NURS 8301 Week 8 PDSA Cycle Plan Example

Course	NURS 8301 Effectively Leading Organizations in Quality Improvement Initiatives
Week	Week 8
Paper type	PDSA cycle plan
Length	About 1,030 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	Doctor of Nursing Practice (DNP)
Updated	September 2026

Free sample paper for NURS 8301 Week 8

Predictions Written Down First: A PDSA Plan for Testing an Evening Readiness Call With One Surgeon's Patients Over Five Operating Days

Student Name

College of Nursing, Walden University

NURS 8301: Effectively Leading Organizations in Quality Improvement Initiatives

Instructor Name

Month Day, Year

What this page is doingThe title leads with the discipline the plan follows, writing predictions before testing, and states the scale of the first test.

Predictions Written Down First: A PDSA Plan for Testing an Evening Readiness Call With One Surgeon's Patients Over Five Operating Days

Purpose

This plan describes the first Plan-Do-Study-Act cycle for the readiness call change in the composite outpatient surgery department's project on avoidable day-of-surgery cancellations. The change comes from the driver diagram's second primary driver, reaching every patient before the day of surgery. Before the call is tried on anyone, the team writes down what it expects to happen and what result would make it drop or change the idea. A systematic review of published PDSA work found that key features of the method, including predictions and iterative cycles, were often missing (Taylor et al., 2014), so this plan makes them explicit. It adds a short failure-mode scan of the call process and a ramp of three later cycles.

Plan

Objective of this cycle. To learn whether a readiness call made between 5 p.m. and 7:30 p.m., two business days before surgery, using the standard checklist, reaches more patients directly than the current afternoon call, and whether it identifies readiness problems in time to fix them.

Scale. One general surgeon's patients over five consecutive operating days, about 20 patients. The surgeon and her office manager agreed to the test. Small scale limits risk and makes it possible to learn from each call (Langley et al., 2009).

Who, when, where. One preoperative nurse who helped design the checklist will make the calls from the department on two evenings each week, paid as extra hours. The nurse will log each call attempt, whether the patient was reached, how long the call took and any problem found.

Predictions. The team predicts that at least 17 of the roughly 20 patients, about 85%, will be reached directly by phone or by callback, compared with the illustrative 60% reached directly by afternoon calls last quarter; that each call will take a median of about eight minutes; that at least two readiness problems, such as an anticoagulant not yet held or no escort arranged, will be found and resolved; and that none of the surgeon's cases in the five days will be canceled for an avoidable readiness reason.

What would make the team drop or change the idea. If fewer than 14 patients are reached directly, the evening timing is not better enough to justify the extra hours, and the team will test a text message with a callback line instead. If the median call exceeds twelve minutes, the checklist needs shortening before any wider test.

What this page is doingWriting a stopping rule alongside each prediction makes clear in advance what result would change the team's course.

Failure-Mode Scan of the Call Process

Before the test, the team spent thirty minutes on a short failure-mode scan of the call process, adapting the approach of health care failure mode and effect analysis, which asks teams to map a process, list ways each step could fail and judge which failures matter most (DeRosier et al., 2002). Table 1 summarizes the highest-priority failures.

Table 1

Highest-Priority Failure Modes in the Evening Readiness Call

Step	Failure mode	Effect	Action before the test
Pull call list	Case added after list is printed is missed	Patient never called	Nurse checks the schedule again at 5 p.m.
Reach patient	Wrong or outdated number	Patient unreachable	Number confirmed by office at scheduling for the test surgeon's patients
Review medications	Nurse unsure of anticoagulant hold instructions	Wrong advice or unresolved question	Anesthesia-approved hold guide at the phone; on-call anesthesiologist number listed
Find a problem	Problem found after office hours cannot be fixed	Case still canceled	Problems logged and sent to the surgeon's office by 8 a.m. the next day, one full day before surgery
Document	Call not documented in the record	Day-of-surgery team unaware	Checklist entered in the preoperative record the same evening

The fourth failure mode shaped the test's timing: calling two business days ahead leaves a working day to fix problems.

Do

During the five days, the nurse will make the calls and keep the log. Anything unexpected, such as patients preferring text, a surgeon office closed on the day after the call or a problem the checklist did not anticipate, will be written in a notes column the same evening, because observations made at the time are more reliable than recollections at the team meeting.

Study

At the team meeting after the fifth day, the team will compare results with each prediction: the share reached directly, the median call time, the number and type of problems found and fixed and whether any of the surgeon's cases were canceled for avoidable readiness reasons. With only about 20 patients, the team will not claim an effect on the cancellation rate; the cycle is designed to learn whether the call process works, not to prove it reduces cancellations. The team will also ask the nurse what surprised her, and it will read the notes column for patterns, such as patients who asked to be called at a different number or who wanted instructions repeated by text. Those details often suggest the next change more clearly than the counts do. Finally, the team will compare the problems found on the calls with the reason codes in the cancellation log, to see whether the checklist is catching the kinds of problems that actually cancel cases.

Act and the Ramp of Later Cycles

The decision after the first cycle will be to adopt, adapt or abandon the evening call. If predictions are met, the team will expand in three further cycles, each larger than the last and each with its own predictions.

Cycle 2: the same surgeon for two more weeks, with a second nurse making calls, to test whether results hold with a different caller.

Cycle 3: all general surgeons' patients for two weeks, adding a text message with a callback line for patients not reached on the first attempt.

Cycle 4: general surgery and urology for one month, with results tracked on the project's monthly run chart of avoidable cancellations.

Reed and Card (2016) warn that PDSA is often used as a single test rather than a sequence of learning, and that scaling too quickly loses the learning. The ramp is designed to avoid both: each cycle changes one thing, and each is large enough to reveal problems the previous one could not.

References

DeRosier, J., Stalhandske, E., Bagian, J. P., & Nudell, T. (2002). Using health care failure mode and effect analysis: The VA National Center for Patient Safety's prospective risk analysis system. The Joint Commission Journal on Quality Improvement, 28(5), 248-267. https://doi.org/10.1016/S1070-3241(02)28025-6

Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.

Reed, J. E., & Card, A. J. (2016). The problem with Plan-Do-Study-Act cycles. BMJ Quality & Safety, 25(3), 147-152. https://doi.org/10.1136/bmjqs-2015-005076

Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety, 23(4), 290-298. https://doi.org/10.1136/bmjqs-2013-001862

The Walden NURS 8301 Week 8 instructions

PDSA plan assignments usually ask you to design the first test of a change from your driver diagram, following the Plan-Do-Study-Act structure. Expect several pages in APA style. State the objective of the cycle and the question it will answer. Keep the scale small and say why. Name who does what, when and where. Write numerical predictions and the results that would make you drop or change the idea. Where a change carries risk, scan the process for failure modes before testing. Describe what will be observed during the test, how results will be studied and how later cycles will scale up, each with its own predictions and each changing one thing.

Inside the NURS 8301 Week 8 example

The purpose section links the change to the driver diagram and cites Taylor and colleagues. The plan section sets the objective, the scale of about 20 patients, the calling nurse and the call log, then gives four predictions and two stopping rules. Table 1 summarizes a thirty-minute failure-mode scan adapted from DeRosier and colleagues, including the missed late addition and the problem found after office hours. A short do section asks for same-evening notes. The study section compares results with predictions, declines to claim an effect on the rate and reviews notes and reason codes. The act section describes three later cycles and cites Reed and Card.

Where the marks sit in the NURS 8301 Week 8 rubric

PDSA plans are generally graded on a clear objective, appropriate scale, explicit predictions, decision rules, risk awareness and a sensible ramp. Objective credit rewards a question the cycle can answer. Scale credit goes to tests small enough to be safe and quick. Predictions earn the most credit when they are numerical and paired with results that would change the plan. Risk awareness is shown by a failure-mode scan proportionate to the change. The ramp is credited when each later cycle is larger and changes one thing. Citation accuracy and source quality finish the score, and graders often penalize plans that are really pilots of a finished idea. Graders also notice whether the plan says how observations will be captured while the test runs.

Common NURS 8301 Week 8 mistakes, and how to avoid them

PDSA plans lose marks when predictions are vague, such as expecting improvement, or missing entirely. Another common loss is a first test so large that failure would be costly. Some plans skip the study step or describe it only as reviewing results. Others scale straight from one cycle to full implementation. State an objective, keep scale small, write numerical predictions and stopping rules, scan for failure modes, plan the study and ramp in steps. The desk can draft a PDSA plan for a change from your own diagram. Decide in advance which single number would make you abandon the idea, and write it in the plan before the test starts.

Get a NURS 8301 Week 8 example written to your instructions

Send the change idea your cycle will test, the driver diagram it came from if you have one, and your PDSA template with the rubric. Your custom cycle plan returns in 24-48h, first one free, predictions stated as counts and adopt, adapt and abandon thresholds set before any data.

More NURS 8301 papers and DNP samples

NURS 8301 Week 8 questions, answered

Why state predictions as numbers?

Because a number can be wrong in a way a hope cannot. Predicting that most patients will be reached leaves the team unable to tell a good week from a lucky one, while predicting a specific count shows how far results departed from expectation and prompts the question why. The sample's three numeric predictions each connect to a tally the charge nurse keeps, so the comparison is ready the moment the week ends.

Is an FMEA required for a PDSA plan?

Rarely, and a full failure modes and effects analysis would be out of proportion for a five-day test. The sample borrows the logic at small scale: list the ways the change could fail, judge which matter most, and build a safeguard into the first cycle. That brief scan puts risk thinking to work on the change itself, which instructors tend to credit, without turning the plan into a separate project.

What should the Act section say before the test has run?

It should set the decision rules. The sample defines what result would lead the team to adopt the call as designed, adapt it for the next cycle, or abandon it, each tied to the predictions. Writing those thresholds in advance keeps the decision honest once results arrive. After the test, the Act section records which rule applied and what the next cycle will change, which feeds the ramp.

Where can I find a free NURS 8301 Week 8 sample paper?

The complete PDSA plan, with predictions, failure-mode table and ramp of later cycles, is published here for free. A cycle plan for a change from your own diagram can be requested.

What would make the team drop the evening call in the NURS 8301 Week 8 plan?

Reaching fewer than 14 of the roughly 20 patients directly, in which case the team would test texting a callback number instead, or a median call longer than twelve minutes.