write and usually marked higher. Where removal is recommended, name what evidence disappears along with the field, because that loss belongs in the same ledger as the hours saved.
How much of the paper should be tables?
Enough that the arithmetic is visible and no more. One assumptions table and one costing table carry most of these papers comfortably. What a reader needs is to follow a single instance through to the annual figure without leaving the page, so a table hiding its own steps is worth less than three lines of plain arithmetic underneath it.
Where can I find a free NR 599 Week 2 sample paper?
The full documentation burden analysis of the twelve-hour Morse reassessment, with assumptions, timings and benefits, is published on this page.
How much time does the reassessment cost in the NR 599 Week 2 analysis?
About 49 minutes a day on one 30-bed unit, roughly 300 hours a year, based on 57 reassessments at a median of 52 seconds.