NURS 8720 Week 11 Project Revision Memo Example

Course	NURS 8720 Doctoral Seminar II
Week	Week 11
Paper type	Revision memo
Length	About 860 words, 5 pages
Format	Memo, APA 7 citations
School	Walden University
Program	Doctor of Nursing Practice (DNP)
Updated	October 2026

Free sample paper for NURS 8720 Week 11

Memorandum

To: Doctoral Seminar II Faculty; project chair

From: DNP student

Date: Month Day, Year

Re: Four changes to the early mobilization project this term, what caused each and what each cost

Purpose

This memo records what changed in my project's approach between the first week of the seminar and the last. It is organized by change rather than by week, so that each change can be read with what preceded it, what caused it and what it cost. Four changes carry the term. The project at the end is smaller, more precisely measured and more honest about what it can claim than the one I described in week 1.

Change 1: The Measure

Before. In week 1 I planned to measure minutes of mobilization per ventilated patient per day, on the assumption that more mobilization was the goal.

Cause. Two things moved me. Last seminar's review had already shown me that pushing mobilization higher in units that already did plenty bought nothing in the biggest trial except extra adverse events (TEAM Study Investigators, 2022), so intensity was the wrong target for a unit trying to move from rare to regular mobilization. And the feasibility analysis showed that minutes per session would need time-stamped entries the record cannot report without an analyst.

After. The project now counts qualifying ventilator days on which a patient got at least as far as sitting up at the bedside, logged once daily as a scale level in one flowsheet field (Hodgson et al., 2014).

Cost. The new measure cannot show how long or how intense mobilization was, and it treats a day at level 3 the same as a day at level 8. A reader interested in dose will learn little from it.

Change 2: The Baseline

Before. The aim's baseline of 18% came from a four-month retrospective review of free-text notes, and I planned to use it as the comparison on the run chart.

Cause. The alignment matrix showed that the retrospective baseline was a single pooled figure collected by a different method, so it could not serve as a run of baseline points on the same chart as prospective data (Perla et al., 2011).

After. For four weeks before the first cycle, staff now record the scale while nothing else changes, giving a baseline measured exactly like the project data.

Cost. The project lost four weeks of improvement time, and the prospective baseline has only four weekly points.

What this page is doingEach change is written as before, cause, after and cost, which keeps the memo from becoming a diary and makes each decision traceable to the work that forced it.

Change 3: The Design

Before. After the design comparison, a classmate made the case in week 6 for comparing my unit with the ICU at our sister hospital, and I took it seriously.

Cause. That ICU intends to start mobilizing its own patients in the spring, so it would stop being a fair comparison partway through; Portela et al. (2015) stress that a controlled design only works while the comparison group stays untouched by the change.

After. The design remains single-unit, with contextual measures, staffing, sedation documentation and a record of other practice changes, charted alongside the main measure.

Cost. The project cannot rule out hospital-wide changes as an explanation, and it now has a known concurrent change, the new sedation order set starting the same month, whose effect it cannot separate from the protocol's.

Change 4: The Scope

Before. Week 1's description included patients on noninvasive ventilation as well as invasive ventilation, on the reasoning that both are immobile and at risk.

Cause. The evidence the project rests on concerns invasively ventilated patients, and the safety criteria were written for them. Noninvasive patients also have different routines and risks, and including them would have mixed two populations in one measure. Their ventilation is often intermittent, which makes an eligible day hard to define, and their mobilization is usually limited by mask fit and oxygen needs rather than by sedation.

After. The project includes only patients receiving invasive ventilation for at least 24 hours.

Cost. Noninvasive patients, some of whom spend days in bed, are outside the project. The final report will name this as a gap for future work.

What Did Not Change

The classification of the project as quality improvement held throughout the term. It was questioned twice in discussion, once from the evaluation side and once from the research side, and both questions improved how I explain it without changing it. The core of the intervention, a nurse-led protocol with a morning safety screen, also held; what changed around it was how it would be measured, compared and bounded.

Looking back, the changes share a pattern. Each one made the project smaller or more modest in what it claims, and each was forced by evidence or by the setting rather than by preference. None of them changed what the unit's patients will experience, which is a morning safety check and a better chance of sitting up while they are on the ventilator. The project lost ambition in its measurement and gained credibility, and I think that trade was the right one for a project that has to be run by the people already working in the unit.

Next Steps

The methods section drafted in week 10 reflects all four changes. Before the next seminar, the project chair will review it alongside this memo, and the hospital's quality improvement review will receive the final version.

References

Hodgson, C., Needham, D., Haines, K., Bailey, M., Ward, A., Harrold, M., Young, P., Zanni, J., Buhr, H., Higgins, A., Presneill, J., & Berney, S. (2014). Feasibility and inter-rater reliability of the ICU Mobility Scale. Heart & Lung, 43(1), 19-24. https://doi.org/10.1016/j.hrtlng.2013.11.003

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895

Portela, M. C., Pronovost, P. J., Woodcock, T., Carter, P., & Dixon-Woods, M. (2015). How to study improvement interventions: A brief overview of possible study types. BMJ Quality & Safety, 24(5), 325-336. https://doi.org/10.1136/bmjqs-2014-003620

TEAM Study Investigators and the ANZICS Clinical Trials Group. (2022). Early active mobilization during mechanical ventilation in the ICU. New England Journal of Medicine, 387(19), 1747-1758. https://doi.org/10.1056/NEJMoa2209083

The Walden NURS 8720 Week 11 instructions

The closing memo in this seminar typically asks you to record how your project changed over the term and why. Organize the memo by change rather than by week, so it does not become a diary. For each change, state what the project looked like before, what caused the change, what it looks like now and what the change cost. Cite a source only where a reading actually prompted a decision. Include changes to measures, baseline, design and scope if they happened. Say what did not change and why, since stable elements matter as much as revised ones. Close with next steps, such as review by your project chair or your organization's oversight process.

Inside the NURS 8720 Week 11 example

The purpose section explains the memo's structure. Change 1 moves the measure from minutes to days at scale level 3, citing the TEAM trial and Hodgson and colleagues, and notes that dose information is lost. Change 2 replaces the retrospective baseline with four prospective weeks, citing Perla and colleagues. Change 3 records the classmate's case for a comparison unit and the decision to stay single-unit, citing Portela and colleagues, noting the overlapping sedation change as a cost. Change 4 limits the scope to invasive ventilation and explains why noninvasive patients differ. A section names what held, the classification and the protocol's core, and reflects on the pattern of changes. Next steps close the memo.

Where the marks sit in the NURS 8720 Week 11 rubric

Revision memos are usually graded on clarity, honesty about what changed and why and evidence of learning across the term. Faculty reward memos that link each change to a specific cause, such as a reading, a classmate's challenge or a feasibility finding. Credit rises when the cost of each change is stated, since every revision gives something up. Memos organized by change rather than chronology are easier to follow and usually score better. Recognizing what did not change, and why, shows judgment. A short reflection on the pattern of changes demonstrates the kind of thinking the seminar aims to build, and graders notice when citations are used only where they mattered.

NURS 8720 Week 11 help from the desk

Revision memos often retell the term week by week, or list changes without saying what caused them. Others present every change as an improvement and never mention what was lost. Some cite many sources that did not actually change anything. Make a list of the decisions in your final methods that differ from your first week, then trace each to the moment it changed. Write one sentence on what each change cost. Our writers can prepare a revision memo for your project, organized by change and honest about what each decision gave up. Keep the memo to two pages so a busy chair will read it.

Get a NURS 8720 Week 11 example written to your instructions

Send the memo prompt, the page limit and whichever earlier papers the assignment names, and a revision memo example written to that shape comes back to you. The first custom one is free, delivered inside 24 to 48 hours. Where the memo must reference specific earlier papers, those references are written into the example at the points they belong.

More NURS 8720 papers and DNP samples

NURS 8720 Week 11 questions, answered

Where can I find a free NURS 8720 Week 11 sample paper?

The finished memo, all four changes with their causes and costs, can be read above without charge.

What was the biggest change in the NURS 8720 Week 11 memo?

The measure, which moved from minutes of mobilization per patient to the share of qualifying ventilator days on which a patient sat up at the bedside or better.

What did the design change cost?

Keeping a single-unit design means hospital-wide changes cannot be ruled out, and the February change to sedation orders is tangled up with the protocol's effect.

Why was the scope narrowed to invasive ventilation?

Because the evidence and safety criteria concern invasively ventilated patients, and noninvasive patients have different routines, risks and intermittent ventilation that make eligible days hard to define.

What stayed the same across the term?

The classification as quality improvement and the core of the intervention, a nurse-led protocol built around a morning safety screen.