NRNP 6547 Week 5 Literature Matrix Example

Course	NRNP 6547 The Aging Experience
Week	Week 5
Paper type	Literature matrix
Length	About 1,370 words, 7 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NRNP 6547 Week 5

Literature Matrix: Vitamin D Supplementation and Falls in Older Adults, Eight Trials Read by Age and Setting

Student Name

College of Nursing, Walden University

NRNP 6547: The Aging Experience

Instructor Name

Month Day, Year

What this page is doingThe title names the question and the two columns that end up doing the analytic work, age and setting. A matrix title that named only the topic would promise a reading list; this one promises a comparison.

Literature Matrix: Vitamin D Supplementation and Falls in Older Adults, Eight Trials Read by Age and Setting

Seven Columns, Chosen

The question behind the matrix: does taking vitamin D reduce falls in people described as older adults? The eight rows are primary randomized trials, not reviews, so each row reports what one group of people actually experienced. Each row has seven columns: citation; design; sample size with the real age range or mean; setting; principal finding on falls; the limitation the authors or the design impose; and, last, what the study is good for in answering this question. The first six are recorded. The seventh is my judgment, and it is where the matrix is meant to earn its keep.

Rows 1 to 5 are community trials, in which people lived in their own homes. Rows 6 to 8 are institutional trials in hostels, nursing homes, and care homes. The two groups are kept apart because the people in them differ in age, frailty, and baseline vitamin D level, and a matrix that mixed them would hide the pattern described below.

Community Settings

Row 1. LeBoff et al. (2020). Design: double-blind, placebo-controlled factorial randomized trial (the VITAL trial). Sample: 25,871 adults, men 50 and older and women 55 and older, mean age 67.1. Setting: nationwide, United States, living at home. Finding: 2,000 IU of vitamin D3 daily for a median 5.3 years did not change the proportion with two or more falls (odds ratio 0.97). Limitation: participants were generally healthy and started with a mean 25-hydroxyvitamin D level of 77 nmol/L, so few were deficient. Good for: showing that routine supplementation does nothing for falls in younger, replete older adults. It says little about an 88-year-old with low levels.

Row 2. Pfeifer et al. (2009). Design: double-blind randomized trial, calcium alone versus calcium plus 800 IU vitamin D daily for 12 months, then 8 months of blinded follow-up. Sample: 242 adults, mean age 77 (SD 4). Setting: community, Germany and Austria. Finding: 27% fewer participants with a first fall at 12 months with vitamin D (relative risk 0.73). Limitation: modest size; both groups received calcium, so the comparison is vitamin D on top of calcium, not against nothing. Good for: the strongest community signal in the set that a moderate daily dose helps people in their late seventies.

Row 3. Uusi-Rasi et al. (2015). Design: 2-year, 2 x 2 randomized trial, vitamin D 800 IU daily or placebo, with or without exercise. Sample: 409 women aged 70 to 80, all with a fall in the past year. Setting: living at home, Tampere, Finland. Finding: neither vitamin D nor exercise reduced falls; exercise reduced injurious falls. Limitation: women only; participants were not selected for deficiency. Good for: separating falls from injurious falls, and suggesting that exercise, not vitamin D, reduces injury in this group.

Row 4. Sanders et al. (2010). Design: double-blind, placebo-controlled trial of one oral dose of 500,000 IU cholecalciferol each autumn or winter for 3 to 5 years. Sample: 2,256 women aged 70 and older at high risk of fracture. Setting: community, Australia. Finding: more falls with vitamin D (rate ratio 1.15) and more fractures (rate ratio 1.26), with the excess concentrated in the months just after each dose. Limitation: tests one unusual dosing schedule, not daily use. Good for: a warning that how vitamin D is given can matter as much as whether it is given.

Row 5. Bischoff-Ferrari et al. (2016). Design: 1-year double-blind randomized trial of three monthly regimens: 24,000 IU, 60,000 IU, or 24,000 IU plus calcifediol. Sample: 200 adults aged 70 and older with a prior fall, mean age 78. Setting: community, Zurich, Switzerland. Finding: falls were a secondary end point; the two higher regimens had a higher incidence of falls, about 66% versus 48%, than the 24,000 IU group. Limitation: small; no placebo group; falls were secondary. Good for: supporting row 4 from a different country and design, that large intermittent doses may increase falls.

What this page is doingEvery row ends with a good-for cell in the writer's own words, which is what turns recorded data into evaluation. Row 1's cell also names what the study cannot answer, which prepares the synthesis.

Institutional Settings

Row 6. Flicker et al. (2005). Design: 2-year double-blind, placebo-controlled randomized trial; all participants also received 600 mg calcium daily. Sample: 625 residents, mean age 83.4, with 25-hydroxyvitamin D between 25 and 90 nmol/L. Setting: 60 hostels and 89 nursing homes, Australia. Finding: fall rate lower with ergocalciferol (incidence rate ratio 0.73); stronger among those taking at least half their capsules. Limitation: falls recorded by care staff in diaries; the adherence subgroup is not randomized. Good for: the best institutional evidence that a daily dose reduces falls in residents in their eighties.

Row 7. Broe et al. (2007). Design: secondary analysis of a 5-month randomized trial of placebo or 200, 400, 600, or 800 IU daily. Sample: 124 nursing home residents, average age 89. Setting: one long-term care facility, United States. Finding: 800 IU reduced the adjusted fall rate by 72% compared with placebo (rate ratio 0.28); lower doses had no effect. Limitation: very small groups of about 25; short; falls were not the original outcome. Good for: suggesting a dose threshold near 800 IU in the oldest residents, as a hypothesis rather than a conclusion.

Row 8. Law et al. (2006). Design: cluster randomized trial by residential unit, ergocalciferol every 3 months (about 1,100 IU a day) or no treatment. Sample: 3,717 residents, average age 85. Setting: 223 units in 118 care homes, Britain. Finding: no difference in falls; 44% of treated and 43% of control residents fell at least once. Limitation: no placebo; falls taken from routinely collected records; median follow-up only 10 months; baseline vitamin D measured in just 18 residents. Good for: the largest institutional test, and a direct challenge to row 6.

The Age Range Column

The phrase older adults covers very different people in this matrix. In row 1 it means a group whose mean age is 67 and who, by design, had no cancer or cardiovascular disease. In row 7 it means nursing home residents whose average age is 89. Read without the age column, row 1 and row 7 contradict each other: one finds no effect across 25,000 people, the other a 72% reduction. Read with it, they stop contradicting. They are studies of different populations, and a result in healthy people in their sixties with adequate vitamin D levels does not transfer to frail residents two decades older.

What this page is doingThe age column justifies itself here by dissolving an apparent conflict between rows 1 and 7. That is the analytic payoff the matrix is built to show.

Contradictions Kept Visible

Rows 6 and 8 contradict outright, and I have left them contradicting. Both enrolled care home residents in their mid-eighties and gave roughly 1,000 IU of ergocalciferol a day or its equivalent, yet Flicker et al. (2005) found fewer falls and Law et al. (2006) found none. Plausible reasons exist: row 6 added calcium, recorded falls prospectively in diaries, and used a placebo, while row 8 gave the dose every 3 months and used routine records with no placebo. But these are explanations I can offer, not ones the studies test, and neither trial is clearly the better one. A reader should see the disagreement, not a smoothed average of it.

A second, softer disagreement sits between rows 2 and 3: the same daily dose of 800 IU in community-dwelling people in their seventies reduced first falls in one trial and not in the other. Row 2 compared against calcium and counted first falls; row 3 compared against placebo and counted all falls. That difference in outcome may account for part of it.

Synthesis

Together the eight trials support three statements. First, giving vitamin D to healthy, replete adults in their sixties and early seventies does not reduce falls (row 1). Second, large intermittent doses, a single annual 500,000 IU dose or monthly doses of 60,000 IU, may increase falls and should not be used to prevent them (rows 4 and 5). Third, in the oldest residents of institutions, a daily dose around 800 to 1,000 IU may reduce falls, though the evidence conflicts (rows 6 to 8). What the set cannot yet answer is the question a clinician most often faces: whether an individual 85-year-old living at home with a low vitamin D level and a history of falls will fall less if supplemented. None of the eight trials enrolled that person specifically, and the answer to it should be framed as uncertain rather than settled.

References

Bischoff-Ferrari, H. A., Dawson-Hughes, B., Orav, E. J., Staehelin, H. B., Meyer, O. W., Theiler, R., Dick, W., Willett, W. C., & Egli, A. (2016). Monthly high-dose vitamin D treatment for the prevention of functional decline: A randomized clinical trial. JAMA Internal Medicine, 176(2), 175-183. https://doi.org/10.1001/jamainternmed.2015.7148

Broe, K. E., Chen, T. C., Weinberg, J., Bischoff-Ferrari, H. A., Holick, M. F., & Kiel, D. P. (2007). A higher dose of vitamin D reduces the risk of falls in nursing home residents: A randomized, multiple-dose study. Journal of the American Geriatrics Society, 55(2), 234-239. https://doi.org/10.1111/j.1532-5415.2007.01048.x

Flicker, L., MacInnis, R. J., Stein, M. S., Scherer, S. C., Mead, K. E., Nowson, C. A., Thomas, J., Lowndes, C., Hopper, J. L., & Wark, J. D. (2005). Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. Journal of the American Geriatrics Society, 53(11), 1881-1888. https://doi.org/10.1111/j.1532-5415.2005.00468.x

Law, M., Withers, H., Morris, J., & Anderson, F. (2006). Vitamin D supplementation and the prevention of fractures and falls: Results of a randomised trial in elderly people in residential accommodation. Age and Ageing, 35(5), 482-486. https://doi.org/10.1093/ageing/afj080

LeBoff, M. S., Murata, E. M., Cook, N. R., Cawthon, P., Chou, S. H., Kotler, G., Bubes, V., Buring, J. E., & Manson, J. E. (2020). VITamin D and OmegA-3 TriaL (VITAL): Effects of vitamin D supplements on risk of falls in the US population. The Journal of Clinical Endocrinology & Metabolism, 105(9), 2929-2938. https://doi.org/10.1210/clinem/dgaa311

Pfeifer, M., Begerow, B., Minne, H. W., Suppan, K., Fahrleitner-Pammer, A., & Dobnig, H. (2009). Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporosis International, 20(2), 315-322. https://doi.org/10.1007/s00198-008-0662-7

Sanders, K. M., Stuart, A. L., Williamson, E. J., Simpson, J. A., Kotowicz, M. A., Young, D., & Nicholson, G. C. (2010). Annual high-dose oral vitamin D and falls and fractures in older women: A randomized controlled trial. JAMA, 303(18), 1815-1822. https://doi.org/10.1001/jama.2010.594

Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., & Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women: A randomized clinical trial. JAMA Internal Medicine, 175(5), 703-711. https://doi.org/10.1001/jamainternmed.2015.0225

What the NRNP 6547 Week 5 instructions ask for

Week 5 of NRNP 6547 often asks for a literature matrix on a question related to older adults. You choose primary studies, set columns that capture what matters for the question, fill each row accurately, and write a synthesis that compares findings. Faculty separate matrices from reading lists by whether studies were evaluated. Cite each study in APA 7. Review articles usually do not count as rows. Columns such as age range and setting matter for older populations. The synthesis should address contradictions. NRNP 6547 faculty want each column justified for the question. Name the dose and form in each trial, since they differ widely. Report baseline vitamin D levels. Separate community and institutional settings. The synthesis should say what the evidence supports and for whom.

Inside the NRNP 6547 Week 5 example

Eight rows, seven columns: citation, design, sample size with the actual age range, setting, principal finding, stated limitation, and a final column in the writer's own words on what the study is good for here. That last column is where the matrix stops being a bibliography. The age range column earns its place immediately, because two studies describing older adults turn out to mean sixty to seventy in one case and seventy eight to ninety four in the other, and their conflicting findings stop conflicting once that is visible. Two rows contradict outright and are left contradicting. Community and institutional settings are separated. Beneath the table, a synthesis paragraph names what the eight support together and what they cannot yet answer.

Reading the NRNP 6547 Week 5 rubric

The row that separates a matrix from a reading list asks whether the studies were evaluated rather than recorded, and the relevance column is where that is demonstrated or missed. Cells copied from abstracts score poorly even when accurate. The example writes its last column in the student's own voice throughout. A second row usually covers currency and appropriateness of sources, so a matrix built from reviews rather than primary studies tends to lose points twice. Marks go when the limitation column is filled with the phrase the authors used and nothing more, and when contradictory findings are smoothed into an agreement the papers do not support. Where a synthesis is required, restating each row in sentence form scores well below one paragraph that reads across them.

NRNP 6547 Week 5 help from the desk

Matrices lose credit when the relevance column is empty or generic. Say how each study bears on the question. Another common gap is mixing community and nursing home trials without noting the difference. Separate them. Writers also average away contradictions. Keep them visible and explain them, as with high annual doses that increased falls. Avoid using reviews as rows. Report baseline vitamin D levels. Keep columns consistent. Close the synthesis with what the evidence supports. Writers also forget to report how falls were defined and counted in each trial. Add the outcome definition. Another frequent slip is choosing trials of younger adults for a question about older adults. Check age ranges. Keep citations in APA 7 with full author lists.

Get a NRNP 6547 Week 5 example written to your instructions

Send the Week 5 prompt, the rubric, and the change you have been assigned to review. The desk builds a filled matrix on that topic with the columns your section requires and a synthesis underneath. The first custom sample is free, arrives inside 24-48 hours, and comes with its citations formatted for your reference list.

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NRNP 6547 Week 5 questions, answered

How many studies belong in the matrix?

The example uses eight, which is enough for a pattern and few enough to keep each row substantive. Prompts commonly set a minimum somewhere between six and ten. What matters more than the count is that the rows differ from each other in design or setting, since eight studies of the same kind produce a table with nothing to compare and a synthesis with nothing to say.

Can review articles fill rows?

One or two can, clearly labeled as such, but a matrix built mostly from reviews usually loses points on the source quality row and again on evaluation, because a review has already done the comparing that the assignment is asking you to do. The example uses primary studies for six rows and marks the two secondary sources plainly in the design column.

Does the matrix need a synthesis paragraph?

Most rubrics in this area ask for one, and it is where the grade separates. The example writes a single paragraph that reads across the rows rather than down them, states what the eight studies support together, and names the question that none of the designs could answer. Summarizing each study again in prose earns very little.

Where can I find a free NRNP 6547 Week 5 sample paper?

The vitamin D and falls matrix is reproduced here with its seven columns, eight trials, setting sections and synthesis, plus margin notes.

What question does the NRNP 6547 Week 5 matrix ask?

Whether vitamin D supplementation reduces falls in older adults, read across eight randomized trials by age and setting.