| Course | NR 632 Nurse Executive Concluding Graduate Experience II |
|---|---|
| Week | 2 |
| Paper type | Implementation update |
| Length | About 1,120 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 632 Week 2
Implementation Update: The Readiness Call as Written Beside the Readiness Call as It Is Being Done, With Every Difference Given an Author
Student Name
College of Nursing, Chamberlain University
NR 632: Nurse Executive Concluding Graduate Experience II
Instructor Name
Month Day, Year
Implementation Update: The Readiness Call as Written Beside the Readiness Call as It Is Being Done, With Every Difference Given an Author
Period Covered
Pilot weeks one and two in operating rooms 3 to 6: 16 to 20 November and 30 November to 4 December 2026. Thanksgiving week was excluded, as planned.
Written Version Beside Running Version
| Step | As written | As being done | Author of the difference |
|---|---|---|---|
| List printed | Pre-admission testing nurse prints next-day first-case list at 13:30 | Printed at 13:15 by the scheduling clerk and left in the tray | Adaptation by staff, from day 2 |
| Six-item check | Nurse checks each patient against six items in the record | Done as written for five items; fasting instructions now confirmed only for patients with phone-only testing | Decision by the pre-admission testing manager, 20 November |
| Call to surgeon's office | By 15:00 for any open item | By 15:30; two offices route calls to voicemail after 15:00 | Adaptation by staff, from day 3 |
| Readiness line at 15:30 huddle | Open items read by room | Read as a printed slip handed to the OR charge nurse, not spoken | Adaptation by staff, from day 4 |
| Morning read in holding | Early-shift charge nurse reads list at 06:00 | Read at 05:45 during the shift huddle | Decision by the student, 23 November |
| Monday first cases | Checked Friday afternoon | Checked Friday only when a nurse is free before 15:00 | Not decided by anyone; Friday shift ends at 15:00 |
Why the Written Version Was Expensive
Three parts of the written plan cost more than expected. Printing at 13:30 meant the nurse waited for the clerk's lunch break to end; the clerk solved this by printing before lunch. Confirming fasting instructions with every patient took about four minutes a call and repeated what the pre-admission testing visit had already done for clinic patients; the manager limited it to phone-only patients, who accounted for most fasting problems in the baseline. Reading the open items aloud at the huddle took longer than five minutes on two days, when equipment issues ran over; the printed slip keeps the information without the airtime.
Adaptations Staff Made Without Asking
The 13:15 print, the 15:30 call deadline and the printed slip were all made by staff. None weakens the design: the list is still current, calls still reach offices, and open items still reach the OR charge nurse. The 15:30 deadline does carry a risk, since an office that closes at 16:00 has less time to respond, and the student's own count of calls returned by 16:30 will show whether that matters.
Fully in Place
The afternoon check on Tuesday to Friday cases: done for 26 of 29 eligible patients in the two weeks, with all three misses in week one while the upgrade slowed the record. The morning read in holding: done on 9 of 10 days. Dated 4 December.
Partly in Place
The check for Monday first cases. In week one, the dry run on Friday 13 November covered all four Monday cases, because extra staff were present. In week two, Monday 30 November's cases fell after the holiday, and only one of four was checked, on Wednesday 25 November. Dated 4 December.
Not Yet Started
The weekly report from the OR information system, which was delayed by the upgrade and is now promised for the week of 7 December. Until then, the on-time figures come from a manual tally of the OR board log. Dated 4 December.
The Difference That Splits the Days
Tuesday to Friday cases are being checked almost every time; Monday cases are not. The gap sits in a staffing rule nobody owns for this project: the pre-admission testing Friday shift ends at 15:00, and the surgeons' offices are busiest on Friday mornings. This split is the most important finding so far, because a Monday case that goes unchecked is exactly the kind the project was designed to catch.
What Staff Have Said
Three comments came to the student unprompted. A pre-admission testing nurse said the calls felt useful because offices often thanked them for the reminder, and that one office manager now sends updated histories by fax before the call. A holding nurse said that knowing which patients had been checked made the 06:00 admissions calmer. The OR charge nurse asked for the slip to list rooms in order, which was done on day five, so the charge nurse can now read the slip from top to bottom while walking the corridor past the rooms in order. None of these is a measure, but each shows where the change is landing in the daily work.
Fidelity Against the Design
The parts of the design that carry the effect are the afternoon check, the call while offices are open and the morning read. The first two are running on four days in five; the third is running every day. The parts that were changed, the print time, the call deadline and the slip, are delivery details. The one gap that touches the core of the design is the Monday check, and that is where attention goes next.
What the Update Does Not Say
It does not report on-time results. Two weeks of first cases is too few to judge, and week one's in-room times are affected by the upgrade, as noted in the week one post.
How This Fits the Evidence
Implementation studies distinguish between whether a change was delivered as intended and whether it worked (Proctor et al., 2011). Adaptations by staff are expected, and continuing measurement with feedback was part of what sustained first-case gains at one academic center (Phieffer et al., 2017); a nurse-driven study of preoperative steps also found that the timed plan had to be adjusted to what happened in practice (Blair et al., 2024).
Risks for the Coming Weeks
Influenza season is beginning, and a single nurse off sick in pre-admission testing would take the afternoon hours with them, since the post that is vacant leaves no slack. The holiday run-up may fill surgeons' lists and add first cases late in the day, after 15:30, which would not be checked. Both are being watched through the paper log, and either would be reported in the next update with the days affected.
Commitment for the Next Two Weeks
The student will ask the pre-admission testing manager by 8 December whether Monday checks can move to Friday from 12:30 to 14:30, and will report the answer in the next update.
References
Blair, K., Mijatovic, O., Thompson, M., Monroe, M., & Davies, C. C. (2024). A nurse-driven plan to diminish first-case operating room delays. The Journal of Nursing Administration, 54(9), 503-506. https://doi.org/10.1097/NNA.0000000000001467
Phieffer, L., Hefner, J. L., Rahmanian, A., Swartz, J., Ellison, C. E., Harter, R., Lumbley, J., & Moffatt-Bruce, S. D. (2017). Improving operating room efficiency: First case on-time start project. Journal for Healthcare Quality, 39(5), e70-e78. https://doi.org/10.1097/JHQ.0000000000000018
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76. https://doi.org/10.1007/s10488-010-0319-7
Reading the NR 632 Week 2 instructions
Build the update around two columns: the change as written and the change as it is being done. Use specific actions as rows, not aims. For every difference, say who authored it, either a decision you or a leader made on a known date or an adaptation staff arrived at without asking. Explain why parts of the written version proved costly. Then give three short passages, on what is fully in place, what is running in one area or on some days only and what has not started, each closed with a date. Name the difference that splits your areas or days. Write in the past tense except for a closing commitment with a date. Keep the table rows to actions someone could watch happen.
Inside the NR 632 Week 2 example
The sample's table covers printing the list, the six-item check, the call to the office, the huddle line, the morning read and Monday cases. Differences include a 13:15 print by the scheduling clerk, fasting checks limited to phone-only patients by the manager's decision, a 15:30 call deadline and a printed huddle slip, all dated. Three costs explain the changes. Tuesday to Friday checks reached 26 of 29 patients; Monday checks reached one of four after the holiday. The weekly report has not started. Staff comments, a fidelity paragraph separating core from detail and two risks follow. The update closes by committing to ask about moving Friday checks by 8 December.
Where the points sit in the NR 632 Week 2 rubric
Updates lose most when they describe the plan again instead of what is happening, which leaves the grader unable to see any difference. Next is a list of differences with no author, so nobody can tell which were leadership choices and which staff made alone. The second kind is the more interesting, and most updates omit it. Many writers report everything as in place when parts run only on some days or in one area. Undated passages make it hard to follow progress over the term. A missing line on why the written version was expensive suggests the writer has not asked. Updates that mix in outcome figures before enough weeks have passed also lose ground. Finally, an update with no commitment and date at its close gives the instructor nothing to check against in the next update.
Common NR 632 Week 2 mistakes, and how to avoid them
Comparing what you planned with what is really happening can be uncomfortable, especially when staff have changed things without asking. We can help you build the two-column table, give each difference an author and date and write the short passages on what is in place, partly in place and not started. We can also help you name the one difference that matters most. Throughout, you supply the facts from your site and decide how the account is worded. It is often easier to see which differences matter once someone outside the project reads the two columns side by side.
Get a NR 632 Week 2 example written to your instructions
Four things make a good brief for this one: the Week 2 instructions, the rubric, any reporting form your section uses, plus two lines on what went live and when. A custom example update comes back on that form inside 24-48h, and a first request costs nothing at all.
More NR 632 papers and MSN samples
- NR 632 Week 1: First Days in Figures
- NR 632 Week 3: Data Collection Plan
- NR 632 Week 4: Process Measure Summary
- NR 632 Week 5: Outcome Comparison
- NR 632 Week 6: Barrier Analysis
- NR 632 Week 7: Evaluation Report
- NR 632 Week 8: Handover Briefing
- NR 631 Week 2: Problem Statement
- NR 588AI Week 2: Technology Governance Brief
- NR 588 Week 2: Partner Analysis
- NR 529 Week 2: Delegation Analysis of a Standing Job
NR 632 Week 2 questions, answered
Is it acceptable that staff changed the process without asking?
It is the most useful thing in the update. An adaptation invented on the floor is a measurement of how expensive the written version was, and executives who record it get better information than those who correct it immediately. What the marks follow is whether the writer noticed, dated it, worked out what it cost to follow the original, and decided knowingly whether to keep the local version.
What if nothing has actually launched yet?
Then the update reports that as its position and says what is holding it, in mechanics rather than in feeling: a post vacant since a named month, a supply item on back order, a system release booked ahead of yours. A truthful account of a change that has not started is markable work. An update implying activity that did not occur is not.
Who is an implementation update actually written for?
Usually two readers at once, which is why the genre is awkward. The classroom reader wants the reasoning visible and the sources present. The reader at your organization wants position in three facts and no background at all. Where a section does not say, write for the workplace reader and let the academic apparatus sit in a short appended section rather than through the body.
Where can I find a free NR 632 Week 2 sample paper?
This page holds the full implementation update comparing the written and running versions of the first-case readiness call.
Why does the NR 632 Week 2 update name an author for each difference?
It separates choices leaders made from adaptations staff made on their own, and the second kind shows how the change is landing in daily work.