NU 700 Unit 4 Literature Matrix Example

Course	NU 700 Knowledge for Nursing Practice
Unit	Unit 4
Paper type	Literature matrix with synthesis
Length	About 470 words, 4 pages
Format	APA 7 student paper
School	Herzing University
Program	MSN
Updated	October 2026

Free sample paper for NU 700 Unit 4

Literature Matrix: Home Blood Pressure Telemonitoring With Clinician Co-Management for Uncontrolled Hypertension

Student Name

Department of Nursing, Herzing University

NU 700: Knowledge for Nursing Practice

Instructor Name

February 10, 2026

What this page is doingThe title names the intervention and the population the matrix is built around. A matrix is interrogated by one question, and a title that stays on the question tells the reader which studies should be in the rows and which should not.

Literature Matrix: Home Blood Pressure Telemonitoring With Clinician Co-Management for Uncontrolled Hypertension

Question

In adults with uncontrolled hypertension treated in primary care (P), does home blood pressure self-monitoring with transmission of readings and clinician co-management by a pharmacist or nurse (I), compared with usual care (C), improve blood pressure control or reduce systolic blood pressure at 6 to 24 months (O)?

Search Record

Databases: PubMed and CINAHL, searched January 2026. Terms: (home blood pressure monitoring OR self-monitoring OR telemonitoring) AND hypertension AND (pharmacist OR nurse OR self-management OR titration) AND randomized. Limits: English, adults, 2005 to 2025. Of 214 records screened by title and abstract, 31 full texts were reviewed, and the six below were selected because they tested the intervention in primary care hypertension with at least six months of follow-up and reported blood pressure outcomes. The set includes four individual randomized trials, one cluster randomized trial, and one individual patient data meta-analysis, so that the finding can be seen across designs and health systems.

What this page is doingThe question is fixed above the table in structured form, and the search record lets a reader judge whether the set is a sample or a selection. A matrix built without a stated question tends to collect sources near the topic rather than on it.

Matrix

Rows are ordered by strength of design, with the meta-analysis last so that it can be read against the trials it pooled.

Citation	Purpose	Design and setting	Sample	Intervention and measures	Key findings	Limitations	Level
Green et al. (2008)	Test home monitoring and web training with or without pharmacist care	Three-arm RCT; integrated health system, Washington State	778 adults, uncontrolled BP	Home monitor plus web training; third arm added pharmacist care by secure messaging. Outcome: BP control at 12 months	Control 56% with pharmacist care vs 31% usual care; home monitoring plus web training alone smaller, nonsignificant gain	Single system; participants had internet access; mostly White	I
Bosworth et al. (2009)	Test nurse telephone behavioral support and home monitoring	2x2 factorial RCT; Veterans Affairs primary care	636 veterans	Nurse telephone tailored behavioral intervention, home monitoring, both, or usual care. Outcome: BP control over 24 months	Combined arm improved control compared with usual care; single components smaller effects	Veterans, mostly men; effect varied over time	I
McManus et al. (2010)	Test self-monitoring with patient self-titration	RCT; general practices, England	527 adults	Self-monitoring plus self-titration of medicines using an agreed plan. Outcome: systolic BP at 12 months	Systolic BP about 5 mm Hg lower than usual care	Many invited declined; selected, motivated group	I
Margolis et al. (2013)	Test telemonitoring with pharmacist case management	Cluster RCT; 16 primary care clinics, Minnesota	450 adults	Home telemonitoring with pharmacist titration by phone. Outcome: BP control at 6 and 12 months	Control about 72% vs 45% at 12 months; benefit persisted, smaller, after intervention ended	One health system; cluster design with few clusters	I
McManus et al. (2018)	Test self-monitoring, with or without telemonitoring, for clinician titration	RCT; 142 general practices, England	1,182 adults	Self-monitoring or telemonitoring used by clinicians to titrate. Outcome: systolic BP at 12 months	Both lower than usual care, by about 3.5 and 4.7 mm Hg	Unmasked; clinicians aware of allocation	I
Tucker et al. (2017)	Estimate effect of self-monitoring and co-interventions	Individual patient data meta-analysis of 25 RCTs	About 10,500 patients	Self-monitoring with or without co-interventions. Outcome: systolic BP at 12 months	Self-monitoring alone gave small reductions; larger with co-interventions such as titration or education	Heterogeneous trials and co-interventions	I

What the Rows Agree On

Across designs, health systems, and countries, home monitoring combined with active clinician co-management, meaning someone uses the readings to adjust treatment, produced better blood pressure control than usual care (Green et al., 2008; Margolis et al., 2013; McManus et al., 2018). The meta-analysis supports the same pattern: self-monitoring alone had a modest effect, and the benefit grew with the intensity of the accompanying intervention (Tucker et al., 2017).

Where the Rows Part

The studies differ on who does the co-management and how. Pharmacist-led titration in the American trials produced the largest differences in control, while patient self-titration in England produced a smaller but still meaningful reduction (McManus et al., 2010). The Veterans Affairs trial found that a nurse behavioral intervention helped most when combined with home monitoring, and its effects varied over the two years (Bosworth et al., 2009). The outcome measures also differ, some reporting the proportion controlled and others the mean systolic reduction, which limits direct comparison.

Gaps

Most samples were drawn from integrated systems or national health services with good access to care and, in the earlier trials, to the internet. None of the six was set in a federally qualified health center or enrolled a majority of uninsured or Medicaid patients, and few reported outcomes by race or income. For a nurse practitioner considering this intervention in a safety-net clinic, the evidence supports the approach but does not show that the effect holds among patients with limited broadband, unstable phone numbers, or hourly jobs that make daytime calls difficult. That gap shapes the next step of this project: finding studies in safety-net populations or planning a pilot that measures outcomes by those factors.

What this page is doingThe reading names what the rows agree on, where they part, and what the set cannot answer for the writer's own setting. A grid without that reading gives the reader data but no synthesis, and the synthesis is what carries the analysis criterion.

References

Bosworth, H. B., Olsen, M. K., Grubber, J. M., Neary, A. M., Orr, M. M., Powers, B. J., Adams, M. B., Svetkey, L. P., Reed, S. D., Li, Y., Dolor, R. J., & Oddone, E. Z. (2009). Two self-management interventions to improve hypertension control: A randomized trial. Annals of Internal Medicine, 151(10), 687-695. https://doi.org/10.7326/0000605-200911170-00148

Green, B. B., Cook, A. J., Ralston, J. D., Fishman, P. A., Catz, S. L., Carlson, J., Carrell, D., Tyll, L., Larson, E. B., & Thompson, R. S. (2008). Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: A randomized controlled trial. JAMA, 299(24), 2857-2867. https://doi.org/10.1001/jama.299.24.2857

Margolis, K. L., Asche, S. E., Bergdall, A. R., Dehmer, S. P., Groen, S. E., Kadrmas, H. M., Kerby, T. J., Klotzle, K. J., Maciosek, M. V., Michels, R. D., O'Connor, P. J., Pritchard, R. A., Sekenski, J. L., Sperl-Hillen, J. M., & Trower, N. K. (2013). Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: A cluster randomized clinical trial. JAMA, 310(1), 46-56. https://doi.org/10.1001/jama.2013.6549

McManus, R. J., Mant, J., Bray, E. P., Holder, R., Jones, M. I., Greenfield, S., Kaambwa, B., Banting, M., Bryan, S., Little, P., Williams, B., & Hobbs, F. D. R. (2010). Telemonitoring and self-management in the control of hypertension (TASMINH2): A randomised controlled trial. The Lancet, 376(9736), 163-172. https://doi.org/10.1016/S0140-6736(10)60964-6

McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J., Bradburn, P., Farmer, A., Grant, S., Greenfield, S. M., Heneghan, C., Jowett, S., Martin, U., Milner, S., Monahan, M., Mort, S., Ogburn, E., Perera-Salazar, R., Shah, S. A., ... Banerjee, T. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): An unmasked randomised controlled trial. The Lancet, 391(10124), 949-959. https://doi.org/10.1016/S0140-6736(18)30309-X

Tucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Earle, K., George, J., Godwin, M., Green, B. B., Hebert, P., Hobbs, F. D. R., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., ... McManus, R. J. (2017). Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLOS Medicine, 14(9), Article e1002389. https://doi.org/10.1371/journal.pmed.1002389

Reading the NU 700 Unit 4 instructions

For Unit 4 you build a literature matrix on a clinical question, usually the one you will carry through later units. Expect to write the question in PICO or a similar format, document your search, and enter a set number of studies into a table with columns such as author and year, design, sample, intervention, outcomes, findings and level of evidence. Many sections also want a brief written synthesis that compares the studies instead of summarizing them again. The minimum number of sources and the date range are set by your instructions, so check both before searching. Some versions require a mix of designs or at least one systematic review. Keep the table readable, since a crowded grid with paragraph-long cells is hard to grade.

Inside the NU 700 Unit 4 example

The sample states its question first, with each PICO element labeled so the grader can check alignment with the rows. The search record is short but complete, giving databases, the month searched, terms joined by AND and OR, and the limits applied. The table itself uses consistent columns and terse cells, and its rows run from individual trials to the meta-analysis so findings can be read against the review that combined them. Under the grid, the agreement section says that monitoring alone helps less than monitoring paired with someone adjusting treatment. The second section explains differences in who did the co-management, from pharmacists to patient self-titration. The gaps section notes who was missing from the samples and why that matters for a safety-net clinic. Each claim names the studies behind it.

Where the points sit in the NU 700 Unit 4 rubric

Herzing rubrics for a literature matrix usually score the clinical question, the search, the completeness and accuracy of the table, and the synthesis. A focused question, with elements that line up with the chosen studies, earns the full points. Search criteria reward documented databases, terms and limits that another reader could repeat. Table points depend on the required number of current, scholarly sources and on cells that are accurate and complete across every column. The synthesis is often where students lose ground, because full credit requires comparison across studies, patterns and gaps, not a paragraph per article. Some rubrics include a level-of-evidence column graded for correct use of a named hierarchy. The last row covers APA 7 references, readable formatting and clear writing.

NU 700 Unit 4 help: mistakes that cost points

The most common Unit 4 problem is a synthesis that summarizes each study again in turn instead of comparing them. Another is a question so broad that the studies in the table answer different questions. Students also mislabel designs, calling a cohort study a trial or a quality improvement report a study. Leaving the search undocumented costs points even when the sources are strong. Cells copied from abstracts make the grid long and hide differences that matter, such as follow-up length or who adjusted medications. Mixing outdated studies in without a reason is risky when the instructions set a five-year window. Finally, list the level of evidence using the hierarchy your course names, and make sure every row also appears in the reference list.

Get a NU 700 Unit 4 example written to your instructions

Send the Unit 4 instructions and the rubric from your NU 700 classroom, along with any template your instructor supplied and the question the table has to answer. We write a custom example against those instructions, columns held parallel and a reading underneath, and return it in 24 to 48 hours. The first one is free.

More NU 700 papers and MSN samples

NU 700 Unit 4 questions, answered

How many studies belong in the table?

Follow the number in your instructions where one is given, since sections differ. Where the choice is open, enough studies to show a pattern and at least one that complicates it is the working standard, and that is usually a handful rather than a shelf. A smaller set read carefully beats a long grid with three empty columns.

Can I put a systematic review in the grid?

Usually yes, and it often belongs there, but treat it as its own kind of row. Its sample is a set of studies rather than people, its design column should say so, and its findings should be recorded as pooled results with the pooling method noted. Mixing it silently among primary studies overstates how much independent evidence the table holds.

Does the matrix need writing underneath it?

In most sections yes, and it is where the points sit. A grid alone shows that eight studies were read. The paragraph beneath shows what reading them together produced: the agreement, the disagreement, the populations nobody has studied and the effect all of that has on the question. Check your rubric for the length expected.

Where can I find a free NU 700 Unit 4 sample paper?

This page shows the NU 700 Unit 4 matrix in full for free, from the PICO question and search record to the grid and the synthesis under it. If your topic differs, a custom matrix can be built around your question and source count.

What goes in the synthesis under a literature matrix?

Write across the rows, not down them: what most studies agree on, where results differ and the likely reason, and what populations or settings are missing. This sample uses three short sections for exactly those points, each naming the studies it draws on.

NU 700 Unit 4 literature matrix example