| Course | NR 721 Topics in Healthcare Systems Leadership II |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 510 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 721 Week 1
Week 1 Discussion: Initial Post
Fourteen Months After We Gave Nurses the Authority to Stop Telemetry: What Happens at 07:00 Today, and Whose Week Holds It
Initial Post
What somebody does differently today. On our 36-bed medical unit, when a patient has been on cardiac telemetry for 48 hours, a reminder fires in the record at 07:00 and asks the nurse to check the patient against the discontinuation criteria printed in the order. If the criteria are met, the nurse may remove the telemetry box without calling a provider and documents the removal and the reason. Before this, only a provider could stop telemetry, and boxes stayed on for days after the reason for them had passed.
When it started. The protocol went live on 12 August 2026, fourteen months ago, built from the national practice standards for electrocardiographic monitoring in hospitals (Sandau et al., 2017) and modeled on a hospital that cut telemetry use by writing those standards into the order itself (Dressler et al., 2014).
The physical thing carrying it. A laminated card clipped to each of the six telemetry charging stations lists the criteria by indication. The cards have curled at the corners, one has a coffee ring across the arrhythmia row, and staff point to them when a new nurse asks what the criteria are.
Whose Week Holds It
The caretaker is the day charge nurse who serves as the unit's telemetry champion, with two hours a week in the schedule to run a report of patients past 48 hours who are still monitored and to ask why. The monitor technician lead keeps a list of removals for the central station. Neither is formally named in the protocol document, which says only that "nursing will maintain compliance."
What I Can and Cannot Say
I am the unit's nurse manager and I led the installation, so I am the person most likely to see it kindly. Telemetry days fell from 41 per 100 patient-days before the change to 27 in its first three months; they are 33 now. That figure says the protocol is partly in use. It does not say whether the 07:00 reminder is answered with an assessment or with a click, and I have started watching to find out.
What I Hope Replies Will Do
I would like classmates to ask me the question I am avoiding. Mine is probably whether the 07:00 reminder, which fires during shift handoff, is being answered by anyone who has actually looked at the patient.
Reply to Simone
Simone, your post says the new fall huddle is now standard practice. Whose shift starts the huddle, and on the days that person is off, who does? If the answer is the charge nurse, it is worth checking what happens on the weekends a float charge nurse covers.
Reply to Darius
Darius, you report 96% compliance with the sepsis screen. Compliance with clicking the screen, or with acting on it? A screen completed in four seconds and a screen that leads to a lactate are both counted as compliant.
References
Dressler, R., Dryer, M. M., Coletti, C., Mahoney, D., & Doorey, A. J. (2014). Altering overuse of cardiac telemetry in non-intensive care unit settings by hardwiring the use of American Heart Association guidelines. JAMA Internal Medicine, 174(11), 1852-1854. https://doi.org/10.1001/jamainternmed.2014.4491
Sandau, K. E., Funk, M., Auerbach, A., Barsness, G. W., Blum, K., Cvach, M., Lampert, R., May, J. L., McDaniel, G. M., Perez, M. V., Sendelbach, S., Sommargren, C. E., & Wang, P. J. (2017). Update to practice standards for electrocardiographic monitoring in hospital settings: A scientific statement from the American Heart Association. Circulation, 136(19), e273-e344. https://doi.org/10.1161/CIR.0000000000000527
NR 721 Week 1 instructions, in plain terms
Stay inside one change on one unit and describe it as it runs today, not as it was launched or planned: what someone does differently now, stated as an action. Give the month it started and how long ago that is. Name the physical thing that carries the change, usually something small and slightly worn, such as a card, a field or a reminder. Then name the caretaker: whose week actually contains the work of the change being standard, and whether any document says so. State your own standing honestly, including whether you led the change and so may see it kindly. Report a figure if you have one, and say what it cannot show. Close by asking replies to raise the question you are avoiding. In replies, separate a classmate's compliance figure from the practice it is meant to show.
How the NR 721 Week 1 example is put together
The sample's opening describes the 07:00 reminder, the criteria printed in the order and the nurse's authority to remove the box without calling a provider. It dates the start to 12 August 2026 and ties the criteria to national monitoring standards and a hospital that wrote them into its order. The physical carrier is a laminated card on six charging stations, curled and stained. The caretaker section names the day charge nurse champion and the monitor technician lead and quotes a protocol that names nobody. The writer, the unit's manager, reports telemetry days of 41, 27 and 33 and says the figure cannot show whether reminders are answered with an assessment. Replies ask who starts a fall huddle on weekends and what a sepsis compliance figure counts.
NR 721 Week 1 rubric: what full points look like
The costliest post is written in the future tense about a change that already happened, which usually means the writer described the plan again instead of the aftermath. Almost as expensive is a change with no caretaker, where the post says the new process is standard practice and never says whose week holds the work. Posts lose ground for reporting only a compliance figure, since a percentage shows a change is present but not how it is done. Marks are also lost when the writer's own position is hidden. Graders reward posts that describe today's practice as an action, name a worn physical carrier and a caretaker with hours and admit what the available figure cannot show.
NR 721 Week 1 help: mistakes that cost points
Describing a change you led as it really runs today, rather than as you designed it, is uncomfortable, and that is exactly what this week asks. Tell us the change, when it started, what carries it physically and who looks after it now, and the post can describe today's practice as an action, name the caretaker and admit your own standing. Writing replies that pull a compliance figure apart from the practice behind it is a skill the rest of the course uses. The change and the figures are your own.
Get a NR 721 Week 1 example written to your instructions
Send the discussion prompt and the rubric your classroom shows, plus one change you have lived with, in a sentence or two. A custom Week 1 post comes back inside 24-48h in your section's citation style. The first one is free, and we can supply the change if you would rather not use your own.
More NR 721 papers and MSN samples
- NR 721 Week 2: Post-implementation Review
- NR 721 Week 3: Drift Analysis
- NR 721 Week 4: Unintended Consequence Memo
- NR 721 Week 5: Workaround Case Study
- NR 721 Week 6: Tradeoff Analysis
- NR 721 Week 7: Continue or Stop Recommendation
- NR 721 Week 8: Decision Communication
- NR 529 Week 1: Discussion on Refusing a Request
- NR 720 Week 1: Cross-Department Occurrence Post
- NR 531 Week 1: Discussion on Who Approves a Change
- NR 711 Week 1: Competing Requests Post
NR 721 Week 1 questions, answered
What if I have never led a change of my own?
Take one you were close to and say so in the opening line. A change you helped run, or watched from inside the unit it landed on, gives you the present-day detail this post needs. What does not work is a change read about in an article, because the post is graded on what you can say about the state of it now.
Does the change have to have worked?
No, and a change that produced a mixed result usually gives you more to write about. What the post needs is a change still in existence, since one abandoned outright leaves nothing to describe in the present tense. If yours was withdrawn, say when and by whom, then write about the traces it left behind on the unit.
Do I need figures in a discussion post?
Rarely more than one or two, and rough is acceptable where you say it is rough. This post is carried by concrete description rather than by measurement, and a writer who reports one honest observation from last Tuesday usually reads stronger than one quoting a percentage nobody else could check.
Where can I find a free NR 721 Week 1 sample paper?
The full Week 1 post on a telemetry discontinuation protocol fourteen months after launch, with two replies, is on this page.
What physical thing carries the change in the NR 721 Week 1 sample?
Laminated criteria cards clipped to the unit's six telemetry charging stations, curled at the corners and stained, which staff point to when asked.