| Course | NR 709A DNP Project & Practicum IV |
|---|---|
| Week | 2 |
| Paper type | Results and limits paper |
| Length | About 1,160 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 709A Week 2
Results and Limits: A Same-Day Behavioral Health Handoff at One Federally Qualified Health Center, 1 March to 24 May 2027
Student Name
College of Nursing, Chamberlain University
NR 709A: DNP Project & Practicum IV
Instructor Name
Month Day, Year
Results and Limits: A Same-Day Behavioral Health Handoff at One Federally Qualified Health Center, 1 March to 24 May 2027
The Measure Set, Restated
The measures were fixed in the proposal and charter two terms ago and are not argued again here (Langley et al., 2009). The table gives each measure as committed and its value for the test weeks, 1 March to 24 May 2027.
| Measure | Type | Committed target | Final value | Base |
|---|---|---|---|---|
| Behavioral health reached inside 30 days after a positive PHQ-9 | Outcome | 50% | 53.1% | 139 of 262 |
| Medical assistant messaged the consultant, behavioral health hours only | Process | 90% | 92.5% | 196 of 212 |
| Patient met the consultant the same day | Process | 50% | 58.5% | 124 of 212 |
| Next-business-day call made by noon for those not seen | Process | 80% | 79.0% | 109 of 138 |
| Median length of a primary care visit with a positive screen | Balancing | Under 60 minutes | 55 minutes | 262 visits |
| Missed primary care follow-up within 60 days | Balancing | Under 20% | 17.2% | 45 of 262 |
The primary outcome met its target. Of 262 eligible patients, 139 had a behavioral health visit or contact inside 30 days, 53.1%, against 32.6% in the baseline period. Messaging and same-day contact both exceeded their targets. The next-day call missed its target by one point, and that figure is conservative: 23 calls had no time recorded and are counted as late, so the rate could be as high as 95.7% if every one of those calls had in fact been made by noon. Both balancing measures stayed inside the stop rule all twelve weeks.
One Figure, One Bound
The headline figure is 53.1%, from 139 of 262. A 95% confidence interval by the Wilson method runs from about 47% to 59%. The interval is included not because the project tests a hypothesis but because the committee will want to know how far the figure could move with a different twelve weeks of patients, and the honest answer is several points either way. The lower end of the interval sits below the 50% target. The paper therefore says the target was met in the test weeks, not that the clinic now performs at or above 50%.
The run chart of weekly outcome rates shows all twelve test weeks above the baseline median of 32.6%, which satisfies the shift rule, which asks for at least six successive weekly values lying above or below that median, (Perla et al., 2011). Weekly values ranged from 41% in week 2, the fortnight's low point during two days of consultant leave, to 64% in week 9. The chart shows a change in the process, and the paper says no more than that.
Limits This Project Actually Has
Two limits matter here, and a list of generic ones would hide them.
The first is the payer change on 1 April 2027. The largest payer at the site began covering behavioral health visits by video, and 18 of the 139 completed contacts were by video. Without the video option, some of those patients might have attended in person anyway, or might not have attended at all. Weeks 1 to 4, before the change, had an outcome rate of 50.0%, 47 of 94; weeks 5 to 12 had 54.8%, 92 of 168. The improvement was present before the payer change, but its size after April cannot be credited to the handoff alone.
The second is that the project ran with one consultant who covered most same-day visits. On the two days that person was on leave, only 2 of 7 eligible patients met anyone from behavioral health before going home. The results describe what one well-staffed clinic achieved with one particular consultant; they do not show that the handoff works when that role is vacant or shared.
A third limit is ordinary and stated briefly: one site, no concurrent comparison group and a baseline drawn from the previous year.
What Was Not Measured
The project did not measure depression outcomes. A repeat PHQ-9 within 60 days was recorded for 71 of the 139 who reached behavioral health, and those patients are likely to differ from the others, so no change in scores is reported. It did not measure how long patients waited for the consultant, except for one week of paper timing in March. It did not measure patients' views of the handoff, since the survey planned in the proposal was dropped in week 3 of NR 707A for lack of interpreter time, a decision the committee accepted on 20 April. And it did not measure cost. Each of these is a question for the health center to decide whether to pursue, and the handover packet lists them as open.
Equity Check
The proposal committed to reporting the outcome by preferred language. English-speaking patients: 79 of 148, 53.4%. Spanish-speaking patients: 60 of 114, 52.6%. The difference is under one percentage point.
Fourteen patients preferred another language and are counted in the total but not split out, as the numbers are too small to report without risking identification. Integrated care models have shown benefit in Latino primary care populations (Horevitz et al., 2015), and this result is consistent with that, though it cannot confirm it.
Fidelity in Brief
Fidelity, meaning delivery as designed, is a separate question from effect (Proctor et al., 2011). Across twelve weeks, the parts of the change that depended only on clinic staff, such as messaging and asking the patient, ran close to design. The parts that depended on another system, such as the scheduling hold and later the coverage rota, ran below design, and the weeks they failed are the weeks the outcome dipped.
The Sentence I Will Be Quoted On
At one health center over twelve weeks, a same-day handoff to an embedded behavioral health consultant was followed by a rise in completed 30-day behavioral health contact from 32.6% to 53.1% after a positive depression screen, with no widening gap between English- and Spanish-speaking patients and no breach of the visit-length or follow-up limits.
That sentence is deliberately narrow. It names the place, the period, the change and the measure. It says "followed by" rather than "caused". Everything wider than that would need a second site, a longer run or a measure of whether patients got better.
If the committee or a conference reviewer asks for a broader claim, the answer is already written: the handoff is a promising local change worth testing at a second site, and the conditions for that test are set out in the transfer memo later this term. A claim that travels further than its count tends to come back on the writer, usually in the question period, and usually from someone who knows the clinic.
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
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
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
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
What the NR 709A Week 2 assignment asks for
Do not repeat the method; restate the committed measures in a table, with the target and the final value beside each, and then read every row aloud in prose. Give each result sentence a companion that says what the figure is a proportion of and how far it could move, so a percentage never stands alone. Report the primary measure first, even if a secondary measure looks better. Name only the limits your project actually has, with numbers where you can, and leave out the generic list that would fit any project. Say plainly what you did not measure and why, and who might pursue it. If you committed to an equity check, report it as counts. Close with the single sentence you expect to be quoted on, and make it no wider than the count behind it, naming the place, the period, the change and the measure.
How this NR 709A Week 2 example is built
The sample's table lists six measures: the 30-day outcome at 53.1% from 139 of 262, messaging at 92.5%, same-day contact at 58.5%, next-day calls at 79.0% with a ceiling of 95.7% if missing times were on time, median visit length of 55 minutes and missed follow-up at 17.2%. A Wilson interval of about 47% to 59% leads the paper to say the target was met in the test weeks, not that the clinic now performs at 50%. All twelve weekly points sit above the baseline median. The first limit is the payer's video coverage, with weeks 1 to 4 at 50.0% before it began. The second is one consultant, whose leave days saw only 2 of 7 patients reached. Depression scores, waits, patient views and cost are listed as unmeasured. The language split is 53.4% and 52.6%.
NR 709A Week 2 rubric: what full points look like
Results papers lose the biggest block of points on a claim wider than the count behind it, such as a statement about practice across the unit drawn from a few dozen records on one shift. Close behind is a limits section copied from a textbook list that would fit any project, while the two limits this project actually carries go unnamed. Many papers report a secondary measure first because it looks better, burying the primary result. Percentages without bases are common and hide how small the numbers are. Writers often skip what was not measured, which invites the reader to assume it was. The closing sentence is frequently the weakest, using words such as effective or proven where the design supports only followed by, and a committee member will quote it back.
NR 709A Week 2 help: mistakes that cost points
Writing results that are exactly as wide as the evidence takes practice, especially after a term of hoping for a good number. Working from your final measures and counts, we can help you build the table, pair every result sentence with its base and bound and find the limits that belong to your project rather than to every project. Together we can shape the line you expect to be quoted on and test it against the design. Reading that sentence aloud to your mentor is a quick way to see whether it overreaches. The findings and the claims are yours.
Get a NR 709A Week 2 example written to your instructions
Upload the week two instructions, the rubric and, if you have them, your final measure values; the example comes back written to your measure set with every figure carrying its base and its bound, inside 24-48h and free the first time. If the values are not settled, say so and the sample is built to take them later.
More NR 709A papers and DNP samples
- NR 709A Week 1: First Week Post
- NR 709A Week 3: Baseline to Endpoint Comparison
- NR 709A Week 4: Conference Abstract Draft
- NR 709A Week 5: Handover Packet Outline
- NR 709A Week 6: Transfer Conditions Memo
- NR 709A Week 7: Final Evaluation Summary
- NR 709A Week 8: Project Closeout Memo
- NR 707A Week 2: Rollout Narrative
- NR 705A Week 2: Intervention Design
- NR 702A Week 2: Practice Gap Write-Up
NR 709A Week 2 questions, answered
Does this paper explain the statistics used?
Only in passing. The analytic reasoning belongs to the methods courses, and a results and limits paper that re-teaches a test instead of reporting an outcome reads as padding. What this document owes the reader is the value, the base, the window and the bound, in language a unit manager could follow. If your section's instructions ask for a method section, send them and the example includes one.
What if the project ended flat?
Much the same, and often stronger. A flat result still has a size, a base and a window, and it still rules things out. The paper reports the value, says what the project delivered in practice against what it designed, and separates a change that was never fully in use from one that was used and did not help. That distinction is the whole document.
How many limits are enough?
Three or four that belong to this project beat ten that belong to any project. Faculty are counting specificity, not entries. A useful test: read each one and ask whether a reader could have written it without seeing your site. If they could, it is not telling anyone anything, and it is taking the place of one that would.
Where can I find a free NR 709A Week 2 sample paper?
The complete results and limits paper for a twelve-week behavioral health handoff test appears on this page.
What limits does the NR 709A Week 2 paper name?
A payer's video coverage that began partway through the test and the reliance on one consultant, plus the ordinary limits of one site and no comparison group.