| Course | NURS 8600 DNP Field Experience |
|---|---|
| Week | Week 1 |
| Paper type | DNP project baseline summary |
| Length | About 1,010 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 8600 Week 1
Where the Clinic Starts: A Baseline Summary of Alcohol Screening and Brief Intervention Documentation Before Launch of a DNP Practice Change
Student Name
College of Nursing, Walden University
NURS 8600: DNP Field Experience
Instructor Name
Month Day, Year
Where the Clinic Starts: A Baseline Summary of Alcohol Screening and Brief Intervention Documentation Before Launch of a DNP Practice Change
Purpose and Aims
This summary fixes the baseline against which the DNP project at a composite rural family medicine clinic will be judged. The approved project plan has three aims, each tied to one process measure: (1) increase documented alcohol screening with a validated instrument at adult annual visits; (2) increase documented brief intervention for adults who screen positive; and (3) increase documented offers of referral to the clinic's behavioral health counselor for adults whose screening result suggests more than brief intervention can address. A balancing measure, time spent in rooming, will show whether the new work slows visits.
National guidance supports the project's direction: the federal preventive services task force advises that primary care ask every adult about drinking and offer short counseling to those whose answers show risk (US Preventive Services Task Force et al., 2018). Before this project the clinic had no standard way of doing either.
Instruments the Baseline Recognizes
Two brief instruments are accepted as screening in this review because both have been validated in primary care. The AUDIT-C uses three items, on frequency of drinking, the usual amount and the frequency of heavy episodes; it was shown to identify heavy drinking and alcohol use disorders among patients in a primary care population (Bush et al., 1998). The single alcohol screening question asks how many times in the past year the person has had a specified number of drinks in a day, and a validation study in an urban primary care clinic found it performed well against a reference standard interview (Smith et al., 2009). The planned workflow will use the AUDIT-C because its score also guides the choice between brief intervention and referral. For the baseline, a record of either instrument counts, since some clinicians used the single question on their own initiative.
Recognizing both instruments at baseline, while the new workflow uses only one, is deliberate. It prevents the baseline from being set artificially low by excluding screening that was genuinely done, which would exaggerate any later improvement.
Methods
Review period. January through March, the three months before the planned April launch.
Eligible visits. Annual preventive or wellness visits for patients aged 18 and older, identified from the billing record by visit type. Visits for acute problems were excluded because the planned workflow applies to annual visits only.
Sampling. Before the project, screening results, when recorded at all, lived only in free-text notes, so no report could count them. The project lead therefore reviewed a random sample of 40 eligible visits per month, 120 in all, drawn with a random number generator from the monthly lists. A second reviewer, the clinic's nurse manager, independently reviewed 20 of the charts, and the two agreed on every measure in 19 of them; the one disagreement was resolved by discussion and the definitions below were tightened.
Definitions. Screening was counted only when a validated instrument, such as the AUDIT-C or the single alcohol screening question, was named or its items were recorded. A note such as "drinks socially" did not count. A positive screen used the instrument's published threshold. Brief intervention was counted when the note recorded feedback about the result and advice or discussion of change. A referral offer was counted when the note recorded that the patient was offered a behavioral health appointment. Rooming time was the interval between the check-in and rooming-complete timestamps, recorded for a subsample of 30 visits.
Privacy. Data were abstracted into a spreadsheet that contained no names, dates of birth or record numbers; each row carried only a study number, visit month and the measures. The key linking study numbers to records stayed on a clinic computer and will be destroyed at project end. The clinic's leadership approved the review as quality improvement.
Illustrative Results
The figures below are illustrative, prepared for a composite clinic to show the structure a baseline summary should follow.
Table 1
Baseline Process Measures, January Through March (Sampled Chart Review)
| Measure | Numerator | Denominator | Proportion |
|---|---|---|---|
| Screening with a validated instrument documented | 29 | 120 annual visits | 24% |
| Brief intervention documented | 2 | 7 positive screens | 29% |
| Referral offer documented | 0 | 2 visits meeting referral criterion | 0% |
| Median rooming time (balancing) | 30 visits | 11 minutes |
Monthly screening proportions were 22 percent in January, 25 percent in February and 26 percent in March, giving a baseline median of 25 percent. The small numbers of positive screens and referral-eligible visits mean that the brief intervention and referral proportions are unstable; they are reported for completeness, not as precise estimates.
Limitations
Four limitations will shape later comparisons. First, the baseline is a sample, while post-launch data will come from a structured field that allows a full count of every eligible visit; the change in method is itself a source of difference, which the final report will state. Second, documentation is not the same as practice. Some clinicians may have asked about alcohol without recording it, so the baseline may understate screening. Third, the small number of positive screens limits what can be said about brief intervention and referral. Fourth, three months may not capture seasonal variation in visit mix, such as school and sports physicals in late summer.
Patient-level outcomes, such as changes in drinking, are not included. The project is designed to change a clinic process over a few months, and a Cochrane review of brief alcohol interventions in primary care measured drinking outcomes at follow-up periods of a year, which this project cannot match (Kaner et al., 2018). The project's claims will therefore be limited to process.
What the Baseline Commits the Project To
Every later report will use the definitions above without change, compare monthly proportions with the baseline median of 25 percent for screening and state denominators beside every percentage. If a definition must change, the change will be reported and the baseline recalculated under the new definition. The baseline is the promise the project makes to its readers about how it will be judged.
References
Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158(16), 1789-1795. https://doi.org/10.1001/archinte.158.16.1789
Kaner, E. F. S., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018). Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews, 2018(2), Article CD004148. https://doi.org/10.1002/14651858.CD004148.pub4
Smith, P. C., Schmidt, S. M., Allensworth-Davies, D., & Saitz, R. (2009). Primary care validation of a single-question alcohol screening test. Journal of General Internal Medicine, 24(7), 783-788. https://doi.org/10.1007/s11606-009-0928-6
US Preventive Services Task Force, Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Kemper, A. R., Kubik, M., Landefeld, C. S., Mangione, C. M., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2018). Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA, 320(18), 1899-1909. https://doi.org/10.1001/jama.2018.16789
NURS 8600 Week 1 instructions, in plain terms
The opening deliverable in the DNP field experience usually asks you to document current practice before your intervention begins, using the measures in your approved plan. Expect a summary of three to five pages with a data table. Restate your aims and the measure attached to each so a reader can check that the baseline matches the plan. Describe exactly how data were collected: the time period, how eligible cases were found, whether you sampled and how, and who checked your work. Define every measure in terms a second reviewer could apply, including what does not count. Explain how privacy was protected. Report numerators and denominators beside each proportion, and write the limitations a later comparison will need to acknowledge. Stay with the process measures your plan names.
How the NURS 8600 Week 1 example is put together
The first section restates three process aims and a balancing measure and cites the federal task force recommendation on screening. A section on instruments cites Bush and colleagues on the AUDIT-C and Smith and colleagues on the single question, and explains why both count at baseline. Methods cover the three-month period, visit selection, a 40-per-month random sample, a second reviewer and de-identification. Table 1 gives the four baseline measures with numerators and denominators, followed by the monthly screening values and their median. Limitations name the change in data source, documentation versus practice, small numbers and season, citing Kaner and colleagues on the follow-up periods outcome studies need. A closing section commits to fixed definitions.
NURS 8600 Week 1 rubric: what earns full marks
Baseline deliverables are commonly weighed on alignment with the approved plan, clarity of definitions, soundness of data collection, protection of privacy and honest limitations. Alignment is checked first, since a baseline measuring something the plan never named cannot support a later comparison. Definitions earn credit when they are precise enough for a second person to apply the same way. Data collection is judged on the sampling approach and any reliability check. Privacy is scored on de-identification and aggregation. Limitations carry weight when they anticipate how the comparison could mislead. Faculty also look for numerators and denominators with every percentage and for APA references to instruments and guidelines. Clear tables help reviewers check the numbers quickly.
Common NURS 8600 Week 1 mistakes, and how to avoid them
Baseline summaries often lose credit by reporting a percentage with no denominator, which leaves the reader unable to judge its stability. Another loss is a definition vague enough that anything counts, such as treating any mention of alcohol as screening. Some summaries add measures the plan never named, which reviewers read as drift. Others skip the change in data source that will occur at launch. Restate aims with measures, define each measure strictly, describe sampling and checking, protect privacy, report counts with percentages and name the limitations that matter later. The desk can draft a baseline summary for the measures in your own approved plan. Keep every figure aggregate so no patient or clinician can be identified.
Get a NURS 8600 Week 1 example written to your instructions
Send the baseline prompt and rubric, with the measure definitions from your approved plan, and a baseline summary written to those definitions returns in 24-48h, free the first time. Those pre-launch records never existed outside this page; every figure in your summary comes from data your project actually collected under its approved procedures.
More NURS 8600 papers and DNP samples
- NURS 8600 Week 2: DNP project launch brief
- NURS 8600 Week 3: DNP as-implemented workflow map
- NURS 8600 Week 4: DNP project PDSA cycle report
- NURS 8600 Week 5: DNP implementation midpoint report
- NURS 8600 Week 6: DNP course-correction memo
- NURS 8600 Week 7: DNP project run chart analysis
- NURS 8600 Week 8: DNP sustainment handoff plan
- NURS 8600 Week 9: DNP final report discussion section
- NURS 8600 Week 10: DNP SQUIRE manuscript outline
- NURS 8600 Week 11: DNP essentials attainment reflection
- DNRS 6211 Week 1: Discussion post
- DNRS 6630 Week 1: Discussion post
NURS 8600 Week 1 questions, answered
Can a sampled chart review serve as a baseline?
Often, when the record system cannot produce a report and the sampling rule is described. The example samples charts because the screen is recorded only as free text. Your approved evaluation plan and your faculty set what is acceptable, and a sampled baseline also commits you to the same sampling approach at later points, or the comparisons will mix two methods.
Should the baseline include patient-level outcomes?
Only if your approved plan measures them. The example's plan uses process measures, so its baseline does the same and explains why outcomes lie outside the project window. Adding outcome data now, unattached to any aim, would create a measure the later evaluation never uses, and a reviewer may read that as drift from the plan you already had accepted.
How is patient privacy handled in a baseline summary?
Through aggregation and de-identification before data leave the practice setting, along with whatever your institution's review process requires. The example reports only aggregate proportions and says where de-identification took place. Nothing in your summary should identify a patient or a clinician, and that includes small counts in rare categories that could point to a particular person.
Where can I find a free NURS 8600 Week 1 sample paper?
The complete baseline summary, instruments, methods, the illustrative table and limitations, is on this page at no charge. A summary for the measures in your approved plan can be requested.
What counts as screening in the NURS 8600 Week 1 baseline?
Only a validated instrument, the AUDIT-C or the single alcohol screening question, named or with its items recorded; a note such as drinks socially does not count.