| Course | NUR 550 Evidence-Based Practice and Scholarly Inquiry |
|---|---|
| Module | Module 7 |
| Paper type | Implementation plan with protocol, training, timeline and resources (paper) |
| Length | About 1,080 words, 6 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 550 Module 7
Implementation Plan: Putting a Five-Part Delirium Prevention Bundle Into Practice on a 30-Bed Medical Unit
[Student Name]
Southern New Hampshire University
NUR 550: Evidence-Based Practice and Scholarly Inquiry
Implementation Plan
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Implementation Plan: Putting a Five-Part Delirium Prevention Bundle Into Practice on a 30-Bed Medical Unit
The evidence supports a multicomponent bundle to prevent delirium in older medical inpatients, and the i-PARIHS assessment narrowed that bundle to five nursing actions a unit without volunteers can deliver, supported by an experienced facilitator and shift champions. This plan turns that design into operational detail. It specifies each component closely enough that a new nurse could carry it out on the first night, changes the one system default most likely to cause delirium, tests the bundle on ten beds before spreading it and budgets the staff time the change will actually take.
The Bundle Protocol
The bundle applies to every patient aged 70 or older from admission to discharge. Its components adapt the risk-factor protocols tested in the original multicomponent trial, which targeted cognition, sleep, mobility, vision, hearing and hydration (Inouye et al., 1999). Table 1 defines each one.
Table 1
Delirium Prevention Bundle Protocol
| Component | What staff do | When | Who | Documented in |
|---|---|---|---|---|
| Orientation | State name, role, day and plan at each contact; update whiteboard with date and nurse; encourage family photos and conversation | Every contact; board each morning | RN, NA | Bundle flowsheet |
| Mobility | Walk or sit out of bed three times daily; active range of motion if unable to walk | Mid-morning, after lunch, early evening | NA with RN; PT for high fall risk | Mobility log |
| Sleep routine | Hallway lights lowered and conversations moved away from doors from 10 p.m.; warm non-caffeinated drink and relaxation music offered; care clustered to allow a four-hour sleep window | Nightly | RN, NA | Night checklist |
| Hydration | Offer fluids hourly while awake unless restricted; water within reach | Hourly, 8 a.m. to 8 p.m. | NA | Intake record |
| Vision and hearing | Glasses on and clean; hearing aids in with working batteries; pocket amplifier if none | Each morning and when needed | NA | Bundle flowsheet |
Note. RN = registered nurse; NA = nursing assistant; PT = physical therapist.
Screening and the Order Set
Every patient in the bundle is screened with the 4AT once daily at 8 p.m., when fluctuating confusion is more likely to appear, and whenever a nurse notices a change. The 4AT was chosen because it performs well without special training, with pooled sensitivity and specificity of 0.88 (Tieges et al., 2021). A positive screen triggers a call to the hospitalist to look for causes such as infection, medicines, retention or pain.
One system change is included because it removes a common trigger at its source. The unit's admission order set currently offers diphenhydramine and zolpidem as default as-needed sleep medicines for all patients. First-generation antihistamines and sedative-hypnotics both appear on the Beers list of drugs older adults should generally not receive, since they are tied to delirium and falls (American Geriatrics Society Beers Criteria Update Expert Panel, 2023). With the hospitalist lead and pharmacy, pharmacy will rebuild the order set so that, for anyone 70 or older, neither drug is preselected; the non-drug sleep routine becomes the default instead.
Training
Training is short and practical. Every registered nurse and assistant attends a 30-minute session during a shift huddle, covering why delirium matters, the five components and the flowsheet. Nurses complete a 20-minute 4AT practice with two recorded patient scenarios. Physical therapy leads a 30-minute session on safe walking and transfers for nursing assistants. Champions receive an additional two hours with the clinical nurse specialist on coaching, data review and running test cycles. With about 60 nursing staff, total training time is roughly 60 staff hours, scheduled over two weeks on all shifts so night staff are included from the start.
Pilot and Test Cycles
The bundle starts on ten beds, one hallway, for four weeks. Each week is a plan-do-study-act cycle: the team predicts what will happen, tries the bundle, reviews completion and screening data and adjusts before the next week (Langley et al., 2009). Likely early adjustments include moving the second walk to fit meal times and assigning hydration rounds to a specific assistant. The pilot will be judged ready to spread when bundle completion reaches 80% on all three shifts for two consecutive weeks. If it does not, the facilitator and champions will narrow or reschedule components rather than spread a bundle the unit cannot sustain, consistent with the framework's emphasis on fitting the innovation to its context (Harvey & Kitson, 2016).
Timeline
Table 2 sets out the sixteen weeks from preparation to full rollout.
Table 2
Sixteen-Week Implementation Timeline
| Weeks | Activities | Lead |
|---|---|---|
| 1-2 | Finalize protocol and flowsheet; revise order set; order supplies; recruit champions | Clinical nurse specialist, manager, pharmacy |
| 3-4 | Staff training on all shifts; 4AT practice; champion preparation | Clinical nurse specialist, PT |
| 5-8 | Ten-bed pilot with weekly test cycles and data review | Champions, clinical nurse specialist |
| 9-12 | Spread to the full unit in two stages | Champions, manager |
| 13-16 | Full operation; biweekly data review; decision on phase two components | Clinical nurse specialist, manager |
Resources
The plan needs no new positions. The main cost is staff time: about 60 hours of training; 15 minutes per shift for one champion, roughly 21 hours a week across all shifts; and four hours a week of the clinical nurse specialist's time. Supplies are modest: whiteboards and wall clocks for 30 rooms, pocket hearing amplifiers, batteries, a relaxation music player per hallway and printed family leaflets, estimated at about $4,500 in total. Informatics support of about 12 hours is needed to build the bundle flowsheet and 4AT fields. The manager has agreed to fund supplies from the unit's quality budget, and the hospital's age-friendly initiative will cover informatics time.
Communication and Ownership
Staff learn of the plan at shift huddles and from a single summary sheet pinned up in the break room, with weekly pilot data displayed by shift. Patients and families receive a short leaflet on admission explaining how they can help, such as bringing glasses and hearing aids and talking with the patient about familiar things. Physicians learn about the order set change through the hospitalist lead. Ownership is explicit: the clinical nurse specialist owns the protocol and data, the manager owns staffing and protected time, champions own shift-level coaching and the pharmacy owns the order set.
Conclusion
This plan specifies what staff do for each of five bundle components, adds daily 4AT screening, removes default sleep medicines for older patients, trains every shift in about 60 staff hours, tests the bundle on ten beds with a clear criterion for spreading and completes rollout in sixteen weeks at modest cost. The evaluation plan in the next module will define how the team will know whether the bundle was delivered and whether it prevented delirium.
References
American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Harvey, G., & Kitson, A. (2016). PARIHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science, 11, Article 33. https://doi.org/10.1186/s13012-016-0398-2
Inouye, S. K., Bogardus, S. T., Charpentier, P. A., Leo-Summers, L., Acampora, D., Holford, T. R., & Cooney, L. M. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients. New England Journal of Medicine, 340(9), 669-676. https://doi.org/10.1056/NEJM199903043400901
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
Tieges, Z., MacLullich, A. M. J., Anand, A., Brookes, C., Cassarino, M., O'Connor, M., Ryan, D., Saller, T., Arora, R. C., Chang, Y., Agarwal, K., Taffet, G., Quinn, T., Shenkin, S. D., & Galvin, R. (2021). Diagnostic accuracy of the 4AT for delirium detection in older adults: Systematic review and meta-analysis. Age and Ageing, 50(3), 733-743. https://doi.org/10.1093/ageing/afaa224
What the NUR 550 Module 7 instructions ask for
The implementation module in NUR 550 usually asks you to describe in detail how your evidence-based change will be put into practice. Prompts commonly require the intervention protocol, the people involved and their roles, training, a timeline, resources and costs, a communication plan and how barriers identified earlier will be addressed. Many sections expect a pilot or small test before full rollout. Plans often run five to seven pages in APA 7 with tables. Write the protocol so specifically that a nurse who missed every meeting could carry it out on the first night, since vague interventions such as increase mobility are the most common reason these plans lose points with graders.
How this NUR 550 Module 7 implementation plan example is built
This sample turns a five-part delirium prevention bundle into an operational plan for a composite medical unit. A protocol table defines what staff do for each component, when, who does it and where it is documented. Daily 4AT screening is timed and linked to a response, and the admission order set is revised to remove default sleep medicines, justified by the Beers Criteria. Training is described by audience and totaled at about 60 staff hours. A ten-bed pilot runs in weekly test cycles with a numeric criterion for spreading, followed by a sixteen-week timeline, a costed resource list and named owners. Five real sources support it, from the original trial to the Beers Criteria and the improvement guide used for test cycles.
Where the NUR 550 Module 7 rubric puts the points
Implementation plans are generally graded on the specificity of the intervention, clarity of roles, adequacy of training, realism of the timeline, identification and costing of resources, communication with stakeholders, alignment with the chosen framework and writing. Specificity carries the most weight: a protocol with actions, times, roles and documentation earns far more than a description of intent. Graders also look for a pilot with a stated criterion for success and for resources expressed in hours and dollars. Plans that address earlier-identified barriers directly, such as including night staff in training, show that the milestones were integrated rather than written separately. Tables for the protocol and timeline help graders find these elements quickly.
NUR 550 Module 7 help: the mistakes that cost points
Implementation plans often go wrong by describing the intervention in a sentence, by assigning tasks to the team rather than to roles, or by skipping resources and costs. Another frequent gap is a pilot with no criterion for deciding whether to spread. Build a protocol table, name who does each action and when, total the training time, define the pilot and its success criterion, set a timeline with leads and cost the supplies and staff time. Include at least one system change if your problem allows, since system changes last longer than training. If your project is different, we can write a detailed implementation plan for it.
Get NUR 550 Module 7 written to your instructions
Send your earlier milestones, the implementation plan guidelines and the rubric. A plan with a protocol table, named roles, training hours, a pilot with a success criterion, a timeline and costed resources is ready in 24 to 48 hours, and the first one is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
More NUR 550 papers and related MSN samples
- NUR 550 Module 1 Discussion: Framing Delirium on a Medical Unit as a Practice Problem
- NUR 550 Module 2 PICOT Question Paper: An Answerable Question About Delirium Prevention
- NUR 550 Module 3 Milestone One: A Documented, Repeatable Literature Search on Delirium Prevention
- NUR 550 Module 4 Critical Appraisal: Appraising the Landmark Multicomponent Delirium Prevention Trial
- NUR 550 Module 5 Evidence Synthesis: What the Evidence on Multicomponent Delirium Prevention Says Together
- NUR 550 Module 6 Milestone Two: Applying the i-PARIHS Framework to a Delirium Prevention Project
- NUR 550 Module 8 Evaluation Plan: Evaluating a Delirium Prevention Bundle With RE-AIM
- NUR 550 Module 9 Final Project: A Complete Evidence Translation Proposal for Delirium Prevention
- NUR 550 Module 10 Journal: The Gap Between Knowing the Evidence and Changing Practice
- NUR 531 Module 5 Root Cause Analysis Paper: A Root Cause Analysis of a Healthcare-Associated Legionnaires' Case
- NUR 520 Module 4 Milestone One: Describing COPD and Smoking in Coös County
- NUR 506 Module 1 Clinical Question Discussion
- NUR 530 Module 3 Milestone One: A Clinical Microsystem Assessment of a Medical Unit
NUR 550 Module 7 questions, answered
Where can I find a free NUR 550 Module 7 Implementation Plan sample?
The complete plan on this page is free to read: a five-part delirium prevention bundle with a protocol table, 4AT screening, an order set change, training hours, a ten-bed pilot, a sixteen-week timeline and costed resources.
How detailed should an implementation plan be?
Detailed enough that a nurse who missed every meeting could carry it out: actions, timing, responsible role and where each is documented.
Why pilot an evidence-based change first?
A small test lets the team find and fix problems in weekly cycles before spreading, and a clear criterion tells them when the change is ready.
What resources should an implementation plan include?
Staff time for training and ongoing roles, supplies, informatics support and any other costs, with who will fund each.
Why change an order set in a delirium project?
Default sleep medicines such as diphenhydramine are on the Beers list for older adults, and removing them from the default removes a common trigger at its source.