| Course | NR 721 Topics in Healthcare Systems Leadership II |
|---|---|
| Week | 8 |
| Paper type | Decision communication memo |
| Length | About 660 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 721 Week 8
Memorandum
To: All 5 West nurses, monitor technicians and hospitalists
From: Nurse Manager, 5 West
Date: 15 November 2027
Re: Telemetry changes on 1 December: the reminder moves to 10:00, the keep-on-tele list goes, transmitters go in the new bin
The Decision
We are keeping nurse-driven telemetry discontinuation on 5 West, with changes that start on Wednesday 1 December 2027.
What You Do Differently From 1 December
Nurses: the telemetry reminder will appear at 10:00, not 07:00. Answer it after you have seen your patient. If the patient meets the criteria on the new card in the telemetry pouch, call the monitor technician, remove the leads and box, drop the box in the return bin at the nurses' station and tick the new "transmitter returned" box in the removal note. If a provider has entered a "continue telemetry" order, the reminder will show it and its reason; follow it until it expires after 24 hours. The "continue, provider preference" answer will no longer be there.
Monitor technicians: keep taking the nurse's call before each removal, as you do now; it is now part of the written protocol. There will be no paper list at your desk after 30 November.
Hospitalists: if you want a patient kept on telemetry beyond the criteria, enter the "continue telemetry" order with a reason. It lasts 24 hours and can be renewed. Please do not add names to a paper list.
Night charge nurses: on 30 November, take down the keep-on-tele list at the start of your shift and give it to the day charge nurse.
Day charge nurses: run the 08:00 report of patients past 48 hours every day you are in charge and ask about each one at the 09:00 huddle.
Why, in Brief
In its first year the protocol cut telemetry days on 5 West by about a quarter and central station alarms by about 250 a day, and reviews found no harm from removals. It also lost 16 transmitters, and the 07:00 reminder landed during handoff, so many reminders were answered without anyone seeing the patient. The changes keep the gain and fix those two problems. The criteria still come from the national monitoring standards (Sandau et al., 2017).
What Happens to the Objects
Table 1
What Happens to Each Object Connected to the Protocol
| Object | What happens | When | Who |
|---|---|---|---|
| Old laminated cards at charging stations | Collected | 30 November | Unit educator |
| New cards | Placed in every telemetry pouch | 30 November | Unit educator |
| Keep-on-tele list | Taken down and kept with the manager for one month | 30 November, start of night shift | Night charge nurse |
| Transmitter return bin | In use; emptied twice a day by clinical engineering | From 1 November, already in place | Clinical engineering |
| 07:00 reminder | Switched to 10:00 | 1 December | Record team |
Note. Note. Keep any old card you find and hand it to the unit educator.
Removing the old cards and the list on a named day matters: when the old version stays in sight, people go on following it out of habit (Norton & Chambers, 2020).
Who to Ask
For questions about the protocol, ask the day charge nurse on duty or me, extension 4417. For questions about the continuation order, ask the hospital medicine medical director. Workarounds usually begin when the official route is hard to use (Debono et al., 2013), so if something in the new routine does not work at the bedside, please tell us rather than finding a way around it; we would rather fix it.
For the Record Team
Build ticket 27-1183: move the reminder to 10:00 for 5 West, remove the "continue, provider preference" answer, add the "continue telemetry" order with a required reason and 24-hour expiry, and add the required "transmitter returned" checkbox to the removal note. Go live 1 December 2027 at 00:01.
Review
We will review the protocol on 1 June 2028. If the review does not happen, the protocol continues as described here.
References
Debono, D. S., Greenfield, D., Travaglia, J. F., Long, J. C., Black, D., Johnson, J., & Braithwaite, J. (2013). Nurses' workarounds in acute healthcare settings: A scoping review. BMC Health Services Research, 13, Article 175. https://doi.org/10.1186/1472-6963-13-175
Norton, W. E., & Chambers, D. A. (2020). Unpacking the complexities of de-implementing inappropriate health interventions. Implementation Science, 15, Article 2. https://doi.org/10.1186/s13012-019-0960-9
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
Reading the NR 721 Week 8 instructions
Address people rather than a committee and keep the communication short and plain. Name the decision in the first lines and the date it takes effect immediately after. Then say exactly what each person or group does differently on that date, in the same working language the change was originally taught in. Keep the reasoning to a short paragraph without relitigating the decision. Say what happens to every object connected to the change, such as cards, lists, reminders and equipment, with a date and a person for each. Name a person to ask, with a way to reach them, and invite staff to report what does not work. Add a line for the people who must build anything, such as a record team ticket. Say when the decision will be reviewed and what happens if it is not.
How the NR 721 Week 8 example is put together
The memo's subject line names the date and the three changes. The decision follows in one sentence. Instructions are given by role: nurses answer at 10:00, follow a continuation order or remove and return the box; technicians keep taking the call; hospitalists use the new order instead of the list; night charge nurses take the list down on 30 November; day charge nurses run the 08:00 report. A short paragraph explains why. A table assigns the old cards, new cards, list, bin and reminder to dates and people. A section names the charge nurse and the manager's extension and invites reports of anything that does not work. A build line gives the ticket number and go-live time, and a review date and default close the memo.
NR 721 Week 8 rubric: what full points look like
The largest loss is a communication that explains at length and never says what anybody does on Monday, which is the version most drafts produce. Next is a missing date, since a decision with no effective day goes on being performed indefinitely by people behaving reasonably. Marks come off for a defensive tone that relitigates the decision and for leaving objects such as old cards and lists in place. Graders also take points when no person is named for questions and when the people who must build the change receive no instruction. Communications score well when the decision and date come first, each group's new action is stated plainly and every object has a fate.
Common NR 721 Week 8 mistakes, and how to avoid them
Announcing a decision so that people actually change what they do on a given day is mostly about instructions and objects, not explanation. Share the decision, the date, the groups affected and the cards, lists or prompts involved, and the communication can open with the decision and date, give each group its new action in familiar words, assign every object a fate and name a person to ask. A line for the build team saves a week of follow-up. The decision and the details belong to your unit.
Get a NR 721 Week 8 example written to your instructions
Send the exact template and rubric your classroom shows, plus the decision that has to be communicated, and a custom Week 8 example returns inside 24-48h written to the audience your prompt names. A first example carries no charge. Tell us whether your section wants an email, a memo or a script for a huddle.
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NR 721 Week 8 questions, answered
Does this have to be an email?
Whatever your prompt specifies, and where it is left open, the format should match how that audience actually receives things. A short email plus a huddle script covers most units, and saying which parts are spoken and which are written shows a reader you have thought about whether the message arrives at all.
How do I communicate a decision I disagreed with?
Deliver it as the organization's decision, clearly, without smuggling your own dissent in through tone or through a hedge. Where the prompt allows it, note that other positions were argued and say where they are recorded. What undermines the document is a writer visibly reluctant to say what happens on the date.
Should the communication include the evidence?
A line or two of it, chosen for what this audience cares about rather than for what the analysis found most interesting. The full case belongs in the earlier deliverable. Where people ask, having somewhere to send them beats attaching twelve pages nobody on a shift is going to open.
Where can I find a free NR 721 Week 8 sample paper?
This page holds the complete decision communication for the telemetry protocol changes on 5 West.
What happens to the keep-on-tele list in the NR 721 Week 8 sample?
The night charge nurse takes it down at the start of the 30 November shift and hands it to the day charge nurse, and the manager keeps it for a month.