| Course | NR 716 Analytic Methods |
|---|---|
| Week | 8 |
| Paper type | Practice recommendation presentation |
| Length | About 1,210 words, 4 pages |
| Format | Slides with speaker notes, APA 7 references |
| School | Chamberlain University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NR 716 Week 8
Practice Recommendation to the Emergency Department Practice Council: A Six-Month Pilot of Early Fascia Iliaca Blocks in Older Hip Fracture Patients
Student Name
College of Nursing, Chamberlain University
NR 716: Analytic Methods
Instructor Name
Month Day, Year
Slide 1: The Ask: Approve a Six-Month Pilot of Early Fascia Iliaca Blocks
Adults 65 and older with X-ray-confirmed hip fracture
Ultrasound-guided block within 60 minutes of the X-ray
Placed by credentialed emergency physicians and advanced practice nurses
Pilot from April to September 2027, then report back
Speaker notes: I am asking the council for one decision today: approval of a six-month pilot. Everything that follows is there to help you test that request, so please hold me to it. The block would be added to our hip fracture pathway, placed within an hour of the X-ray by clinicians who have completed supervised placements, and the pilot would report to this council in October with a recommendation to keep, adjust or end it.
Slide 2: Our Problem in One Number
214 older adults with hip fracture admitted through our department in FY2026
61 screened positive for delirium before surgery: 28.5%
No blocks placed in the department; a third got one from anesthesia, a median of 26 hours later
Speaker notes: This is our own data, not a national figure. More than one in four of our older hip fracture patients became delirious before they reached the operating room. Delirium in this group is linked to falls, longer stays and worse recovery. The block we are discussing is already given by anesthesia to about a third of patients, but a day after arrival, after the hours of highest pain have passed.
Slide 3: What the Evidence Supports, Compressed
Review of 49 trials: pain on movement about 2.5 points lower within 30 minutes
Delirium risk about one third lower; one case avoided for every 12 treated
Both rated high certainty
The national orthopedic guideline backs nerve blocks too
Speaker notes: I am not going to walk through every study. Most of the weight rests on a Cochrane review pooling 49 trials, which rated both of these findings high certainty (Guay & Kopp, 2020). The orthopedic surgeons' national guideline already recommends regional blocks for hip fracture pain (O'Connor & Switzer, 2022). Our question is narrower: does an early block, placed here, add anything to the late one patients already receive?
Slide 4: The Closest Trial to Our Plan
Emergency physicians placed blocks on arrival, three New York hospitals
Two-hour pain score: 3.5 with the block, 5.3 with usual care
Patients reporting opioid side effects: 3% with the block, 12.4% without
Caution: unblinded, and patients also had a catheter later
Speaker notes: One trial tested almost exactly what we propose, emergency physicians placing a block at arrival (Morrison et al., 2016). Pain was nearly two points lower at two hours, and opioid side effects were far less common. I have two cautions. Patients knew they had a block, which can inflate pain differences, and they also had a catheter placed by anesthesia later, so our single injection will probably do less, for a shorter time.
Slide 5: Certainty, Said Plainly
Delirium and early pain: high certainty
Opioid savings: low; trials disagree
Placement by non-physicians: low; one cohort
Technique choice: low; one trial
Speaker notes: Here is how sure we can be, outcome by outcome. We can be confident about delirium and early pain. We cannot promise you lower opioid use: the trials that found none were blinded and started with pain already controlled. That is why the pilot measures opioids but does not count on them. On who places the block, we have one Australian study showing similar results for nurses and doctors, which is why the pilot is limited to physicians and advanced practice nurses.
Slide 6: If the Evidence Is Wrong for Us
Stop at once: any local anesthetic toxicity or nerve injury, pending review
Reconsider at six months: delirium not below 28.5%
Reconsider: fewer than 60% of eligible patients blocked within 60 minutes
Look again in two years: four trials still recruiting
Speaker notes: This is the slide I expect most questions on. If the block harms anyone, we stop and review every case. If delirium does not fall after about 100 blocks, we bring that back to you rather than continuing on faith. And if we cannot deliver the block on time to most patients, the pilot has not tested the block at all, and I will say so. The evidence may also change: four trials are recruiting now.
Slide 7: Who Does Something Differently
Emergency physicians and advanced practice nurses: place the block within 60 minutes; anesthesia supervises first five placements
Emergency nurses: monitor vital signs and symptoms every 15 minutes for the first hour
Pharmacy: an order set dosed by weight, capped at a maximum
Orthopedic unit nurses: continue the 4 A's Test each shift, no change
Speaker notes: Each group has one clear change. Clinicians place the block; anesthesia has offered to supervise each clinician's first five. Our nurses take on a defined monitoring hour, with lipid emulsion already stocked in resuscitation. Pharmacy builds the order set, which needs its own committee approval. The orthopedic unit changes nothing, which matters, because their delirium screening is our outcome and it is already recorded on every shift.
Slide 8: What We Will Measure, and When
Primary: preoperative delirium, 4 A's Test, arrival to surgery or 72 hours
Secondary: IV morphine equivalents over the first 12 hours
Delivery: share of eligible patients blocked within 60 minutes
Safety: every adverse event reviewed within 7 days
Reported separately for patients with and without dementia
Speaker notes: All four measures come from records we already keep, so nothing new has to be built. We will look at the numbers monthly at this council and report in full in October. We will report delirium separately for patients with dementia, a third of our population, because most trials excluded them and we owe the council an honest look at the group most at risk.
Slide 9: What It Costs to Find Out
Training: anesthesia-supervised placements, about 55 clinician hours in total
Supplies: block needles and local anesthetic, about $38 per block
Time: about 15 minutes per placement, plus one hour of nurse monitoring
No new equipment: two ultrasound machines already in daily use
Speaker notes: The pilot is inexpensive because we already have the machines and the skills for ultrasound-guided lines. The main cost is time, clinician time to train and nursing time to monitor. At about 100 blocks over six months, supplies come to roughly $3,800. I am not claiming savings; the evidence on opioid use does not support that yet.
Slide 10: The Decision Requested
Approve the six-month pilot from April 2027
Refer the order set to pharmacy and therapeutics in March
Refer the supervised placement pathway to credentialing in March
Report to this council in October 2027
Speaker notes: To close, the request is the same as on the first slide, with the two referrals it depends on. If the council approves today, pharmacy and credentialing can consider their pieces this month and the first blocks can be placed in April. Thank you. I welcome challenge on any part of it, especially the stopping rules.
References
Guay, J., & Kopp, S. (2020). Peripheral nerve blocks for hip fractures in adults. Cochrane Database of Systematic Reviews, 2020(11), Article CD001159. https://doi.org/10.1002/14651858.CD001159.pub3
Morrison, R. S., Dickman, E., Hwang, U., Akhtar, S., Ferguson, T., Huang, J., Jeng, C. L., Nelson, B. P., Rosenblatt, M. A., Silverstein, J. H., Strayer, R. J., Torrillo, T. M., & Todd, K. H. (2016). Regional nerve blocks improve pain and functional outcomes in hip fracture: A randomized controlled trial. Journal of the American Geriatrics Society, 64(12), 2433-2439. https://doi.org/10.1111/jgs.14386
O'Connor, M. I., & Switzer, J. A. (2022). AAOS clinical practice guideline summary: Management of hip fractures in older adults. Journal of the American Academy of Orthopaedic Surgeons, 30(20), e1291-e1296. https://doi.org/10.5435/JAAOS-D-22-00125
NR 716 Week 8 instructions, in plain terms
Put the request on an early slide, ideally the first, so the audience can test the argument against it from the start. Show the problem on one slide with a local figure if you have one. Compress the evidence to what supports the decision rather than replaying studies one by one, and say the certainty out loud, outcome by outcome, without upgrading it. Give one slide to what happens if the evidence is wrong for your setting, including the conditions for stopping. Make the closing slides operational: who does something differently, what will be measured, when it will be reviewed and what it costs. Keep slide text short and let the speaker notes carry the argument, figures and citations. End by repeating the specific decision you want, so nobody has to guess what they are being asked to approve.
How the NR 716 Week 8 example is put together
Slide 1 states the request: a six-month pilot of ultrasound-guided blocks within an hour of the X-ray by credentialed clinicians. Slide 2 gives the department's figures, 61 of 214 patients delirious before surgery and no blocks placed there. Slide 3 compresses the review and guideline, and slide 4 presents the closest trial with two cautions on the same slide. Slide 5 states certainty for four outcomes. Slide 6 lists stopping and reconsideration rules and the trials still recruiting. Slide 7 assigns changes to clinicians, emergency nurses, pharmacy and the orthopedic unit. Slide 8 lists the primary, secondary, delivery and safety measures with dementia reported separately. Slide 9 prices training time and supplies at about $38 per block. Slide 10 repeats the request with two referrals and a report date.
Where the points sit in the NR 716 Week 8 rubric
The costliest deck is one that never asks for anything: a term's analysis presented, thanks offered and a closing slide inviting questions. An audience left to infer the request will supply its own. Next is a deck that buries the ask behind background slides. Marks are lost for slides carrying paragraphs while the notes are empty, for evidence replayed study by study as if the audience were grading the appraisal and for certainty that grows stronger between the paper and the slides. Graders take points for a missing slide on being wrong and for recommendations with no roles, measures or review date. Decks score well when the ask comes early, the certainty is stated plainly and the closing slide names a decision the room can make.
NR 716 Week 8 help: mistakes that cost points
Turning a synthesis into a presentation means deciding what the audience must decide and cutting nearly everything else. Send us your recommendation, a description of your audience and your synthesis, and we can help you put the ask first, compress the evidence, state certainty honestly, build the slide about being wrong and assign roles, measures and a review date. Speaker notes that carry the detail without crowding the slides are part of that work. The recommendation and the figures come from your own project and setting, and the deck presents them for your room.
Get a NR 716 Week 8 example written to your instructions
Send the Week 8 instructions, the slide template your section issues and your synthesis, and a custom example is built into that template with notes and returned inside 24 to 48 hours. The first one is free. Presenting it, and answering for it, stay yours.
More NR 716 papers and DNP samples
- NR 716 Week 1: Model Placement Post
- NR 716 Week 2: PICOT Question Write-Up
- NR 716 Week 3: Search Strategy Write-Up
- NR 716 Week 4: Evidence Appraisal Table
- NR 716 Week 5: Literature Matrix
- NR 716 Week 6: Critical Appraisal Paper
- NR 716 Week 7: Evidence Synthesis Paper
- NR 715 Week 8: Practice Problem Synthesis
- NR 714 Week 8: Results Presentation
- NR 709A Week 8: Project Closeout Memo
- NR 702A Week 8: Readiness Memo
NR 716 Week 8 questions, answered
How much evidence belongs on the slides?
Less than the paper and more than a logo. The room needs what the set supports, where it disagrees, and how certain you are, which is usually a handful of slides. Detail lives in the notes and in a backup slide or two for the questions you expect. A deck reproducing the appraisal is answering something nobody in that meeting asked.
What if the group would refuse the change?
Then the risk slide and the plan slides are where this is won or lost, and pretending otherwise is visible from the back of the room. Name the obstacle that genuinely applies, propose the smallest version worth trialing, and give the point at which it would be stopped. A recommendation with a stop rule attached is easier to approve.
Is this the same as a project defense?
No. A defense argues that the work was done properly; this one asks a group to change something on the strength of it. The audience is practitioners rather than examiners, so method detail moves into the notes and the decision moves to the front. Decks built as defenses tend to run long and never make the ask.
Where can I find a free NR 716 Week 8 sample paper?
The complete ten-slide recommendation for a fascia iliaca block pilot, with speaker notes, is shown on this page.
Why does the NR 716 Week 8 deck repeat its request on the last slide?
So the council ends on the specific decision it is being asked to make, with the two referrals that decision depends on.