| Course | NURS 8705 Doctoral Seminar |
|---|---|
| Week | Week 1 |
| Paper type | Discussion post with two peer replies |
| Length | About 720 words, 4 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NURS 8705 Week 1
Week 1 Discussion: Initial Post
Thirty-Seven Rebooked Visits in One Month: Failed Peripheral Access in an Outpatient Infusion Suite as a Practice Problem Worth Doctoral Work
In one month this spring, the outpatient infusion suite where I work sent 37 patients home without their scheduled infusion because a peripheral intravenous catheter could not be placed or failed before the infusion was complete. Each of those patients was rebooked, usually for three to seven days later. The suite runs 22 chairs and gives scheduled infusions of iron, biologic agents for inflammatory bowel disease and rheumatoid arthritis, and immunoglobulin. Thirty-seven of roughly 980 scheduled visits is close to 4%. That is the practice trouble I am bringing to this seminar: not vascular access in general, but scheduled treatment that does not happen because access fails.
Rescheduling is more than an inconvenience, and this is where I think the problem earns its place. Many of these infusions are given at fixed intervals, and a delay of several days can mean a patient spends part of a cycle below the drug level the schedule was designed to maintain. The loss also falls repeatedly on the same people. When I looked at the 37 rebooked visits, 14 belonged to 6 patients, all with a documented history of difficult access. For those patients the problem is not an occasional bad day but a recurring gap in their treatment. Peripheral catheter failure is common enough that it has been described as accepted practice that should not be accepted (Helm et al., 2015), and the infusion standards of practice expect organizations to assess vascular access needs and plan for patients with difficult access before treatment begins (Nickel et al., 2024).
I also have to admit that this trouble may already be settled in print. Ultrasound-guided placement, vein visualization devices and early referral for longer-dwelling devices have all been studied, and ultrasound guidance alone has been the subject of a meta-analysis in adults (van Loon et al., 2018), and a literature search may show that the answer is known and simply not used in my setting. If so, would the problem still deserve years of doctoral work? I think it would, under one condition: if the gap is not in knowledge but in getting known practice to happen in an outpatient suite with no vascular access team, then the doctoral problem is implementation, and that is a problem a DNP project can own. Should the evidence prove thin, the problem changes shape but does not disappear.
My practice trouble: scheduled infusions lost to failed peripheral access, concentrated in a small group of patients with difficult access. I would welcome challenges to whether this is one problem or two.
Reply to Marisol
Marisol, you argued that my real problem is the 6 patients, not the 37 visits, and that I should frame the trouble around patients with difficult access rather than around rebooking. I think you are partly right. Those 6 patients account for more than a third of the lost visits, and a project aimed at them could have a large effect. But I am not ready to drop the other 23 rebooked visits, which were spread across 23 different patients. Some of those may be patients whose access is becoming difficult, which a narrower framing would miss. Perhaps the problem statement should name both: a concentrated group with known difficult access and a wider group whose failures are not yet predicted. Would you see that as one problem or as two that should be separated now?
Reply to Desmond
Desmond, you questioned whether a 4% rebooking rate is high at all, given that peripheral catheters fail often in every setting. That is the right question, and I do not yet have a good comparison. Helm et al. (2015) describe high failure rates for peripheral catheters overall, but most of those figures come from inpatient settings, where catheters stay in for days rather than hours. An infusion suite places a catheter for a single visit, so a failure rate built from multi-day dwell times may not apply. I would need outpatient figures to judge whether our rate is unusual. If it turns out to be typical, I think the problem still stands, because a typical rate of lost treatment is not an acceptable one. But you have shown me that my significance argument cannot rest on the number alone.
References
Helm, R. E., Klausner, J. D., Klemperer, J. D., Flint, L. M., & Huang, E. (2015). Accepted but unacceptable: Peripheral IV catheter failure. Journal of Infusion Nursing, 38(3), 189-203. https://doi.org/10.1097/NAN.0000000000000100
Nickel, B., Gorski, L., Kleidon, T., Kyes, A., DeVries, M., Keogh, S., Meyer, B., Sarver, M. J., Crickman, R., Ong, J., Clare, S., & Hagle, M. E. (2024). Infusion therapy standards of practice, 9th edition. Journal of Infusion Nursing, 47(1S), S1-S285. https://doi.org/10.1097/NAN.0000000000000532
van Loon, F. H. J., Buise, M. P., Claassen, J. J. F., Dierick-van Daele, A. T. M., & Bouwman, A. R. A. (2018). Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: A systematic review and meta-analysis. British Journal of Anaesthesia, 121(2), 358-366. https://doi.org/10.1016/j.bja.2018.04.047
The Walden NURS 8705 Week 1 instructions
Opening threads in the doctoral seminar typically want one problem from your own practice, stated plainly, with a case for why it could sustain a DNP project. Begin inside the setting with a number rather than with a topic area such as patient safety or access to care. Explain why the problem matters beyond inconvenience, ideally by showing who bears the loss and how often. Bring in two or three sources that support specific claims. Admit that the problem may already be solved in the literature, and say under what condition it would still deserve doctoral work, for example if the gap lies in practice rather than in knowledge. Replies should engage the strongest point a classmate makes and adjust the framing where the evidence supports them.
Inside the NURS 8705 Week 1 example
Paragraph one gives the 37 rebooked visits out of about 980, the suite's 22 chairs and the kinds of infusions involved. Paragraph two explains interrupted treatment intervals and shows that six patients with known difficult access absorbed 14 of the losses, citing Helm and colleagues and the Nickel infusion standards. Paragraph three concedes that ultrasound guidance and other techniques are well studied, with van Loon and colleagues, and argues that an implementation gap would still be a doctoral problem. The highlighted line states the trouble and invites challenge. The reply to Marisol keeps the 23 scattered visits alongside the six patients. The reply to Desmond accepts that inpatient failure rates may not apply to single-visit catheters and that significance cannot rest on the number alone.
Reading the NURS 8705 Week 1 rubric
Faculty grading this first thread tend to reward a specific, local problem, a clear reason it matters, sources that do real work and replies that engage. A post that opens with a count from the writer's setting usually earns more than one describing a broad topic. Credit rises when the writer shows who is affected and how often, since that is the beginning of a significance argument. Honesty about whether the literature already answers the question is valued, because it shows the writer understands what a doctoral problem is. Replies earn their share when they concede a sound point and say how it changes the framing, rather than defending the original post line by line. Professional tone and accurate citations account for the remainder.
Common NURS 8705 Week 1 mistakes, and how to avoid them
First posts in the seminar often describe a topic, such as falls or medication errors, rather than a problem with a place, a number and a consequence. Others claim importance without saying who bears the loss. Some avoid the possibility that the answer is already known, which leaves them exposed when a classmate raises it. Start by counting something in your own setting for one month, then ask which patients carry most of the burden. Write the paragraph that admits what may already be settled before you finish the post. Keep identifying details out, describing your unit by type and size. Our writers can prepare an opening post around the practice trouble you have in mind, with replies that take positions.
Get a NURS 8705 Week 1 example written to your instructions
Paste in the discussion prompt, the word floor your section sets and how many replies it counts, and an example for this week comes back matched to those numbers. The first custom one costs nothing and arrives within 24 to 48 hours. The shift you actually worked is not something a library supplies, and this page does not pretend otherwise.
More NURS 8705 papers and DNP samples
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NURS 8705 Week 1 questions, answered
Is the infusion suite a real one?
Not a real one. Those details were constructed so the page could show something concrete, since the trouble a grader wants argued is the one you have watched yourself and can defend when a classmate pushes back. What carries over is proportion: how much detail a single failure needs before a reader believes it, and how fast the post moves past it.
How much of the grade sits in the replies?
A distinct share in most sections, judged against a minimum of its own, which is why both responses sit here in full instead of being mentioned as having happened. The two answer different classmates and take different tacks, one granting the point before narrowing it and one rejecting its starting claim outright, so a reader sees more than one usable move.
Does a first post have to name the project already?
Nothing published for this course says so, and the example does not. It names a trouble and argues its worth, which is a smaller commitment than a project and the one an opening thread can actually support. Sections differ on how firm they expect that choice to be by the closing week, and the rubric in your classroom governs what the post owes.
Where can I find a free NURS 8705 Week 1 sample paper?
The opening post on lost infusions, its two replies and three references are published above, and reading them costs nothing.
Why does the NURS 8705 Week 1 post focus on six patients?
Because those six patients, all with documented difficult access, accounted for 14 of the 37 lost visits, so for them the problem is a recurring gap in treatment rather than an occasional bad day.