| Course | NR 719 Topics in Advanced Practice Leadership II |
|---|---|
| Week | 5 |
| Paper type | Outcomes evaluation write-up |
| Length | About 1,110 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 719 Week 5
Outcomes Evaluation of Kilogram-Only Pediatric Weighing, February to June 2027: Predictions Set Beside Results, With the Measure That Did Not Move
Student Name
College of Nursing, Chamberlain University
NR 719: Topics in Advanced Practice Leadership II
Instructor Name
Month Day, Year
Outcomes Evaluation of Kilogram-Only Pediatric Weighing, February to June 2027: Predictions Set Beside Results, With the Measure That Did Not Move
What Was Predicted, Before Any Result
In October 2026, before the scales and field were locked, the project fixed four predictions for the five months from February to June 2027. First, the proportion of audited child triage records showing a kilogram measurement would exceed 90% in three consecutive months. Second, parent-stated weights would fall below 5% of records. Third, the median door-to-provider time for children would rise by no more than two minutes. Fourth, two signs of workarounds, whole-number weights and weights copied from clinic visits more than 30 days old, would not rise. The baseline was the summer 2026 audit of 400 records, in which 57.0% of weights were measured in kilograms and 22.0% were stated by a parent.
Process Before Outcome
A change that was not delivered has not been tested, so delivery comes first. All four triage scales were locked to kilograms by 11 January, except the chair scale, which could not be locked and was replaced on 2 February. The record field accepted only kilograms from 11 January. Shift huddles on the new routine were held on 41 of the 42 shifts in the first two weeks. The orientation card reached 9 of the 13 travel nurses who started between January and June, 69%, and none of the four who started in April and May. Delivery was complete for the locks and the huddles and incomplete for orientation.
How the Records Were Audited
Each month, the data analyst drew 50 pediatric triage records at random from all pediatric visits that month, using the record's random sample function, and the project lead classified each weight from the triage note and the weight method field as measured in kilograms, stated by a parent, copied from a recent clinic visit or missing. To check the classification, the pediatric emergency care coordinator independently classified 25 of the March records; the two agreed on 24. The same procedure and the same definitions were used at baseline, except that baseline records could also be measured in pounds and converted, a category that no longer exists. Because staff knew a monthly audit was running, the results describe practice while being watched, which is one reason the audit continues after handover rather than stopping when the target was met.
Results Against Predictions
Table 1
Predictions and Results, Kilogram-Only Pediatric Weighing
| Measure | Prediction | Baseline | February to June 2027 | Met? |
|---|---|---|---|---|
| Weight measured in kilograms | Above 90% for three consecutive months | 228 of 400, 57.0% | 234 of 250, 93.6%; March to June each 94% or higher | Yes, from March |
| Weight stated by a parent | Below 5% | 88 of 400, 22.0% | 9 of 250, 3.6% | Yes |
| Pediatric door-to-provider, median | Rise of 2 minutes or less | 22 minutes | 24 minutes | Yes, at the limit |
| Whole-number kilogram weights | No rise | 71 of 228 measured, 31.1% | 77 of 234 measured, 32.9% | Held still |
| Clinic weight older than 30 days | No rise | Not separately recorded | 0 of 250 | Not testable |
Note. Note. February to June figures come from 50 randomly selected pediatric triage records a month. Baseline from the May to July 2026 audit. Five records used a clinic weight from the past 30 days, which the policy allows; two were missing.
February missed the first target at 44 of 50, 88.0%, and every month after met it: 47, 48, 47 and 48 of 50. Parent-stated weights fell from 22.0% to 3.6%, and more than half of the nine came in May, when two travel nurses who had not received the card were on triage.
The Indicator That Held Still
One measure did not move. Before the change, 31.1% of weights measured in kilograms were whole numbers; afterward the figure was 32.9%. The scales read to one decimal place, so if weights were recorded exactly, only about one in ten would end in zero. A third ending in zero means nurses were rounding before the change and still are. The project did not address rounding, so the result is not surprising, but it matters most for infants, for whom half a kilogram is a large share of body weight and of a weight-based dose. Two other explanations are possible: the audit cannot tell a rounded weight from a weight that really was a whole number, and the sample of infants, 41 records, is too small to measure rounding in that group alone. Neither explanation removes the finding; it means the next step should measure infants specifically.
What the Results Can and Cannot Claim
The comparison is before and after in one department, with no comparison group, so the results show that the measured share rose after the locks, not that the locks alone caused it. Designs of this kind leave open whatever else changed during the period (Portela et al., 2015). Two are known: the audit itself, which staff knew about, and a winter respiratory season that raised pediatric volume about 6% and may also explain part of the two-minute rise in door-to-provider time. No weight-related safety report was filed from January to June, against three in the previous twelve months, but counts that small cannot show a change in harm and are not presented as one. The report follows the structure recommended for improvement work, with the intervention, its delivery, the measures and the limits described separately (Ogrinc et al., 2016).
What Follows
Three actions follow from the results. The change continues, owned from July by the pediatric emergency care coordinator, the role national readiness guidance recommends for this purpose (Remick et al., 2018). Orientation moves into the coordinator's checklist, since the only lapse came from new staff who were never shown the routine. And a small next change is proposed: weights for children under 10 kilograms recorded to one decimal place, with the audit counting infants separately, so the measure that held still can be tested. That proposal will go to the operations meeting in August with its own prediction written down first: that whole-number weights among infants will fall below 15% within three months, measured on all infant records rather than a sample, since there are only about 40 a month. If they do not fall, the rounding has a cause the project has not yet found, and the next step will be to ask the triage nurses why they round.
References
Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986-992. https://doi.org/10.1136/bmjqs-2015-004411
Portela, M. C., Pronovost, P. J., Woodcock, T., Carter, P., & Dixon-Woods, M. (2015). How to study improvement interventions: A brief overview of possible study types. BMJ Quality & Safety, 24(5), 325-336. https://doi.org/10.1136/bmjqs-2014-003620
Remick, K., Gausche-Hill, M., Joseph, M. M., Brown, K., Snow, S. K., Wright, J. L., American Academy of Pediatrics Committee on Pediatric Emergency Medicine and Section on Surgery, American College of Emergency Physicians Pediatric Emergency Medicine Committee, & Emergency Nurses Association Pediatric Committee. (2018). Pediatric readiness in the emergency department. Pediatrics, 142(5), Article e20182459. https://doi.org/10.1542/peds.2018-2459
NR 719 Week 5 instructions, in plain terms
State what you predicted before you report what you observed, so the gap between them is visible. Report process measures beside outcome measures, starting with whether the change was fully delivered, because a change not delivered has not been tested. Give every result its numerator, denominator and period. Where an indicator held still, say so in the same plain tone you used for the gains, and offer competing explanations honestly. Describe how the data were collected and checked, including anything that might have changed behavior, such as staff knowing about an audit. Avoid causal verbs on before-and-after data; say what changed after the intervention, not what it caused. Name other events in the same period. Close with what follows from the results, including any next change and its own prediction.
Inside the NR 719 Week 5 example
The sample lists four predictions and the summer baseline. Delivery comes next: locks complete by 11 January except one chair scale replaced in February, huddles on 41 of 42 shifts and the orientation card reaching 9 of 13 travel nurses. A section describes monthly random samples of 50 records and a second nurse who agreed on 24 of 25. A results table compares each prediction with its outcome, marking door-to-provider time as met at the limit. The section on the unchanged measure explains why a third of weights ending in zero means rounding, notes the small infant sample and keeps the finding. Causal limits, a winter volume rise and SQUIRE structure are addressed, and the paper proposes measuring infant weights to one decimal place.
Where the points sit in the NR 719 Week 5 rubric
The most expensive habit is causal verbs on before-and-after data, where a change reduced or improved something with no comparison group. Next is percentages without denominators, which lets a reader imagine a handful of cases behind a large improvement and stop believing the rest. Marks are also lost for a missing null result, usually detectable because the process measures vanished too, and for a table that contradicts its text. Graders take points when predictions appear only after results. Evaluations score well when delivery is reported before effect, when every figure carries a denominator and period, when an unchanged measure is reported plainly with alternatives and when the next step follows from what the data showed.
Common NR 719 Week 5 mistakes, and how to avoid them
Reporting a measure that did not improve, in the same tone as the ones that did, is the habit this assignment tests. Share your original predictions, your process data and your results, with denominators. From that material, the write-up can set each prediction beside its result, report delivery first, describe how the data were gathered and checked and keep causal language within what the design supports. Deciding what follows from an unchanged measure is often the most useful part of the paper. The data and the interpretation are entirely your own.
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NR 719 Week 5 questions, answered
What if my results were not statistically significant?
That is a result, and written well it earns more marks than a strained claim would. The finished example reports the observed difference, states plainly that the design cannot support an inference, and discusses practical meaning separately. Small samples in a single unit rarely reach significance, and doctoral readers know it, so the honest treatment is the safe one.
Can I evaluate a change that is only partly implemented?
Yes, provided you say that is what you are doing. The write-up separates delivery from effect: this many staff adopted it, this share of eligible cases received it, and here is what happened. Partial delivery explains a flat outcome better than most other reasons, and naming it early keeps the interpretation section from sounding defensive.
How does this differ from the results chapter in the project course?
The project course documents an entire completed project and everything that surrounds it. This write-up is a leadership document about a stretch of measurement, aimed at whether the work continues and at what scale. Same numbers, different job: here the numbers exist to support a decision about the future of the change.
Where can I find a free NR 719 Week 5 sample paper?
The full outcomes evaluation of kilogram-only pediatric weighing, with predictions beside results, can be read on this page.
Which measure did not move in the NR 719 Week 5 sample?
The share of kilogram weights recorded as whole numbers, about a third before and after, which points to rounding that matters most for infants.