| Course | NUR 550 Evidence-Based Practice and Scholarly Inquiry |
|---|---|
| Module | Module 9 |
| Paper type | Evidence translation proposal (final project) |
| Length | About 1,140 words, 7 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 550 Module 9
Final Project: An Evidence Translation Proposal for a Nurse-Delivered Delirium Prevention Bundle on a Medical Unit
[Student Name]
Southern New Hampshire University
NUR 550: Evidence-Based Practice and Scholarly Inquiry
Final Project
[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.
Final Project: An Evidence Translation Proposal for a Nurse-Delivered Delirium Prevention Bundle on a Medical Unit
Executive Summary
About one in six patients aged 70 and older on the unit develop acute confusion during their stay, and most of the unit's falls involve these patients. Strong, consistent evidence shows that bundling several non-drug measures cuts delirium among older medical patients by about two-fifths and lowers falls too. This proposal asks for approval to implement a five-part, nurse-delivered bundle with daily 4AT screening, a revised admission order set, a ten-bed pilot and a sixteen-week rollout, at a supply cost of about $4,500 and no new positions, evaluated with RE-AIM against a screening baseline and a comparison unit. The main risk, delivering the bundle without volunteers, is addressed through facilitation by the unit's clinical nurse specialist and shift champions.
The Problem
Delirium, an acute disturbance of attention and thinking, is common in hospitalized older adults, often missed, costly and associated with death and loss of independence; prevention through several non-drug measures is the most effective strategy known (Inouye et al., 2014). On this unit, a chart audit of 110 patients aged 70 or older found 18 with documented acute confusion after admission, and seven of eleven falls in the same period involved a confused patient. No one screens for delirium systematically, and the admission order set offers sleep medicines by default.
Question and Evidence
The project answers this PICOT question: for adults 70 and older admitted to an acute medical unit, does a nurse-delivered multicomponent delirium prevention bundle, compared with usual care, reduce new delirium found on daily 4AT screening before discharge? A documented search of three databases retained nine sources. Table 1 condenses what they support.
Table 1
What the Evidence Supports
| Question | Verdict | Key sources |
|---|---|---|
| Does bundled prevention reduce delirium? | Yes, by roughly 40%, moderate certainty | Burton et al. (2021); Inouye et al. (1999); Hshieh et al. (2018) |
| Does it reduce falls? | Yes, consistently | Hshieh et al. (2018) |
| Does it reduce deaths? | Little or no effect shown | Burton et al. (2021) |
| Can nurses screen reliably each day? | Yes, with the 4AT (sensitivity and specificity 0.88) | Tieges et al. (2021) |
| Can it work outside research settings? | Yes, usually with volunteer support | Hshieh et al. (2018) |
Framework and Bundle Design
The i-PARIHS framework, which treats facilitation of the innovation, its recipients and their context as the core of implementation (Harvey & Kitson, 2016), shaped three design decisions. The innovation was narrowed to five actions nurses and assistants can deliver: orientation whenever staff enter the room, three walks daily, a sleep routine without drugs, hourly fluids while awake and glasses and hearing aids in use. Recipients' barriers, including night staff feeling left out and uncertainty about who walks patients, are met with night-shift champions and joint training with physical therapy. And the context, a unit with a recent falls success and a hospital in an age-friendly initiative that names mentation as a priority (Fulmer et al., 2018), provides both momentum and a reporting route.
Rollout
Preparation, including the order set revision and supply orders, takes two weeks. Training reaches every nursing staff member on all shifts over the next two weeks, about 60 staff hours in total. A ten-bed pilot runs for four weeks in weekly test cycles and spreads when bundle completion reaches 80% on every shift for two consecutive weeks. The whole unit follows over weeks 9 to 12, and weeks 13 to 16 establish routine operation. Accountability sits with three people: the nurse specialist for protocol and data, the manager for champions' protected time and the pharmacist lead for the order set.
Evaluation
The evaluation follows RE-AIM (Glasgow et al., 1999). Reach is the share of eligible patients with the bundle started within a day; effectiveness is delirium incidence on daily 4AT screening and falls per thousand bed-days; adoption is staff trained and shifts with a champion; implementation is bundle completion by shift and 4AT accuracy checks; maintenance is the same measures at six and twelve months. A four-week 4AT baseline replaces the chart audit so that better detection is not mistaken for more delirium, a similar unit screens in parallel as a comparison, and falls during walks, restraint and antipsychotic use, overtime and patient-reported sleep are tracked as balancing measures.
Budget
Direct costs are modest: about $4,500 for whiteboards, clocks, hearing amplifiers, batteries, music players and family leaflets, funded from the unit quality budget. Staff time is the larger cost, about 60 hours of training, 21 hours a week of champion time and four hours a week of the nurse specialist, absorbed within existing staffing with protected time agreed by the manager. Informatics needs about 12 hours, covered by the age-friendly initiative. Program evaluations of the Hospital Elder Life Program reported savings in hospital costs per patient (Hshieh et al., 2018), but the proposal does not count on savings; its case rests on fewer episodes of delirium and fewer falls.
Ethics and Review
The project implements established evidence as a quality improvement initiative rather than testing a new intervention, and its data are collected for care and improvement. It will nevertheless be submitted to the hospital's research office for a formal determination that it does not require full ethics committee review, since the comparison unit and plans to present results could be seen as research. Patient autonomy is respected in each component: patients may decline walks or the sleep routine, and families are invited, not required, to take part. Data will be reported only in aggregate.
Sustainability and Dissemination
Sustainability is built in from the start. The bundle becomes part of unit standard work and new-staff orientation, the 4AT stays in the electronic record, the order set change is permanent and bundle completion joins the unit's monthly quality board. At twelve months, the unit will decide on phase two components, such as therapeutic activities, and on requesting a volunteer program. Results will be shared at the hospital's nursing research and quality day, with the age-friendly steering group for possible spread to the other two medical units, and, if the findings warrant, as an abstract to a regional nursing conference.
Limitations
The adapted bundle omits components that depended on volunteers in the original program, so its effect may be smaller than published estimates. The comparison unit is similar but not matched, and the project cannot rule out every alternative explanation. The 4AT will miss some cases, and its accuracy on this unit will be checked but not guaranteed. Finally, a single unit's results may not generalize to others with different staffing or patient mix.
Request
The proposal requests approval to begin preparation next month, protected champion time of 15 minutes per shift, the $4,500 supply budget and informatics support from the age-friendly initiative. With approval, the ten-bed pilot can start in week five, and the first results will reach unit leadership within eight weeks.
References
Burton, J. K., Craig, L. E., Yong, S. Q., Siddiqi, N., Teale, E. A., Woodhouse, R., Barugh, A. J., Shepherd, A. M., Brunton, A., Freeman, S. C., Sutton, A. J., & Quinn, T. J. (2021). Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database of Systematic Reviews, 2021(7), Article CD013307. https://doi.org/10.1002/14651858.CD013307.pub2
Fulmer, T., Mate, K. S., & Berman, A. (2018). The Age-Friendly Health System imperative. Journal of the American Geriatrics Society, 66(1), 22-24. https://doi.org/10.1111/jgs.15076
Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89(9), 1322-1327. https://doi.org/10.2105/AJPH.89.9.1322
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
Hshieh, T. T., Yang, T., Gartaganis, S. L., Yue, J., & Inouye, S. K. (2018). Hospital Elder Life Program: Systematic review and meta-analysis of effectiveness. The American Journal of Geriatric Psychiatry, 26(10), 1015-1033. https://doi.org/10.1016/j.jagp.2018.06.007
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
Inouye, S. K., Westendorp, R. G. J., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911-922. https://doi.org/10.1016/S0140-6736(13)60688-1
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 9 instructions ask for
The NUR 550 final project usually asks for a complete evidence translation or evidence-based practice proposal built from the course milestones. Typical requirements include the problem and its significance, the PICOT question, the search and synthesis, the implementation framework, the intervention and implementation plan, the evaluation plan, resources and budget, ethical considerations, sustainability and dissemination. Many rubrics also ask for an executive summary or abstract. Final proposals often run eight to twelve pages in APA 7 with tables. Write for a decision maker rather than a grader, as though the proposal might really be funded: lead with what you are asking for and why, and compress earlier milestones instead of reproducing them word for word.
How this NUR 550 Module 9 final project example is built
In the sample, the course's delirium prevention work is assembled into one proposal for a composite medical unit. An executive summary states the problem, evidence, request, cost and main risk in a paragraph. The problem uses a current review and local audit figures, and a single table gives the evidence verdict on five questions. The framework section shows the decisions i-PARIHS drove, and the rollout and evaluation are compressed with their key features intact. New sections cover the budget without promised savings, research versus quality improvement review, sustainability through routines and dissemination. Limitations and a precise request close it, supported by eight real sources. Every section can be traced back to a milestone or forward to the request.
Where the NUR 550 Module 9 rubric puts the points
Final proposals are generally graded on integration of the milestones, how well the evidence supports the change, how clear and feasible of the intervention and implementation plan, the rigor of the evaluation is, and whether resources, ethics, sustainability, dissemination and writing are handled well. Integration is judged by whether the parts form one argument: the question drives the search, the evidence drives the design and the design drives the measures. Feasibility credit depends on concrete costs, owners and timelines. Ethics and sustainability are frequently thin in otherwise strong papers, so addressing review requirements and naming the routines that will keep the change alive can make a noticeable difference to the grade. A clear request at the end is often what reviewers remember.
NUR 550 Module 9 help: the mistakes that cost points
The usual weak spots are a proposal stitched from milestones, where repetition buries the argument, by omitting a budget or ethics section, or by ending without a clear request. Start with an executive summary, condense each milestone to its conclusions, add the sections the milestones did not cover, state limitations honestly and finish with what you need and by when. Use tables for the evidence verdict and the plan so reviewers can find them quickly. Keep terminology consistent throughout. If your project is different, we can assemble a complete translation proposal from your milestones and instructor feedback. A reviewer should be able to find the cost, the risk and the request within a minute.
Get NUR 550 Module 9 written to your instructions
Upload the milestones you have already submitted, the feedback on each and the brief and rubric for the proposal. A complete evidence translation proposal with an executive summary, budget, ethics, sustainability and a clear request 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 7 Implementation Plan: An Implementation Plan for a Delirium Prevention Bundle
- NUR 550 Module 8 Evaluation Plan: Evaluating a Delirium Prevention Bundle With RE-AIM
- NUR 550 Module 10 Journal: The Gap Between Knowing the Evidence and Changing Practice
- NUR 540 Module 6 Short Paper: Minimal Change Nephrotic Syndrome in a Toddler
- NUR 508 Module 3 Professional Philosophy Paper
- NUR 520 Module 4 Milestone One: Describing COPD and Smoking in Coös County
- NUR 531 Module 6 SWOT Analysis: A SWOT Analysis of a Hospital Water Management Program
NUR 550 Module 9 questions, answered
Where can I find a free NUR 550 Module 9 Final Project sample?
The complete proposal on this page is free to read: a nurse-delivered delirium prevention bundle from problem and question to evidence, framework, rollout, evaluation, budget, ethics, sustainability and a clear request, with eight real sources.
What sections belong in an evidence translation proposal?
An executive summary, problem, PICOT question, evidence synthesis, framework, intervention and implementation plan, evaluation, budget, ethics, sustainability, dissemination, limitations and a request.
Does an evidence-based practice project need IRB review?
Quality improvement projects often do not, but many hospitals require a formal determination, especially if results will be presented or a comparison group is used.
How do I show sustainability in a proposal?
Name the routines and systems that will carry the change, such as standard work, orientation, electronic record fields and regular quality reporting.
How long is the NUR 550 final project?
Often eight to twelve pages in APA 7 with tables, depending on the section's guidelines.