| Course | NR 705A DNP Project & Practicum II |
|---|---|
| Week | 8 |
| Paper type | Design defense summary |
| Length | About 1,100 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NR 705A Week 8
Design Defense Summary: Every Decision of the Design Term With Its Rejected Alternative, Two Objections at Full Strength and a Stop Rule
Student Name
College of Nursing, Chamberlain University
NR 705A: DNP Project & Practicum II
Instructor Name
Month Day, Year
Design Defense Summary: Every Decision of the Design Term With Its Rejected Alternative, Two Objections at Full Strength and a Stop Rule
The Change
Chosen: meeting the consultant before leaving the clinic, with a next-business-day call for patients not seen that day. Rejected: a faster callback alone. Reason: most lost patients were never reached by phone, and a callback alone repeats the step that loses them. Wrong if: same-day contacts stay below 30% of eligible patients during behavioral health hours, which would mean the same-day part is not happening and the project is in effect testing a faster callback.
The Population
Chosen: adults at their first qualifying primary care visit at one site, with a PHQ-9 total of 10 or higher. Rejected: all positive PHQ-2 screens. Reason: many positive PHQ-2 screens do not lead to a PHQ-9 of 10 or more, and the site's referral rule uses the PHQ-9 threshold (Kroenke et al., 2001). Wrong if: the consultant reports seeing many patients with lower scores who would have benefited.
The Window
The window has to be long enough to show a shift and short enough to finish within the term. Chosen: 12 weeks, 1 March to 24 May 2027. Rejected: 6 weeks. Reason: about 20 eligible patients a week gives about 240 in 12 weeks, enough to see a shift on a run chart; 6 weeks would give about 120 and wide week-to-week swings. Wrong if: a staffing change mid-test, such as the consultant's absence, breaks the window into two short pieces.
The Measures
Chosen: completed contact within 30 days as outcome; same-day contact, handoff requested and next-business-day call as process; visit length and missed follow-ups as balancing. Rejected: PHQ-9 change at 3 months. Reason: three-month follow-up would end after the project. Wrong if: contact rises but patients drop out after one visit, which the evaluation term will check.
The Instrument
The instrument had to fit what the site agreement allows. Chosen: an eight-item anonymous staff survey on feasibility and acceptability. Rejected: a patient survey. Reason: the site agreement does not allow patient contact for the project. Wrong if: staff responses are too few for groups of five, in which case results will be reported for all staff together.
The Pathway
Chosen: a request to the program's committee for a determination. Rejected: proceeding on the assumption that it is improvement. Reason: the decision is not the student's to make.
Objection 1: Too Small to Show Anything
This objection arrives at every design review and deserves a full answer. "Twelve weeks at one site, about 240 patients, can't prove the change works." The objection is right that the design cannot prove cause or generalize. It is not designed to. It is designed to show, with a run chart, whether the site's own figure shifts after the change, against a 26-week baseline of 580 patients with a stable median of about 33%. Run chart rules treat a long sequence of weeks all above the baseline median as unlikely to arise by chance (Perla et al., 2011). With 240 patients, a rise from 33% to the target of 50% would produce such a shift if it is real. A smaller rise, to about 40%, might not, and the evaluation would then report the result as uncertain rather than claiming success or failure.
Objection 2: The Change Was Tested Elsewhere and Did Not Always Work
"A study of Latino patients found warm handoffs did not help, and may have harmed, uptake among English-speaking Latinos (Horevitz et al., 2015). Many of your patients are Latino." The objection is fair and is the strongest against the design. Three answers. Anyone who declines the introduction still gets a phone call the next working day, so patients who would prefer a standard referral still get one. The measures can be split by preferred language, English or Spanish, since language is a structured field; the analyst will report both. And the study used a two-month window and an initial visit as its outcome, close to ours, so a similar effect would be visible here. If English-speaking Latino patients do worse after the change, the evaluation will say so, and the team will consider offering those patients a choice between meeting the consultant and receiving a call.
Feasibility, as Arithmetic
Feasibility is easier to judge in numbers than in words. Four eligible patients a day, two open slots a day for the consultant, plus walk-in time when free: on most days the consultant can see three or four. Ten follow-up visits a week displaced to the psychologist's days and telehealth, which have about twelve open slots a week. The assistant's morning calls: about one or two a day after hours. Staff teaching: about 15 minutes per medical assistant. Analyst time: about two hours a week for the weekly measures, within the hours agreed in the charter. Student time: about six hours a week during the test, within the practicum plan. None of these figures requires new money.
A Stop Rule With a Tripwire
The test will pause, and the team will meet within a week, if any of these happens: median visit length for eligible visits rises by more than 15 minutes for two consecutive weeks; missed follow-up visits rise above 25% in a month; or two or more staff report a patient complaint about feeling pressured. The tripwire is checked weekly by the student together with the behavioral health director.
What the Term Has Not Settled
Whether staff will keep messaging on busy days, whether the consultant's open slots will survive pressure from booked patients and whether the language split will show a difference. Each is a question the test will answer, not one the design can.
How the Design Will Be Judged at the End
By the run chart against the baseline median, by the process measures that show whether the change happened, by the balancing measures that show whether it cost something elsewhere and by the staff survey. The evaluation will report all four, including any that look unfavorable. A design that is judged only on its outcome measure can look successful while staff quietly abandon it or another service absorbs the cost, and the evaluation is planned to see both.
Still in the Future Tense
Nothing here has happened yet. The test starts 1 March, subject to the determination.
References
Horevitz, E., Organista, K. C., & Arean, P. A. (2015). Depression treatment uptake in integrated primary care: How a "warm handoff" and other factors affect decision making by Latinos. Psychiatric Services, 66(8), 824-830. https://doi.org/10.1176/appi.ps.201400085
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895
Reading the NR 705A Week 8 instructions
Give each decision from the term a short entry: what was chosen, what was rejected, the reason and what would have to turn out otherwise for the choice to be wrong. Cover the change, population, window, measures, instrument and approval pathway. Give two objections full treatment rather than a clause, especially that the design is too small to show anything and any published evidence against your change. Set out feasibility as arithmetic: patients a day, slots available, staff hours. Add a stop rule with specific tripwires. Say how the design will be judged at the end. Keep everything in the future tense, since nothing has happened yet.
Inside the NR 705A Week 8 example
The sample chooses a same-day introduction over a faster callback, adults with a qualifying PHQ-9 over all positive two-item screens, 12 weeks over 6, 30-day contact over three-month symptom change, a staff survey over a patient survey and a committee determination over assuming improvement status. The first objection is answered with run chart reasoning against a 26-week baseline. The second is answered with the next-day call for those who decline, a language split and a matching outcome window. Feasibility counts four eligible patients and two open slots a day. Tripwires cover a 15-minute rise in visit length, missed follow-ups above 25% and pressure complaints. It also says what the term has not settled and how the design will be judged, including unfavorable results.
Reading the NR 705A Week 8 grading rubric
Design defenses lose most when they restate the design without the alternatives it beat, which leaves the choices looking arbitrary. Next is an objection answered in a clause, usually the one about sample size, which reviewers always raise. Many defenses ignore published evidence against their change, which a reviewer will find. Feasibility is often asserted rather than worked out as numbers. Stop rules are frequently missing or vague, leaving no plan for harm. Defenses written in the past or present tense, as though results exist, lose credibility. Saying how the design will be judged, including unfavorable results, is often left out. Defenses that never set out how the design will be judged also leave room to call any result a success. Graders look for that commitment.
NR 705A Week 8 help: mistakes that cost points
Defending a design means anticipating the questions a review panel will ask and answering them in writing. A guided draft can help you pair each decision with its rejected alternative and the condition that would make it wrong. We can also help you answer the two hardest objections in full, work out feasibility as arithmetic and write a stop rule with tripwires. Asking a colleague to play the skeptical reviewer usually surfaces the objection you were avoiding. The design and its defense are yours. Writing the stop rule first often clarifies everything else.
Get a NR 705A Week 8 example written to your instructions
Hand over the defense guidelines, the rubric and anything your section says about the live portion, and a custom NR 705A Week 8 design defense summary is written to them and returned inside 24-48h, the first one free. Tell the desk which objection worries you and it gets the fullest answer.
More NR 705A papers and DNP samples
- NR 705A Week 1: Change Proposal Post
- NR 705A Week 2: Intervention Design
- NR 705A Week 3: Change Package Outline
- NR 705A Week 4: Baseline Description
- NR 705A Week 5: Measure Definitions
- NR 705A Week 6: Survey Instrument
- NR 705A Week 7: Determination Memo
- NR 702A Week 8: Readiness Memo
NR 705A Week 8 questions, answered
What if faculty ask something the summary did not anticipate?
That is expected and is usually handled well by saying which part of the design the question touches and what it would take to settle it. A defense is not a quiz. Writers who have listed what remains unsettled tend to find the unanticipated question already sitting on that list, which turns it into a planned answer rather than an ambush.
Does this defense do the same job as the capstone defense later?
The later one argues about results that exist, and every verb in it looks backward. This one argues about choices, none of which have been tested, so the currency is reasons and rejected alternatives instead of findings. Confusing the two is visible in a single paragraph, and it is the error this week produces most often.
Can the design still change after this week?
Usually yes, and a summary claiming otherwise is less convincing than one that names the two open items and the date each closes. What faculty want settled is the part the next term cannot start without: the change, the population, the measures and the window. A wording choice on an audit form can move; the fraction it feeds cannot.
Where can I find a free NR 705A Week 8 sample paper?
This page carries the complete design defense summary for the warm handoff project.
What stop rule does the NR 705A Week 8 design include?
A pause and team review if visit length rises over 15 minutes for two weeks, missed follow-ups exceed 25% in a month or two staff report a patient feeling pressured.