NURS 6341 Week 10 Scholarly Paper Example

Course	NURS 6341 Specialty in Clinical Nursing
Week	Week 10
Paper type	Scholarly paper
Length	About 1,060 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NURS 6341 Week 10

Elements Without a Team: What Nurses Can and Cannot Yet Claim About Preventing Delirium After Hip Fracture

Student Name

College of Nursing, Walden University

NURS 6341: Specialty in Clinical Nursing

Instructor Name

Month Day, Year

What this page is doingThe title carries the thesis in compressed form: the elements transfer to nursing, the team model has not yet been shown to.

Elements Without a Team: What Nurses Can and Cannot Yet Claim About Preventing Delirium After Hip Fracture

Delirium is among the most frequent complications of hip fracture surgery in older adults, and it is linked to worse recovery, longer stays and death. Specialty guidance says it can often be prevented, but it assumes a team that many hospitals do not have. This paper argues that nurses on orthopedic units without geriatricians should adopt every element of multicomponent prevention now, but that the evidence does not yet show nurses can match team results without a structured daily review, which those units must build rather than assume. The argument proceeds in four steps: the elements work, the evidence for them comes mostly from team models, the one nurse-only trial cannot carry the weight placed on it, and the missing piece is oversight rather than skill.

The Elements Reduce Delirium Across Settings and Designs

The case for the elements is the strongest part of the literature. Programs that combine reorientation, sleep protection, early mobility, vision and hearing aids, hydration and medication review have reduced delirium in general medical patients, in surgical patients and in hip fracture patients, under randomized and nonrandomized designs. The trial that established the approach cut delirium by about a third on a medical service (Inouye et al., 1999), and a Cochrane review of 14 randomized trials outside intensive care found a relative reduction of 43%, with moderate certainty (Burton et al., 2021). A broader meta-analysis that included nonrandomized studies found similar reductions and a large fall in falls among intervention patients (Hshieh et al., 2015), which matters on a unit where a fall can break the repaired hip. The geriatrics society rated the recommendation to implement such programs strong, on moderate-quality evidence, the best-supported of its prevention recommendations (American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults [AGS], 2015).

Hip fracture trials point the same way, though less consistently. Proactive geriatric consultation reduced delirium from half of patients to about a third (Marcantonio et al., 2001), a consultation team on Belgian trauma wards produced a similar difference (Deschodt et al., 2012), and a specialized geriatric ward in Sweden reduced both incidence and duration (Lundström et al., 2007). A pooled analysis of four randomized trials of comprehensive geriatric assessment found a modest overall reduction, concentrated in models where a team visited patients on the orthopedic unit (Shields et al., 2017).

The Evidence Comes From Teams, and One Strong Trial Found Nothing

Nearly every hip fracture trial above was led by a geriatrician or a geriatric team that saw patients daily and gave recommendations others carried out. Nurses delivered much of the care, but the model tested was a physician-led team, and the guideline's own recommendation specifies a team including physicians and nurses (AGS, 2015). This matters because the effect may depend on the daily oversight as much as on the elements. In the Boston trial, orthopedic staff followed 77% of the geriatrician's recommendations (Marcantonio et al., 2001), which suggests that someone checking every day is part of what produced the result.

The Oslo trial complicates even the team model. Treatment on an acute geriatric ward with comprehensive assessment and daily interdisciplinary meetings did not reduce delirium compared with an orthopedic ward (Watne et al., 2014). Part of the explanation is timing, since many patients were delirious before surgery, and part may be that the comparison ward already delivered good care. Either way, it warns that a well-designed program is not guaranteed to work, and that the results of the positive trials depend on their settings.

The Nurse-Only Evidence Is Promising but Cannot Yet Carry the Claim

Only one randomized trial in hip fracture has tested a protocol delivered by nurses without a physician-led team, and its result was striking: no delirium in 41 intervention patients against 15% of 43 controls (Unal et al., 2022). A recent systematic review of nurse-led prevention in older orthopedic patients found reductions across eight studies, but only two were randomized, and larger studies showed smaller effects (Kraonual et al., 2026). A small trial with a low control rate and a review of mostly nonrandomized studies are enough to justify trying nurse-led prevention, and not enough to claim it matches team results. The pattern of shrinking effects with larger samples is exactly what one would expect if the true nurse-only effect were real but modest.

Nurses also face a measurement problem that teams partly solve. When nurses rated delirium from routine observation, they identified it in under a third of the patients whom researchers found delirious, and the quiet, hypoactive form was the strongest predictor of being missed (Inouye et al., 2001). A nurse-led program that relies on the same nurses to detect its outcome risks undercounting both its failures and its baseline.

What Nurse-Led Units Must Build Is Oversight, Not Skill

The elements themselves are nursing work. Reorientation, sleep protection, mobilization, sensory aids and hydration are already within the scope of every orthopedic nurse, and a nurse-delivered sleep protocol was shown to be feasible, with adherence on about three quarters of patient-days, a generation ago (McDowell et al., 1998). What a unit without a geriatrician lacks is the daily review that checks each element for each patient and corrects omissions. The practical implication is a nurse-led daily delirium round, run by a charge nurse or clinical nurse specialist, that asks the same questions a geriatric team would ask and records the answers where they can be counted, paired with structured screening that does not depend on noticing a quiet patient. That is a claim about what should be built, and it should be tested as it is built.

Conclusion

The literature supports adopting every element of multicomponent delirium prevention for older adults after hip fracture, and it supports nurses delivering them. It does not yet show that nurses working without a team can reproduce the reductions seen in team-led trials, and the one strong null trial is a reminder that programs can fail. Units without geriatricians should therefore adopt the elements now, replace the missing team rounds with a structured nurse-led daily review and routine screening, and measure delirium incidence before and after. If their results match the team trials, the field will have gained a model most hospitals can use; if they do not, the field will have learned what the team was contributing.

References

American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. (2015). American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults. Journal of the American Geriatrics Society, 63(1), 142-150. https://doi.org/10.1111/jgs.13281

Burton, J. K., Craig, L., Yong, S. Q., Siddiqi, N., Teale, E. A., Woodhouse, R., Barugh, A. J., Shepherd, A. M., Brunton, A., Freeman, S. C., Sutton, A. J., & Quinn, T. J. (2021). Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database of Systematic Reviews, 2021(11), Article CD013307. https://doi.org/10.1002/14651858.CD013307.pub3

Deschodt, M., Braes, T., Flamaing, J., Detroyer, E., Broos, P., Haentjens, P., Boonen, S., & Milisen, K. (2012). Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. Journal of the American Geriatrics Society, 60(4), 733-739. https://doi.org/10.1111/j.1532-5415.2012.03899.x

Hshieh, T. T., Yue, J., Oh, E., Puelle, M., Dowal, S., Travison, T., & Inouye, S. K. (2015). Effectiveness of multicomponent nonpharmacological delirium interventions: A meta-analysis. JAMA Internal Medicine, 175(4), 512-520. https://doi.org/10.1001/jamainternmed.2014.7779

Inouye, S. K., Bogardus, S. T., Jr., Charpentier, P. A., Leo-Summers, L., Acampora, D., Holford, T. R., & Cooney, L. M., Jr. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients. New England Journal of Medicine, 340(9), 669-676. https://doi.org/10.1056/NEJM199903043400901

Inouye, S. K., Foreman, M. D., Mion, L. C., Katz, K. H., & Cooney, L. M., Jr. (2001). Nurses' recognition of delirium and its symptoms: Comparison of nurse and researcher ratings. Archives of Internal Medicine, 161(20), 2467-2473. https://doi.org/10.1001/archinte.161.20.2467

Kraonual, S., Thongpeth, W., & Thongpet, T. (2026). The effectiveness of nursing interventions for preventing postoperative delirium in older adults undergoing major orthopedic surgery: A systematic review. BMC Nursing, 25, Article 676. https://doi.org/10.1186/s12912-026-04821-7

Lundström, M., Olofsson, B., Stenvall, M., Karlsson, S., Nyberg, L., Englund, U., Borssén, B., Svensson, O., & Gustafson, Y. (2007). Postoperative delirium in old patients with femoral neck fracture: A randomized intervention study. Aging Clinical and Experimental Research, 19(3), 178-186. https://doi.org/10.1007/BF03324687

Marcantonio, E. R., Flacker, J. M., Wright, R. J., & Resnick, N. M. (2001). Reducing delirium after hip fracture: A randomized trial. Journal of the American Geriatrics Society, 49(5), 516-522. https://doi.org/10.1046/j.1532-5415.2001.49108.x

McDowell, J. A., Mion, L. C., Lydon, T. J., & Inouye, S. K. (1998). A nonpharmacologic sleep protocol for hospitalized older patients. Journal of the American Geriatrics Society, 46(6), 700-705. https://doi.org/10.1111/j.1532-5415.1998.tb03803.x

Shields, L., Henderson, V., & Caslake, R. (2017). Comprehensive geriatric assessment for prevention of delirium after hip fracture: A systematic review of randomized controlled trials. Journal of the American Geriatrics Society, 65(7), 1559-1565. https://doi.org/10.1111/jgs.14846

Unal, N., Guvenc, G., & Naharci, M. (2022). Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study. Journal of Clinical Nursing, 31(7-8), 1082-1094. https://doi.org/10.1111/jocn.15973

Watne, L. O., Torbergsen, A. C., Conroy, S., Engedal, K., Frihagen, F., Hjorthaug, G. A., Juliebo, V., Raeder, J., Saltvedt, I., Skovlund, E., & Wyller, T. B. (2014). The effect of a pre- and postoperative orthogeriatric service on cognitive function in patients with hip fracture: Randomized controlled trial (Oslo Orthogeriatric Trial). BMC Medicine, 12, Article 63. https://doi.org/10.1186/1741-7015-12-63

Reading the NURS 6341 Week 10 instructions

The tenth NURS 6341 week has students write a scholarly paper on their specialty question. Make a central claim, build it through sections that each advance one point, synthesize evidence across studies and state what remains uncertain. Synthesis decides the grade and shows in how paragraphs are built. Cite sources in APA 7. Ten to fifteen pages is common. Earlier weeks' work feeds the paper but should be rewritten into argument. An abstract is usually required; check your instructor's guidance. Headings that state claims help readers follow the argument. Plan the paper around three to five claims, each a section with a heading that states it. Within each section, set studies against each other instead of taking them in turn, and end with what the section shows.

How this NURS 6341 Week 10 example is built

The paper carries a thesis in its opening paragraph, and that thesis is arguable, meaning a competent reader could disagree with it. Headings then name arguments rather than topics, so the sequence of headings reads as a case being built. Inside each section sources are combined: two or three studies appear in the same paragraph because they speak to the same point, and the paragraph reaches a conclusion neither study reached alone. Disagreement in the literature is handled where it belongs instead of in a separate limitations heading. The closing section comes back to the central claim and says what the field should take from it, at the strength the evidence supports. The reference list is long, current, and drawn from inside the specialty.

Where the marks sit in the NURS 6341 Week 10 rubric

Synthesis decides this paper, and it becomes visible in paragraph construction long before a grader reaches the conclusion. The example earns the row by building paragraphs around points and combining sources inside them, which is the structural expression of synthesis rather than a claim about it. Argument quality carries a second row, served by headings stating claims and by a thesis worth contesting. The predictable losses: a source by source march through the literature, a thesis nobody would dispute, counterevidence quarantined at the end, and a conclusion introducing material the body never argued. At this length, reference list errors and inconsistent heading levels quietly cost a band of their own.

NURS 6341 Week 10 help: mistakes that cost marks

Scholarly papers score poorly when each paragraph reports one study. Build paragraphs around claims. A second weakness is overstating what nurse-only studies show. Match claims to evidence. Writers also hide null results. Address them. Avoid a conclusion that adds new evidence. Draw together what the sections showed. Use claim headings. A heading such as the nurse-only evidence is promising but cannot yet carry the claim tells readers exactly what the section argues. Close with what nurse-led units should build first. Read the headings alone and check that they form an argument.

Get a NURS 6341 Week 10 example written to your instructions

Send the prompt, your section's rubric and whatever earlier work the paper is meant to build on, and the desk writes it around your thesis and your field. The first custom sample is free, returned inside 24-48 hours, with headings, synthesis and a complete reference list you can verify source by source.

More NURS 6341 papers and MSN samples

NURS 6341 Week 10 questions, answered

How long is the paper in the example?

It runs to the length these end of term assignments usually reach, though no page count here is official and your prompt is what governs. The structure holds at either extreme, since headings carrying claims and paragraphs built on points work as well across ten pages as they do across twenty.

Does it reuse work from earlier weeks?

The example draws on the same evidence base the term assembled, which is what most prompts intend by a culminating paper. Whether you may reuse your own earlier submissions is a question for your instructor, since sections differ. Send the earlier work and the desk builds forward from it rather than starting over.

Is an abstract required?

Some sections ask for one and some do not, so nothing here is official. Where an abstract is required the example carries one written last, at the length the format specifies, reporting the paper rather than advertising it. Where it is not required, the paper opens directly on its thesis.

Where can I find a free NURS 6341 Week 10 sample paper?

The delirium prevention scholarly paper is on this page with four claim sections, the synthesis across studies and the conclusion.

What can nurses claim about delirium prevention in NURS 6341 Week 10?

That the prevention elements work, but evidence for nurses delivering them without a team is promising rather than proven.