| Course | NURS 8720 Doctoral Seminar II |
|---|---|
| Week | Week 3 |
| Paper type | Design comparison paper |
| Length | About 1,040 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 8720 Week 3
One Unit Watched Monthly or Two Units Compared: Choosing a Design for Nurse-Led Early Mobilization, With the Losing Option Left on the Page
Student Name
College of Nursing, Walden University
NURS 8720: Doctoral Seminar II
Instructor Name
Month Day, Year
One Unit Watched Monthly or Two Units Compared: Choosing a Design for Nurse-Led Early Mobilization, With the Losing Option Left on the Page
The Problem Both Designs Must Answer
Both designs below answer the same question: will a protocol run by bedside nurses raise how often ventilated patients in a 14-bed community ICU get as far as sitting up over the edge of the bed, moving the unit from fewer than one in five qualifying days toward half of them? The question is about change in one unit's practice. It is not about patient outcomes months later, which the evidence review found larger trials have already addressed. Both designs are realistic for a doctoral project, and both would produce a defensible report. They differ in what they can claim and in what they demand.
The comparison draws on an overview of study types for improvement interventions, which sets out the strengths and weaknesses of designs from simple before-and-after studies to controlled and randomized designs (Portela et al., 2015).
Design A: Single-Unit Improvement Design With Monthly Run Charts
The protocol is introduced in the project unit in January after four months of retrospective baseline. The measure is recorded daily and plotted monthly on a run chart, with weekly points during the first two months to show early change. The protocol is adjusted through small cycles of testing, each changing one element and recording what happened. A sustained shift or trend is judged using standard run chart rules, which can distinguish a signal of change from random variation with as few as ten to twelve points (Perla et al., 2011). Process measures, such as the share of mornings on which the safety screen was completed, are charted alongside the main measure, and adverse events during mobilization are counted as a balancing measure.
Design A also asks little of anyone outside the unit, which matters in a community hospital where quality staff support many projects at once. All of its data come from the unit's own flowsheet, and its analysis is visual, so the people doing the work can read the chart themselves at a staff meeting without waiting for a report. That accessibility is part of the design's purpose, since improvement depends on staff seeing the effect of their own changes quickly.
Design B: Controlled Before-and-After With a Sister ICU
The same protocol and measures are used in the project unit. A second ICU, at a 120-bed sister hospital in the same health system, serves as a comparison. The comparison unit does not introduce the protocol; its ventilator days are reviewed over the same months using the same definitions. The change in the project unit is compared with the change in the comparison unit, so that a seasonal or hospital-wide shift that touched both units does not get credited to the protocol. Controlled before-and-after designs are stronger than uncontrolled ones because they account for some secular trends, though they remain vulnerable when the two units differ in ways that change over time (Shadish et al., 2002).
Design B also has practical demands that are easy to underestimate. The two units would need to define an eligible day identically, record the scale level in the same way and extract data on the same schedule, which means training staff in a unit that gains nothing from the project. If the comparison unit's recording were less complete, its apparent stability could simply reflect missing data.
Comparison on Five Criteria
Table 1 compares the designs on five criteria fixed before either was chosen.
Table 1
Two Candidate Designs Compared on Five Criteria
| Criterion | Design A: single unit, run charts | Design B: controlled before-and-after |
|---|---|---|
| What it can claim about cause | That practice changed after the protocol began; leaves open whatever else shifted in those months | That practice changed more than in a comparison unit; stronger against hospital-wide trends |
| What it demands of the project unit | Daily recording, monthly charts, cycle notes | The same |
| What it demands of others | Nothing outside the unit | Monthly chart review in a second hospital by staff who gain nothing from it |
| How it handles changes during the project | Adjusts the protocol in cycles, which is its purpose | Changes weaken the comparison, since the intervention is no longer fixed |
| What happens if the comparison unit changes practice | Not applicable | The comparison is lost or contaminated |
The criteria were fixed before the designs were scored, so that the preferred design did not shape the measures used to judge it.
Choosing
The project will use design A. The deciding criteria are the fourth and fifth. The protocol is expected to change: the first version of the morning safety screen, the time of day mobilization is attempted and the way respiratory therapists are called will almost certainly need adjusting, and improvement cycles exist to make those adjustments. A controlled design works best when the intervention is fixed, and adjusting it repeatedly would make the comparison harder to interpret. The fifth criterion turned out to be decisive in practice. When the comparison unit's nurse manager was asked about participating, she reported that her unit is planning its own mobility initiative in the spring, which would contaminate the comparison just as the project reached its main months.
Design B is not abandoned without cost. Its claim about cause is stronger, and a reader of the final report will reasonably ask whether something else in the hospital changed during the project. Design A answers that question less well. To reduce the gap, the project will record every other practice change in the unit during the project period, including sedation protocols, staffing changes and equipment, and report them alongside the run charts. It will also chart a second process measure that the protocol should not affect, the share of days with a documented sedation assessment, to see whether general documentation improved at the same time. These steps do not make design A as strong as a controlled design, but they let a reader judge the most obvious alternative explanations.
What Would Change the Choice
If the sister hospital postponed its own initiative, and if the protocol stabilized after the first two cycles, a controlled comparison could be added for the final three months. The project will check both conditions in March and record the decision.
References
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
Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin.
What the NURS 8720 Week 3 instructions ask for
The design paper commonly asks you to compare two realistic ways of carrying out your project and to choose one. State the problem both designs must answer in a single line so the comparison stays fair. Describe each design clearly enough that a reader who knew neither could tell them apart. Fix the comparison criteria before scoring, and include what each design can claim about cause, what it demands of your unit and of others and how it handles change during the project. Present the comparison in a table. Choose, name the criteria that decided it and state what the losing design would have given you. Explain how you will reduce that loss and what would make you revisit the choice.
How this NURS 8720 Week 3 example is built
The opening section restates the question, describes both designs as defensible and cites Portela and colleagues. Design A's section describes the baseline, the cycles, the Perla shift and trend rules and the process and balancing measures, then adds a paragraph on its accessibility to staff. Design B's section describes the sister ICU comparison, cites Shadish and colleagues and adds the practical demands on a unit that gains nothing. Table 1 compares five criteria. The choosing section names changing protocols and the sister unit's planned initiative as decisive, then lists steps to record other practice changes and chart sedation documentation. A final section names conditions for adding a comparison later.
Where the marks sit in the NURS 8720 Week 3 rubric
Design comparisons are usually assessed on fairness, accuracy about each design's strengths and weaknesses, clarity of the decision and honesty about what is lost. Faculty reward papers that set criteria before choosing, so the choice cannot shape the criteria. Credit rises when the writer describes each design's causal claims accurately and does not overstate the chosen one. A table that makes the comparison visible is valued. The strongest submissions name the deciding criterion, describe the practical evidence behind it and say how the weaknesses of the chosen design will be reduced. Stating conditions under which the decision would change shows judgment that graders tend to reward.
NURS 8720 Week 3 help: mistakes that cost marks
Design comparisons often present one strong design and one weak straw man, so the choice was never real. Others describe designs abstractly without applying them to the project's setting. Some choose a design and then never mention its weaknesses again. Pick two designs you could actually run, describe each in the terms of your own unit and write your criteria before deciding. Ask the people who would need to take part in each design what it would cost them. Keep a short list of what your chosen design cannot show and plan how to address each item. Our writers can prepare a design comparison for your project, with a fair table and a clearly argued choice.
Get a NURS 8720 Week 3 example written to your instructions
Send the prompt, the two approaches your section named and any table template it distributes, and a comparison example written to those constraints comes back to you. The first custom one is free, delivered inside 24 to 48 hours. Nothing on this page substitutes for the agreement a real clinic would have to give before either approach could run there.
More NURS 8720 papers and DNP samples
- NURS 8720 Week 1: Project Classification Post
- NURS 8720 Week 2: SMART Aim Statement
- NURS 8720 Week 4: PDSA Model Brief
- NURS 8720 Week 5: Project Alignment Matrix
- NURS 8720 Week 6: Method Defense Reply
- NURS 8720 Week 7: Practice Setting Analysis
- NURS 8720 Week 8: Project Feasibility Analysis
- NURS 8720 Week 9: Design Limitations Post
- NURS 8720 Week 10: Methods Section Draft
- NURS 8720 Week 11: Project Revision Memo
- NURS 8710 Week 3: Inclusion Criteria Memo
- NURS 8705 Week 3: Problem Statement Critique
- NURS 8600 Week 3: DNP as-implemented workflow map
- DNRS 6211 Week 3: Budget worksheet
NURS 8720 Week 3 questions, answered
Can both approaches be judged acceptable?
They can, and saying only that is what loses marks. The example concedes that either would produce a defensible project and then decides anyway, naming the criterion that broke the tie. Graders at this level are reading for a candidate who can commit under uncertainty, so a paper ending in balanced admiration for both options reads as unfinished rather than as fair.
How many criteria belong in the table?
Five works in the example because each one changes something about the eventual project. Ten criteria usually mean several are decorative, and a reader notices when three rows say the same thing in different words. Where a prompt specifies criteria, those govern; where it does not, criteria that would alter the decision if their answers flipped are the ones worth the space.
Where can I find a free NURS 8720 Week 3 sample paper?
The full comparison of the single-unit and controlled designs, with the five-criterion table, is shown above at no cost.
Why does the NURS 8720 Week 3 paper reject the controlled design?
Because the protocol will change between cycles, which weakens a fixed comparison, and the sister ICU plans its own mobility initiative that would contaminate the comparison.
How does the paper reduce the single-unit design's weakness?
By recording every other practice change in the unit and charting sedation documentation, a measure the protocol should not affect, to check for general shifts.