| Course | NURS 6223 Healthcare Quality Assurance and Risk Management in Healthcare Organizations |
|---|---|
| Week | Week 8 |
| Paper type | Quality improvement plan |
| Length | About 640 words, 5 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | October 2026 |
Free sample paper for NURS 6223 Week 8
Quality Improvement Plan: Automated Early Warning Scores That Page the Rapid Response Nurse
Student Name
College of Nursing, Walden University
NURS 6223: Healthcare Quality Assurance and Risk Management in Healthcare Organizations
Instructor Name
Month Day, Year
Quality Improvement Plan: Automated Early Warning Scores That Page the Rapid Response Nurse
Problem
The root cause analysis of an overnight respiratory arrest on a composite medical unit found three conditions that allowed a rising early warning score to go unescalated for about three hours: nurses totaled the score manually only after finishing a whole round of vital signs, calling criteria permitted rather than required a rapid response call, and pages went to a covering provider responsible for three units. The analysis rated automated scoring with direct paging as its strongest action, because it changes the system rather than relying on memory or training (National Patient Safety Foundation, 2015).
Aim
On two medical units, reduce unplanned transfers to intensive care that were preceded by an unescalated qualifying score by at least half over six months, compared with the prior six months. An unescalated qualifying score is a score at or above the threshold that was not followed by a rapid response call or a provider bedside assessment within 30 minutes.
Intervention
The electronic record will calculate the early warning score automatically each time a set of vital signs is entered. When the score reaches the threshold, the system will page the rapid response nurse directly and display an alert to the bedside nurse and the charge nurse. Within half an hour the rapid response nurse will see the patient in person and decide with the bedside nurse whether to call the full team. The bedside nurse may still call at any score. The change moves the first escalation decision from a busy bedside nurse to a dedicated responder, triggered automatically. In a controlled before-and-after trial across twelve general wards, automated vital sign capture with score calculation was associated with more rapid response calls for respiratory abnormalities and better survival after those calls (Bellomo et al., 2012).
Ownership
The director of medical nursing owns the clinical workflow, including the rapid response nurse's response standard and staff education. The clinical informatics lead owns the build: score calculation, threshold logic, paging and alert display, and the reports needed for monitoring. The two meet weekly during the first month and monthly after that.
Measures and Monitoring
Table 1
Family of Measures
| Type | Measure | Source | Frequency |
|---|---|---|---|
| Outcome | Unplanned intensive care transfers preceded by an unescalated qualifying score, per 1,000 patient days | Transfer log matched to score data | Weekly, plotted on a run chart |
| Process | Percentage of threshold-level scores that reach the rapid response nurse as a page | Paging and score reports | Weekly |
| Process | Share of pages answered at the bedside within 30 minutes | Rapid response nurse log | Weekly |
| Balancing | Rapid response calls per shift, and rapid response nurse reports of alarm burden | Rapid response log; monthly survey | Weekly and monthly |
Weekly data will be plotted on run charts, which display data in time order so that a team can judge whether a change is followed by real improvement rather than random variation (Perla et al., 2011). Six months of baseline weeks will be plotted first, with the median as the center line.
What Would Show the Plan Is Not Working
The plan will be judged not to be working if, after three months, the outcome run chart shows no shift, meaning no run of six or more consecutive weeks below the baseline median, while the process chart shows that most qualifying scores are generating pages. That combination would mean the system is escalating as designed but escalation is not changing outcomes, and the team would need to look at what happens after the page. If instead the process measure stays low, the problem is the build or the workflow, not the idea. And if rapid response calls per shift rise so much that the rapid response nurse cannot reach patients within 30 minutes, the threshold will be reviewed before the plan continues.
References
Bellomo, R., Ackerman, M., Bailey, M., Beale, R., Clancy, G., Danesh, V., Hvarfner, A., Jimenez, E., Konrad, D., Lecardo, M., Pattee, K. S., Ritchie, J., Sherman, K., & Tangkau, P. (2012). A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. Critical Care Medicine, 40(8), 2349-2361. https://doi.org/10.1097/CCM.0b013e318255d9a0
National Patient Safety Foundation. (2015). RCA2: Improving root cause analyses and actions to prevent harm.
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895
What the NURS 6223 Week 8 instructions ask for
The eighth NURS 6223 week usually asks for a quality improvement plan linked to an earlier analysis. You state the problem, a measurable aim, the intervention, owners and measures, and how you would know the plan is failing. Faculty reward measurable plans, and measures such as training attendance lose points. Cite improvement methods in APA 7. A disconfirming measure names in advance what failure would look like, such as no fall in time to escalation. A run chart shows change week by week, which a two-point comparison cannot. Linking to the Week 3 analysis is common. A clear plan follows the paper's own order from problem to the failure signal.
How the NURS 6223 Week 8 example is put together
Five pages under plan headings. The problem statement cites the three conditions the root cause analysis found and quotes the aim: fewer unplanned transfers to intensive care preceded by an unescalated score, on two medical units, over six months. The intervention paragraph describes the change as who does what: the electronic record calculates the score with each set of vital signs, and a score above threshold pages the rapid response nurse directly. Ownership is split between a nursing director for the workflow and an informatics lead for the build. Monitoring names the outcome, a process measure tracking the share of qualifying scores that generate a page, and a balancing measure of rapid response calls per shift. A final paragraph states which run chart pattern would show the plan is not working.
NURS 6223 Week 8 rubric: what earns full marks
Measurability tends to decide this week, and its sharpest form is whether the plan could be shown not to work. Plans evaluated by attendance at training, or by counting how many staff received an email, measure activity and earn little on the evaluation item. Rubrics commonly look for an owner who is a role with authority rather than a committee, since a committee cannot be asked why a date slipped. Alignment with the prior analysis is read closely: an intervention with no link to a stated cause looks chosen for convenience. The balancing measure is credited more often than drafts expect, because adding a paging stream can overload the team being paged. Timelines without milestones cost a smaller share, and a plan promising improvement with no aim to test leaves the evaluation criterion empty.
NURS 6223 Week 8 help: mistakes that cost marks
Improvement plans lose the most when success is measured by activity, such as staff trained. Measure the outcome or process. Aims also go wrong when they lack a target figure and a deadline. Add both. Writers also skip the failure signal. Name a disconfirming measure. Avoid a single before-and-after comparison. Use a run chart. Assign an owner to each part. Add a balancing measure, such as rapid response team workload, so a reader sees what the plan might worsen. Close with the first data point you will plot.
Get a NURS 6223 Week 8 example written to your instructions
Include the findings or cause analysis your plan must answer, the Week 8 template and the rubric, plus any aim your instructor has already approved. Within 24-48h the quality improvement plan comes back, the first free, its disconfirming result stated in the monitoring section and a composite hospital standing in for the one where you work.
More NURS 6223 papers and MSN samples
- NURS 6223 Week 1: Discussion Post
- NURS 6223 Week 2: Adverse Event Analysis
- NURS 6223 Week 3: Root Cause Analysis
- NURS 6223 Week 4: Discussion Post
- NURS 6223 Week 5: Failure Modes Analysis
- NURS 6223 Week 6: Risk Assessment
- NURS 6223 Week 7: Incident Review Summary
- NURS 6223 Week 9: Discussion post
- NURS 6223 Week 10: Safety culture analysis
- NURS 6223 Week 11: Reflection
- NURS 6224 Week 8: Corrective action plan
- NURS 6221 Week 8: Recruitment and Retention Plan
- NURS 6226 Week 8: Comparative policy analysis
- NURS 6201 Week 8: Discussion Post
NURS 6223 Week 8 questions, answered
What is a disconfirming measure?
A result, stated in advance, that would show the intervention is not working. The sample defines it as several consecutive weeks of high process adherence with no movement in the outcome, which would mean the change was delivered and the theory behind it failed. Naming that pattern before implementation protects the plan from being declared a success by whoever reads the data most hopefully.
Why a run chart instead of a before-and-after comparison?
Because improvement happens over time and a two-point comparison hides the path between. Plotting the measure weekly lets a team see a shift or trend as it develops and tell it apart from ordinary variation, an idea that runs back through Deming to Shewhart. The sample names the chart rules it would apply. A before-and-after comparison can still appear in the final evaluation as a summary.
Does the plan have to use the Week 3 analysis?
Many sections build the course as a sequence, and a plan that inherits its problem from earlier work reads as continuous. Where your prompt supplies a new case, the same structure applies: state the cause, choose an action that addresses it and attach the measures. The sample links back explicitly because traceability from finding to intervention is something instructors look for throughout this course.
Where can I find a free NURS 6223 Week 8 sample paper?
The automated early warning score plan is printed here with the problem, aim, intervention, owners, measures and the disconfirming measure.
What does the electronic record do in NURS 6223 Week 8?
It calculates the early warning score and pages the rapid response nurse when the score reaches a set threshold.