| Course | NSG 633 Safety and Quality |
|---|---|
| Unit | Unit 8 |
| Paper type | Frontline improvement pitch |
| Length | About 820 words, 4 pages |
| Format | Business memo with analysis, APA 7 references |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 633 Unit 8
Memorandum
To: Unit Manager, Medical Floor; Chair, Nursing Practice Council
From: Staff Nurse, Medical Floor (NSG 633 student)
Date: March 4, 2026
Re: Giving Parkinson's medications at home times: an eight-week trial with a charge-nurse check
The Problem
Patients with Parkinson's disease on this floor regularly receive their carbidopa-levodopa late. At home most of them take it at their own fixed times, often four or five times a day at intervals chosen with their neurologist. On admission the order is converted to our standard dose times (for example 0900, 1300, 1700, and 2100), which may be hours from the patient's routine, and it then competes with the full medication pass at each of those times. In a two-week look-back at the medication record for the nine Parkinson's patients admitted to the floor, 71 of 212 scheduled doses (33%) were given more than 30 minutes after the patient's usual home time. Late or missed doses are a recognized cause of deterioration in hospital, where patients with Parkinson's disease can lose mobility, fall, or develop swallowing problems during a stay (Gerlach et al., 2012). As the barrier analysis in Unit 1 found, these delays are almost never reported, because our policy's 60-minute window defines them as on time.
The Change, and What It Replaces
Proposed change: for patients with Parkinson's disease, pharmacy enters carbidopa-levodopa and other Parkinson's medications at the patient's own home times, confirmed at admission, and these doses are flagged as time-critical with a 30-minute window on the medication record.
What it replaces: the automatic conversion of these orders to standard dose times, and the 60-minute window that currently applies to them. Nothing is added to the medication pass; the doses move to their own times and leave the busiest pass times, which should make them easier to give on time, not harder. National guidance on timely administration already separates a short list of time-critical medications, to be given within 30 minutes of their scheduled time, from the rest, and it leaves each hospital to decide which medications belong on that list; our hospital adopted that guidance when it set its current policy (Institute for Safe Medication Practices [ISMP], 2011); this proposal asks that Parkinson's medications be added to it.
Owner, and Whose Time It Costs
Owner: the day and night charge nurses on this floor, as a group, with the unit manager as sponsor. The pharmacy clinical coordinator owns the order-entry step.
Costs: at admission, the admitting nurse spends about two minutes asking the patient or family for home dose times and entering them in the reconciliation note; the pharmacist spends a similar time entering custom times. During each shift, the charge nurse spends about one minute at the 1500 and 0300 huddles checking the last dose time of each Parkinson's patient on the floor, usually one to three patients. No new equipment, staff, or software build is needed; custom dose times and the time-critical flag already exist in our system.
Measure, Baseline, and Review
Measure: the share of scheduled Parkinson's doses given within 30 minutes of the patient's home time. The charge nurse records it on the huddle sheet from the medication record's timing column, so no data request to another department is needed.
Baseline: 33% of doses given more than 30 minutes late in the two-week look-back (71 of 212).
Review: weekly counts plotted on a simple run chart on the huddle board, with a formal review at eight weeks. Run charts of this kind let a small team see whether a change is making a difference over time rather than reacting to one good or bad week (Langley et al., 2009). A balancing measure will be tracked at the same time: the share of other time-critical medications given within their window, to check that moving Parkinson's doses does not make other doses late.
Two Expected Objections
"Custom times will mean more med passes, not fewer." For most patients the home times differ from ours by less than two hours, and each dose moved off a standard pass is one less dose competing at 0900. The balancing measure will show whether total workload shifts, and the trial is short enough to stop if it does.
"Why this drug and not the others?" Other drugs matter too, and the time-critical list already covers several of them. Parkinson's medications are proposed because this floor has local data showing a problem, the patients can tell us their own times, and the harm from delay is well described. If this works, the same method could be applied to the next drug group.
When I Would Withdraw It
I will recommend stopping the trial at eight weeks if the late-dose share has not fallen below 15%, or if the balancing measure shows other time-critical doses being given late more often than at baseline. In either case the problem is real but this change is not the answer, and the next option to examine would be the medication pass structure itself, not more reminders.
References
Gerlach, O. H., Broen, M. P., van Domburg, P. H., Vermeij, A. J., & Weber, W. E. (2012). Deterioration of Parkinson's disease during hospitalization: Survey of 684 patients. BMC Neurology, 12, Article 13. https://doi.org/10.1186/1471-2377-12-13
Institute for Safe Medication Practices. (2011). Acute care guidelines for timely administration of scheduled medications.
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.
Reading the NSG 633 Unit 8 instructions
Unit 8 asks you to write a short improvement proposal a frontline team could approve. Expect to state the problem with local data, describe the change and what it replaces, name an owner and whose time it costs, define a measure with baseline and review date, answer objections and say when you would withdraw it. Students often ask how big the change should be and who should own it. One focused change on one unit is best. Owners should be roles that will exist after you leave. Measures should come from data the unit already has. Answering objections in advance shows you listened to colleagues. A withdrawal condition shows you will judge the change honestly.
How the NSG 633 Unit 8 example is put together
The pitch opens with the problem and why Parkinson's doses are time-critical. The change section describes pharmacy entering home times with a flag and what standard times it replaces. The owner section names charge nurses and estimates the minutes each shift. The measure section defines on-time doses, gives a baseline from medication records and sets an eight-week review. The objections section answers two concerns with reasons. The withdrawal section sets a specific threshold for stopping. The pitch fits on one page in memo form and connects back to the Unit 1 reporting analysis, which closes the course's thread. Families are named as a source for each patient's home schedule, since they often know it best.
Reading the NSG 633 Unit 8 rubric
Herzing's rubric for a frontline improvement pitch usually covers the problem, the change, ownership, measurement, objections and withdrawal criteria. Measurement and withdrawal criteria draw the closest reading, since a proposal that cannot fail cannot be judged. Problem points reward local data, such as the share of late doses last quarter, and clinical significance. Change criteria look for a specific replacement of current practice rather than a goal. Ownership earns credit when roles and time costs are named honestly. Objection points go to concerns raised by colleagues and answered in advance. A one-page memo format is usually expected. The link back to the Unit 1 reporting analysis is often credited. The Parkinson's Foundation guidance and ISMP time-critical medication list support the proposal.
NSG 633 Unit 8 help: mistakes that cost points
A Unit 8 improvement pitch often weakens when the change is proposed without local data. Another frequent problem is an owner who will leave, such as the student. Students often skip whose time the change costs. Measures are not defined or lack a baseline. Objections are ignored, though colleagues will raise them at the first meeting. No withdrawal condition is set. The pitch runs long. Pharmacy's role in entering custom times is overlooked. Patients and families, who know the home schedule, are not involved. Finally, say when you would stop, because graders reward a proposal that treats its own success as something to test.
Get a NSG 633 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NSG 633 classroom, together with any earlier pieces the pitch should build on. We write a custom example that compresses the problem, names what the change replaces, gives it an owner and a bedside measure, and states the withdrawal condition. First custom sample free, returned in 24 to 48 hours.
More NSG 633 papers and BSN samples
- NSG 633 Unit 1: Barrier to reporting analysis
- NSG 633 Unit 2: Near miss narrative analysis
- NSG 633 Unit 3: Unit level hazard walk
- NSG 633 Unit 4: Control strength comparison
- NSG 633 Unit 5: Patient identification audit
- NSG 633 Unit 6: Interruption and workload study
- NSG 633 Unit 7: Escalation chain trace
- NSG 233 Unit 8: Unstable patient timeline
- NSG 298 Unit 8: Error pattern portfolio
- NSG 421 Unit 8: Bedside technology evidence file
- NSG 423 Unit 8: Professional stance portfolio
NSG 633 Unit 8 questions, answered
Can the pitch build on my earlier submissions?
Most sections expect it, and the proposal is stronger when the hazard and the event behind it were already worked through. Rewrite the earlier material rather than pasting it, and confirm what your course permits about reusing work handed in before. The parts carrying credit here are the change, the owner and the measure, so protect their space.
How ambitious should the change be?
Small enough that the named owner could start it inside a term, and specific enough to be measured. A proposal to redesign a service reads as ambitious and cannot be evaluated, while a change to one step in one routine can carry a baseline and a review point. Many sections say plainly that scale is not what the rubric rewards.
Does the pitch need cost figures?
Not in money, and inventing figures is a worse answer than none. What a reader needs is whose time the change costs and where that time comes from, written in minutes a shift or as a step added to a routine. Where the instructions ask for a budget, use the ranges your course supplies rather than numbers from a workplace.
Where can I find a free NSG 633 Unit 8 sample paper?
Read the complete NSG 633 Unit 8 improvement pitch here at no charge, Parkinson's doses at home times with a measure and a withdrawal point. Ask for a custom pitch on another frontline change.
Why are Parkinson's medications time-critical in the hospital?
Late doses of carbidopa-levodopa can cause stiffness, falls, swallowing problems and slower recovery. This sample proposes giving them at each patient's home times and measuring the share given within 30 minutes.