| Course | NURS 8705 Doctoral Seminar |
|---|---|
| Week | Week 2 |
| Paper type | Problem statement draft with marked copy |
| Length | About 1,060 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | October 2026 |
Free sample paper for NURS 8705 Week 2
Unplanned Nasogastric Tube Removal on a Twenty-Two-Bed Neuroscience Unit: A One-Sentence Problem Statement, Its Support and the Marked Copy
Student Name
College of Nursing, Walden University
NURS 8705: Doctoral Seminar
Instructor Name
Month Day, Year
Unplanned Nasogastric Tube Removal on a Twenty-Two-Bed Neuroscience Unit: A One-Sentence Problem Statement, Its Support and the Marked Copy
The Problem Statement
Between January and June, 31 nasogastric feeding tubes were removed without a clinical order on the 22-bed neuroscience unit of a community teaching hospital, each removal interrupting enteral feeding for a median of 9 hours and requiring a repeat radiograph to confirm the replacement tube's position.
Supporting Sentences
The local figure. The unit placed 118 nasogastric feeding tubes in the six months, so 31 unplanned removals means roughly one in four tubes was removed before the care team intended. The count comes from the unit's incident reports cross-checked against radiology orders for tube confirmation, since some removals were not reported as incidents but were visible as second confirmation films within 48 hours.
The published comparison. Tube dislodgement is a recognized problem in critical care. In a randomized trial in a surgical intensive care unit, securing tubes with a nasal bridle reduced dislodgement compared with adhesive tape (Seder et al., 2010), which shows both that dislodgement is common enough to study and that it can be reduced. Safe practice recommendations for enteral nutrition also treat securement and verification of position as core safety practices (Boullata et al., 2017). Neuroscience patients, many with agitation, confusion or impaired awareness after stroke or brain injury, are a population in which pulling at tubes would be expected.
What is excluded. The statement excludes every removal ordered by a clinician, including planned removals at the end of feeding, removals for repositioning and removals for transfer to a longer-term feeding route. It also excludes tubes placed for gastric decompression, which are managed differently on this unit.
Fixing the Boundaries
The closing phrase of the statement, between January and June on the 22-bed neuroscience unit, fixes both window and unit. Without it, the statement could later widen to the hospital, to all enteral tubes or to a longer period, and the problem would quietly become a different one. The statement deliberately does not name a cause. Possible causes include patient agitation, the securement method, the nursing assessment of risk and the use or avoidance of restraints, but naming one in the problem statement would assume the answer the project has not yet sought. Doctoral project texts advise that a problem statement describe the gap and its consequences while leaving the explanation to later stages (Moran et al., 2020).
The statement also uses counts rather than rates in its main clause, because a faculty reader can check a count against a source. The rate, roughly one in four tubes, appears in the supporting sentence where its denominator is explained.
The Marked Copy
The faculty reader returned the draft with four annotations, three of them on words that could be read two ways. Table 1 reproduces them with the writer's response.
Table 1
Faculty Annotations on the Draft Statement and the Revisions Made
| Word or phrase in the draft | Faculty note | Revision |
|---|---|---|
| "removed" | Removed by whom? Patient, staff during care, accidental? | Changed to "removed without a clinical order," which includes all three and excludes planned removals |
| "feeding tubes" | All tubes, or nasogastric only? Small-bore and large-bore? | Changed to "nasogastric feeding tubes" and decompression tubes excluded in the supporting sentence |
| "interrupting feeding" | Measured how? Ordered hours or delivered hours? | Changed to "a median of 9 hours," defined as hours from removal to resumed feeding at the ordered rate |
| "a community teaching hospital" | Is the hospital needed, or only the unit? | Kept; the unit's staffing model and radiology access depend on the hospital type |
Only the fourth annotation was declined, and the reason is given in the table.
What the Marked Copy Taught
Three of the four notes landed on ordinary words that I had read as precise because I knew what I meant by them. "Removed" meant, to me, removed by the patient, but a reader could equally have counted removals during bathing or turning, which are also unplanned and which the unit's incident reports do include. Settling the word changed the count: the draft's figure of 26 rose to 31 when removals during care were added. "Interrupting feeding" sounded measurable until the reader asked how. Feeding orders give a rate, but the record of what was actually delivered is kept in a different part of the electronic record, and the median of 9 hours had to be rebuilt from pump records.
The lesson for the next draft is that a problem statement is tested by a reader who does not share the writer's setting. Every term that the writer uses daily should be checked by asking how someone from another unit, or another hospital, would read it.
The marked copy also showed what the reader did not question. No note appeared on the count itself, the window or the unit, because each was stated with a source a reader could check. That pattern suggests a working rule for the next draft: wherever a reader can verify a phrase, the phrase is done; wherever a reader has to guess what the writer meant, the phrase needs work. It also suggests a limit on how much a single sentence should carry. The draft statement originally included a third consequence, the cost of replacement tubes and radiographs, which the reader marked as a separate argument. Moving cost into the significance section later in the term kept the statement to one event and two consequences, both of which the unit measures already.
Limits of the Statement
Incident reports undercount events, and cross-checking against confirmation radiographs catches only removals followed by replacement; a tube removed and not replaced, because feeding was stopped, would be missed. The 9-hour median depends on pump data that were complete for 27 of the 31 events. These limits do not change the statement but should be stated wherever its figures are used.
A second limit concerns the population. The unit admits patients after stroke, brain injury, spinal surgery and seizures, and the risk of a patient pulling at a tube is likely to differ greatly across these groups. The statement counts all of them together because the unit's practice applies to all of them, but a later stage will need to describe who the 31 removals involved before any explanation is proposed. If most removals cluster in one group, such as agitated patients early after traumatic brain injury, the problem may narrow again.
References
Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii-Wolfe, C., Sullivan, J., Wood, A., Malone, A., & Guenter, P. (2017). ASPEN safe practices for enteral nutrition therapy. Journal of Parenteral and Enteral Nutrition, 41(1), 15-103. https://doi.org/10.1177/0148607116673053
Moran, K. J., Burson, R., & Conrad, D. (2020). The doctor of nursing practice project: A framework for success (3rd ed.). Jones & Bartlett Learning.
Seder, C. W., Stockdale, W., Hale, L., & Janczyk, R. J. (2010). Nasal bridling decreases feeding tube dislodgment and may increase caloric intake in the surgical intensive care unit: A randomized, controlled trial. Critical Care Medicine, 38(3), 797-801. https://doi.org/10.1097/CCM.0b013e3181c311f8
NURS 8705 Week 2 instructions, in plain terms
In this seminar, the second week's work generally centers on a short problem statement that a reader can evaluate on its own. Aim for one sentence that names the event, the place, the period, a count and the consequences you can measure. Support it with a few sentences: one giving the local figure and its source, one setting it beside published evidence and one stating what you have excluded. Fix the window and the unit so the statement cannot widen later. Leave causes out, because naming one assumes an answer the project has not reached. If your section returns a marked copy, respond to each comment by revising the wording or explaining why you kept it, and note the limits of your data.
How this NURS 8705 Week 2 example is built
The statement sits alone under its own heading and is highlighted. Supporting sentences follow under three italic labels: the local figure of roughly one in four tubes, the published comparison drawn from Seder and colleagues' securement trial and the ASPEN safe practices, and the exclusions. A section on boundaries explains the window, the absence of a cause and the use of counts rather than rates, citing Moran and colleagues. Table 1 reproduces four annotations on removed, feeding tubes, interrupting feeding and the hospital, with one declined. A reflective section shows how settling the word removed raised the count from 26 to 31. The final section names undercounting and incomplete pump data as limits.
Reading the NURS 8705 Week 2 rubric
Problem statement drafts at this stage are usually assessed on clarity, precision, evidence and boundaries. A one-sentence statement that names event, setting, period and consequence scores higher than a paragraph describing a broad concern. Faculty look for local data with a stated source and for published evidence that places the local figure in context. Exclusions and a fixed window show that the writer has thought about how the statement could be misread. Leaving causes out of the statement is often credited explicitly. When a marked copy is part of the assignment, thoughtful responses to each comment, including a reasoned refusal, demonstrate scholarly judgment. Graders also notice when the writer explains how a definition change altered the count.
Common NURS 8705 Week 2 mistakes, and how to avoid them
Draft statements often run to several sentences and quietly contain more than one problem. Others use ordinary words, such as removed or delayed, that the writer understands precisely and the reader does not. Some name a cause in the statement itself, which commits the project before any evidence is gathered. Read your sentence as someone from another unit would, and ask how each key word could be counted. Replace any word that could mean two things. Check that every number has a source you could show a faculty reader. Our writers can draft a problem statement for the practice issue you are developing, with supporting sentences and clear exclusions.
Get a NURS 8705 Week 2 example written to your instructions
Send the statement prompt along with any template your section distributes and the length it expects, and an example matched to those constraints comes back to you. First custom one is free, turned around inside 24 to 48 hours. Counts pulled from your own record system stay in your custody; what travels is the shape of the sentence, never the numbers inside it.
More NURS 8705 papers and DNP samples
- NURS 8705 Week 1: Practice Problem Post
- NURS 8705 Week 3: Problem Statement Critique
- NURS 8705 Week 4: Evidence Brief Example
- NURS 8705 Week 5: Significance Argument
- NURS 8705 Week 6: Population and Setting Memo
- NURS 8705 Week 7: Setting Size Discussion Post
- NURS 8705 Week 8: Scope Revision Memo
- NURS 8705 Week 9: Preliminary Search Record
- NURS 8705 Week 10: Revised Problem Statement
- NURS 8705 Week 11: Next-Step Plan Example
- NURS 8600 Week 2: DNP project launch brief
- NURS 8546 Week 2: Needs Assessment Paper
- NURS 8544 Week 2: Learning Problem Analysis
- NURS 8542 Week 2: Program Data Analysis
NURS 8705 Week 2 questions, answered
Why is the statement only one sentence?
Because a statement that needs two sentences usually holds two problems, and a reader will pick the one you did not mean. The example keeps a single main clause and lets the modifiers carry population, setting and window. Sections vary on length, and some accept a short paragraph, so whatever your prompt specifies is the constraint that actually applies.
Do the numbers in the example come from a real unit?
No. The unit size, the count and the six-month window were assembled to demonstrate a proportion, not to report anything. Figures from your own facility are pulled by you under whatever permission your site requires, and they never pass through here. The transferable part is where a number belongs in the page and how much of a denominator a reader needs to see.
Is the marked copy part of what students submit?
It is not. The annotated version was added so the page can show which clauses a reader tends to challenge, which is more useful than a clean draft that looks settled. In most sections you submit the draft alone and receive comments afterward, and how those comments arrive differs from classroom to classroom.
Where can I find a free NURS 8705 Week 2 sample paper?
You can read the full statement, its supporting sentences and the annotated marked copy above at no charge.
Why does the NURS 8705 Week 2 statement leave out a cause?
Because naming agitation, securement or restraint use in the statement would assume an answer the project has not yet sought, so causes are left to later stages.