NURS 8705 Week 8 Scope Revision Memo Example

Course	NURS 8705 Doctoral Seminar
Week	Week 8
Paper type	Scope revision with memo
Length	About 1,020 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 8

From Four Problems to One: A Scope Revision Narrowing Stroke Transitions Across a Health System to Fourteen-Day Follow-Up at One Stroke Clinic

Student Name

College of Nursing, Walden University

NURS 8705: Doctoral Seminar

Instructor Name

Month Day, Year

What this page is doingThe title states the before and after of the revision and its final boundary, so the reader can follow the subtraction the paper defends.

From Four Problems to One: A Scope Revision Narrowing Stroke Transitions Across a Health System to Fourteen-Day Follow-Up at One Stroke Clinic

The Original Statement

My problem statement from week 2 read: Patients discharged after stroke or transient ischemic attack across our health system experience fragmented transitions, with high readmission, poor medication adherence, missed follow-up and inadequate education. It runs 26 words and seemed compact when I wrote it. Faculty feedback and my own attempt to plan measurement for it showed that it contains four separable problems: readmission, adherence to secondary prevention medication, completion of follow-up visits and the quality of discharge education. Each has its own measures, its own owners and its own literature. A project addressing all four across a five-hospital system would be a program of research, not a doctoral project.

The Revised Statement

In the past twelve months, 46% of adults discharged home after a minor stroke or transient ischemic attack from the regional medical center did not complete a visit at its outpatient stroke clinic within 14 days of discharge.

The revised statement keeps one of the four problems, follow-up completion, and fixes it to one hospital, one clinic, one population and one window. The 14-day window reflects the high early risk of recurrent stroke after a minor stroke or transient ischemic attack and the guideline emphasis on prompt evaluation and initiation of secondary prevention (Kleindorfer et al., 2021).

What this page is doingPlacing the original and the revision one after the other lets a reader count what was removed before reading why.

The Cuts

Cut 1: Readmission. Removed on grounds of measurability. Readmission after stroke has many causes, from infection to falls to a second stroke, and a change in follow-up practice would affect only some of them. A project measuring readmission would need a large sample to detect any change and would struggle to attribute it. A reader loses a measure that hospital leaders care about. The narrowed question still matters because a completed early visit is the point at which recurrent stroke risk is assessed and prevention is adjusted, which is one plausible route to fewer readmissions, even if the project does not measure that route directly.

Cut 2: Medication adherence. Removed on feasibility. Measuring adherence requires pharmacy fill data or patient report, neither of which the stroke clinic currently collects, and the system's outpatient pharmacy serves only some patients. A reader loses the outcome most directly linked to prevention. The narrowed question keeps the visit at which adherence is checked and barriers discussed, so adherence remains something the project's intervention could affect, even though it will not be the outcome.

Cut 3: Discharge education. Removed because it belongs to a different service line. Stroke education at discharge is designed and delivered by inpatient nursing and the stroke coordinator, while follow-up scheduling is run by the outpatient clinic and its schedulers. Combining them would make the project depend on two departments with different leaders and budgets. A reader loses the chance to improve what patients know when they leave. The narrowed question does not need education to improve, because a patient can be scheduled and reminded without knowing much about stroke.

Cut 4: The other four hospitals. Removed on feasibility. The system's other hospitals send patients to three different outpatient settings, two of them outside the system. Only the regional medical center refers to the stroke clinic directly through the electronic record. Keeping all five hospitals would mean studying five referral processes.

Each cut was tested against one question before it was made: would the remaining statement still describe something the stroke clinic could change within a year? Readmission failed that test because the clinic does not control most of its causes. Adherence failed because the clinic cannot yet measure it. Education failed because another department owns it. The other hospitals failed because their patients do not reach this clinic. Follow-up completion passed, because the clinic receives the referrals, schedules the visits and can see within days whether a patient arrived. Applying the same question to every cut kept the revision from becoming a matter of preference about which problems seemed most interesting.

Why the Narrow Question Still Answers Something

A system-wide transitional care model for stroke has already been tested at scale. In a large pragmatic trial in North Carolina, a comprehensive post-acute stroke transitional care model did not improve patients' functional status at 90 days compared with usual care, and many patients in the intervention hospitals did not receive the early follow-up visit the model called for (Duncan et al., 2020). That finding suggests that the step of getting patients to an early visit is itself a weak link, worth studying on its own before larger models are layered over it. A project that explains and reduces missed early visits at one clinic addresses a narrow problem but one that larger efforts depend on.

Guidelines for early management of acute ischemic stroke also stress organized systems of care that continue after discharge (Powers et al., 2019). The narrowed question asks whether one part of that system works for the patients it serves.

What this page is doingUsing a published trial to show that the remaining question is a known weak point turns the narrowing from a retreat into a choice.

What the Narrowed Statement Can No Longer Claim

The revised statement cannot claim to improve stroke outcomes, readmission or adherence, and any later paper must not imply that it does. It cannot claim to represent the health system, since the other hospitals refer differently. It cannot speak for patients with moderate or severe strokes, who are usually discharged to rehabilitation facilities and follow different paths. And it cannot address education, even though a reader may assume that missed visits reflect poor understanding.

What it can claim is a measured gap, 46% of eligible patients without an early visit, in a defined population at one site with a clear referral process. That is a smaller claim than the original, and it is one the project can test.

The narrowing also changes what counts as success. Under the original statement, almost any improvement anywhere in the system could have been described as progress. Under the revised one, success is a single, checkable change: a smaller share of eligible patients leaving without a completed visit at 14 days. That is less impressive to describe and far easier to verify, which is the trade the revision makes deliberately.

References

Duncan, P. W., Bushnell, C. D., Jones, S. B., Psioda, M. A., Gesell, S. B., D'Agostino, R. B., Sissine, M. E., Coleman, S. W., Johnson, A. M., Barton-Percival, B. F., Prvu-Bettger, J., Calhoun, A. G., Cummings, D. M., Freburger, J. K., Halladay, J. R., Kucharska-Newton, A. M., Lundy-Lamm, G., Lutz, B. J., Mettam, L. H., . . . Rosamond, W. D. (2020). Randomized pragmatic trial of stroke transitional care: The COMPASS study. Circulation: Cardiovascular Quality and Outcomes, 13(6), Article e006285. https://doi.org/10.1161/CIRCOUTCOMES.119.006285

Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., Lennon, O., Meschia, J. F., Nguyen, T. N., Pollak, P. M., Santangeli, P., Sharrief, A. Z., Smith, S. C., Jr., Turan, T. N., & Williams, L. S. (2021). 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke, 52(7), e364-e467. https://doi.org/10.1161/STR.0000000000000375

Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., Jauch, E. C., Kidwell, C. S., Leslie-Mazwi, T. M., Ovbiagele, B., Scott, P. A., Sheth, K. N., Southerland, A. M., Summers, D. V., & Tirschwell, D. L. (2019). Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 50(12), e344-e418. https://doi.org/10.1161/STR.0000000000000211

The Walden NURS 8705 Week 8 instructions

Revision weeks in this seminar typically ask you to narrow a problem statement and explain what you gave up. Present the original statement, the revised statement and a memo between them. In the memo, give each cut a heading and a paragraph stating what was removed, what a reader loses and why the remaining question still matters. Use different grounds where they apply, such as measurability, feasibility or ownership by another service. Apply a consistent test to every cut so the revision does not look like preference. Use evidence to show that the narrowed question is worth answering. Close with what the revised statement can no longer claim, so later papers do not drift back toward the original scope.

How the NURS 8705 Week 8 example is put together

The original 26-word statement is quoted and separated into its four problems. The revised statement follows with its 14-day window, supported by Kleindorfer and colleagues. Four italic cuts explain the removal of readmission, adherence, education and the other hospitals, each with what is lost and why the remaining question survives. A paragraph sets out the single test applied to every cut. A section uses Duncan and colleagues' COMPASS trial, where many patients missed the early visit, and Powers and colleagues on organized systems of care to defend the narrow question. The final section lists claims the revision gives up and explains how success becomes checkable.

NURS 8705 Week 8 rubric: what earns full marks

Scope revisions are usually assessed on the logic of each cut, honesty about what is lost and the strength of the case that the narrowed question still matters. Faculty reward memos that apply a consistent test rather than cutting whatever seems hardest. Credit rises when each cut names a specific ground, such as measurability or ownership, and when the writer states the cost of the cut plainly. Evidence that the remaining question is a known weak point strengthens the revision considerably. A closing list of claims the statement can no longer make shows discipline. Clear presentation of before and after versions helps graders follow the change. Graders also look for evidence that the narrowed question connects to a larger concern.

NURS 8705 Week 8 help from the desk

Scope revisions often trim words without removing problems, so the statement looks shorter but still contains several questions. Others narrow so far that the remaining question no longer matters to anyone. Some never say what was lost. List every separate problem in your original statement and ask, for each, whether your setting could change it within a year. Keep the one that passes and write down what the others would have offered. Find evidence that your remaining question is a step larger efforts depend on. Our writers can prepare a scope revision for your problem statement, with a memo that defends each cut. Keep the original statement on the page so the cuts are visible.

Get a NURS 8705 Week 8 example written to your instructions

Send the original statement, any comments you received and the revision prompt, and an example showing both versions with the reasoning between them comes back to you. First custom one is free, inside 24 to 48 hours. Anything a review board must eventually see is drafted by you, start to finish.

More NURS 8705 papers and DNP samples

NURS 8705 Week 8 questions, answered

How much narrowing is enough?

Enough that one candidate could finish the work inside the time a project sequence allows, which usually means one population, one setting and one measurable question. The example ends at a single follow-up contact for one clinic. Faculty judgment varies, and a statement that looks narrow to one reader can look unmanageable to another with more experience of the setting.

Does the memo go to the same reader as the statement?

In most sections both are submitted together, which is why the example keeps them formatted as one document with clear divisions rather than as separate files. The memo is written for somebody who has read the original, so it does not re-explain the problem area and spends its words on the reasoning instead.

Is it a failure to have started too broad?

No, and revision weeks exist partly because starting broad is the normal path. What draws comment is arriving at this week with the same statement submitted earlier and a memo arguing it was already narrow. The example takes a genuinely oversized statement and cuts three quarters of it, which is closer to the usual scale of the change.

Where can I find a free NURS 8705 Week 8 sample paper?

The original and revised statements and the memo explaining each cut are published above in full, and reading them is free.

Which problem does the NURS 8705 Week 8 revision keep?

Completion of a stroke clinic visit within 14 days of discharge after a minor stroke or transient ischemic attack, at one hospital and one clinic.