NUR 650 Module 10 Journal Example

Reviewed by Delia Ravenscroft, MSN, RN

This NUR 650 Module 10 Journal sample closes the care coordination course with the writer's own voice. It is written for SNHU NUR 650 (NUR-650), the MSN course on care coordination and outcomes management, where the final module usually asks how your understanding of the nurse leader's role has changed. The author, a telemetry nurse moving into a clinical nurse leader position, reflects on three lessons from a term of work on heart failure readmissions. Discharge is a handoff rather than an ending, a point Jencks and colleagues' Medicare data make painfully clear. Good interventions can fail, as the null result of Kripalani and colleagues' pharmacist trial showed. And patients carry their care across settings only when someone builds their ability to do so, the lesson of Coleman and colleagues' coaching model. The entry ends with three commitments for the first months in the new role.

CourseNUR 650 Care Coordination and Outcomes Management
ModuleModule 10
Paper typeclosing reflective journal on care coordination leadership
LengthAbout 480 words, 3 pages
FormatAPA 7 student paper
SchoolSouthern New Hampshire University
ProgramMSN
UpdatedSeptember 2026

Free sample paper for NUR 650 Module 10

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Module Ten Journal

The Patient Leaves; the Responsibility Does Not

For eleven years my sense of a good shift ended at the unit doors. If my patient left with a complete discharge packet and a smile, I had done my job. This course took that belief apart one patient at a time. When I pulled the charts for our heart failure readmissions, I kept finding people who had left exactly as I would have been proud of and returned within a week. Jencks et al. (2009) found that nearly a fifth of Medicare patients were back in the hospital within a month, many without seeing any clinician in between. I had always read numbers like that as someone else's problem, primary care's or the patient's. Now I read them as evidence that the discharge I thought was the end of my work was a handoff that often reached no one.

The second lesson was humbling. I began the term certain that a pharmacist on every discharge would solve our medication problems. Then I read the trial by Kripalani et al. (2012), in which an intensive pharmacist intervention did not significantly reduce clinically important errors after discharge. My first reaction was to look for a flaw in the study. My second, better reaction was to ask where the errors were happening, which led our team to extend reconciliation into patients' homes and primary care. A null result taught me more than a positive one would have.

What this page is doingThe writer describes how readmission charts and a null trial overturned two beliefs about discharge and medications.
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The third lesson came from Mr. D., the patient who stopped his diuretic because his ankles looked better. Coleman et al. (2006) showed that coaching patients to manage their own medications, records, follow-up and warning signs lowered readmissions. What struck me was the idea that the patient is the only person present in every setting. No handoff between clinicians will ever be as reliable as a patient who understands why the water pill matters and knows what a two-pound gain means. Teach-back used to feel like a box to check. Now it feels like the most important handoff I make.

I also learned to care about process data. Early in our test cycles, I wanted to know whether readmissions had dropped. Our quality director kept asking a different question: did the patients actually get the appointment, the call, the teaching? I now understand that without that answer, an outcome tells you nothing about what to fix.

What this page is doingThe third lesson connects coaching evidence to a specific patient, and the writer reflects on learning to value process measures.
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In my first months as a clinical nurse leader, I will do three things. I will review every heart failure readmission within a week with the discharging nurse, not to assign blame but to find where the handoff failed. I will post our bundle delivery rates on the unit monthly, next to the readmission rate. And I will ask each patient, before they leave, to tell me in their own words what they will do if their weight rises. The patient leaves; the responsibility does not.

What this page is doingThree commitments follow from the lessons, and the last line echoes the title.
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References

Coleman, E. A., Parry, C., Chalmers, S., & Min, S. (2006). The care transitions intervention: Results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 1822-1828. https://doi.org/10.1001/archinte.166.17.1822

Jencks, S. F., Williams, M. V., & Coleman, E. A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 360(14), 1418-1428. https://doi.org/10.1056/NEJMsa0803563

Kripalani, S., Roumie, C. L., Dalal, A. K., Cawthon, C., Businger, A., Eden, S. K., Shintani, A., Sponsler, K. C., Harris, L. J., Theobald, C., Huang, R. L., Scheurer, D., Hunt, S., Jacobson, T. A., Rask, K. J., Vaccarino, V., Gandhi, T. K., Bates, D. W., Williams, M. V., & Schnipper, J. L. (2012). Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: A randomized trial. Annals of Internal Medicine, 157(1), 1-10. https://doi.org/10.7326/0003-4819-157-1-201207030-00003

What the NUR 650 Module 10 instructions ask for

In the final NUR 650 module, the journal generally asks what the course did to your view of care coordination and of your own role as a nurse leader, and to say what you will do next. The writing is personal, yet it should still draw on the evidence you studied, usually two or three sources in APA 7. Around 400 to 600 words is common. Build the entry around a few real shifts in thinking, each tied to a specific patient, dataset or study from the term, and close with actions concrete enough that a manager or colleague could tell within a few months whether you followed through.

How this NUR 650 Module 10 journal example is built

This journal comes from a telemetry nurse stepping into a clinical nurse leader role. Readmission charts and the Jencks Medicare data show that discharge is a handoff that often reaches no one. The null result of the Kripalani pharmacist trial leads the writer to extend reconciliation into the home and primary care. A patient who stopped his diuretic, together with the Coleman coaching trial, reframes teach-back as the most important handoff. The writer also learns to value process data over outcomes alone. The entry ends with three commitments: weekly readmission reviews with discharging nurses, posted bundle delivery rates and teach-back on weight gain before every discharge. Its final line echoes the title.

Where the NUR 650 Module 10 rubric puts the points

Reflective journals in this course are generally judged on the depth of the change described, the connection between that change and course evidence, the relevance to the writer's future role, organization and APA 7 mechanics. The entries that score highest ground each lesson in a concrete moment, a chart, a patient or a study result, and show the writer's thinking actually shifting. Graders appreciate honesty about beliefs the evidence overturned, including reactions to studies that did not support the writer's assumptions. Commitments tied to a specific role and timeframe read as far more credible than general promises to coordinate care better. Returning to one central idea at the end helps the entry read as a whole.

NUR 650 Module 10 help: the mistakes that cost points

Journals lose points when they summarize course topics rather than the writer's own change, when lessons float free of any patient or study, when sources are listed but not used or when the closing plans are too general to check. Anchor each lesson in a concrete moment, tie it to evidence, admit what you got wrong and end with actions linked to your role and a timeframe. A short return to the entry's central idea helps it hold together. For a prompt built around interprofessional leadership, population health or working with payers, send it with your NUR 650 notes and the reflection will follow that thread instead.

Get NUR 650 Module 10 written to your instructions

Tell us what NUR 650 changed in how you see your role and share the assignment wording. Your reflection will ground each lesson in a patient, dataset or study and close with commitments tied to your role, within 24 to 48 hours, free the first time. 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.

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NUR 650 Module 10 questions, answered

Where can I find a free NUR 650 Module 10 Journal sample?

This page carries the full journal: a clinical nurse leader reflects on care after discharge, a null pharmacist trial and measuring delivery, with three commitments.

What should a NUR 650 closing journal cover?

Real changes in how you see care coordination and your leadership role, each tied to course evidence, and specific actions you will take.

Why include a study that did not work in a reflection?

Null results can reveal where problems actually arise, and describing how one changed your thinking shows genuine learning.

Why is the patient central to care coordination?

The patient is the only person present in every setting, so building their understanding is the most reliable handoff.

What makes a commitment credible in a leadership reflection?

It names a specific action, a role and a timeframe, such as reviewing every readmission weekly with the discharging nurse.