| Course | NU 730 Systems-Based Practice |
|---|---|
| Unit | Unit 8 |
| Paper type | Outcome evaluation plan |
| Length | About 600 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU 730 Unit 8
Outcome Evaluation Plan for a Nurse-Initiated Sepsis Screening Protocol in the Emergency Department
Student Name
Department of Nursing, Herzing University
NU 730: Systems-Based Practice
Instructor Name
April 8, 2026
Outcome Evaluation Plan for a Nurse-Initiated Sepsis Screening Protocol in the Emergency Department
The Change Being Evaluated
On March 2, a composite 300-bed hospital's emergency department began a nurse-initiated sepsis screening protocol. At triage and at each reassessment, nurses screen adults with suspected infection using a modified screening tool; a positive screen triggers blood cultures and lactate drawn by the nurse under standing order, a bedside huddle with the emergency physician within 15 minutes, and a goal of first antibiotic dose within one hour of a positive screen. Timely antibiotic treatment matters: in a large statewide cohort, the longer the bundle and first antibiotic dose were delayed, the higher the risk of dying in hospital, hour by hour (Seymour et al., 2017), and current guidelines recommend antibiotics within one hour for patients with possible septic shock or a high likelihood of sepsis (Evans et al., 2021). This plan describes how the hospital will know whether the protocol is working, what it costs in unintended effects, and when it would be changed or stopped.
Measures, Fully Specified
Each measure states what is counted, in whom, over what interval, from which system, and who reports it. Baseline is the six months before go-live.
| Measure | Type | Definition | Population | Source | Baseline | Target |
|---|---|---|---|---|---|---|
| Screening completion | Process | Adults with suspected infection screened at triage / all adults with suspected infection | ED visits, adults | EHR triage flowsheet | Not measured | 95% by month 3 |
| Time to antibiotics | Process | Median minutes from positive screen to first antibiotic | Positive screens | EHR timestamps | 142 minutes (from triage) | 60 minutes or less |
| Lactate within 1 hour | Process | Lactate resulted within 60 minutes of positive screen / positive screens | Positive screens | Laboratory system | 48% | 85% |
| In-hospital mortality, sepsis | Outcome | Deaths / adults admitted from ED with sepsis diagnosis | Sepsis admissions | Hospital discharge data | 14.2% | Decrease; no fixed target |
| ICU transfer within 48 hours | Outcome | Floor admissions with sepsis transferred to ICU within 48 hours | Sepsis floor admissions | EHR ADT data | 11% | Decrease |
| Antibiotics without infection | Balancing | Positive screens given antibiotics with no infection confirmed at discharge | Positive screens | Chart review, 30 per month | Not measured | Monitor; review if above 25% |
| Hospital-onset C. difficile | Balancing | Cases per 10,000 patient-days, hospital-wide | All inpatients | Infection prevention | 5.8 | No increase |
| ED length of stay | Balancing | Median ED length of stay, all adults | All adult ED visits | EHR ADT data | 4.1 hours | No increase above 4.4 |
Early Process Indicators Versus Later Outcomes
Process indicators, screening completion, time to antibiotics, and lactate timing, should move within weeks of go-live, and they tell the team whether the protocol is being carried out. Outcome indicators, mortality and intensive care transfers, move slowly, are affected by case mix, and need months of data before any change can be distinguished from chance. The plan therefore judges the protocol's implementation at three months on process measures, and its effect at 12 months on outcome measures, adjusted for age and severity using the hospital's risk-adjustment model. Separating implementation from effect prevents two mistakes: declaring success because processes improved when outcomes did not, and declaring failure because outcomes had not yet moved (Proctor et al., 2011).
Review Cadence and Ownership
Weekly for the first month, then monthly: the emergency department nurse educator and the sepsis coordinator review process measures on run charts and discuss them at the department's quality huddle. Monthly: the sepsis committee, chaired by an emergency physician with nursing, pharmacy, infectious disease, and quality members, reviews all measures and every death or late intensive care transfer among patients who screened positive. Quarterly: results are reported to the hospital quality council. The quality department's analyst produces the reports; the sepsis coordinator owns the data definitions and ensures they do not drift, because a change in how a positive screen is counted can make performance look better or worse without any change in care. Any change to a definition is recorded with its date, and the run charts are annotated at that point.
Stop, Revise, or Continue
Revise if, at three months, screening completion is below 85% or time to antibiotics has not fallen by at least 30 minutes; the likely causes, such as workflow at triage or delays in antibiotic availability, will be investigated first. Revise if, at any monthly review, antibiotics without confirmed infection exceed 25% of positive screens, which would suggest the screening threshold is too sensitive for this population. Stop and reassess if hospital-onset C. difficile rises by more than 25% over two consecutive quarters with no other explanation, or if emergency department length of stay rises above 4.4 hours for three consecutive months because of the protocol. Continue and spread to inpatient units if, at 12 months, process targets are met and risk-adjusted sepsis mortality has fallen or shows no increase, with balancing measures stable.
References
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., ... Levy, M. (2021). Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock 2021. Critical Care Medicine, 49(11), e1063-e1143. https://doi.org/10.1097/CCM.0000000000005337
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76. https://doi.org/10.1007/s10488-010-0319-7
Seymour, C. W., Gesten, F., Prescott, H. C., Friedrich, M. E., Iwashyna, T. J., Phillips, G. S., Lemeshow, S., Osborn, T., Terry, K. M., & Levy, M. M. (2017). Time to treatment and mortality during mandated emergency care for sepsis. New England Journal of Medicine, 376(23), 2235-2244. https://doi.org/10.1056/NEJMoa1703058
The Herzing NU 730 Unit 8 instructions
For Unit 8 you write an evaluation plan for a practice or system change, describing how its outcomes will be measured and judged. Expect to identify the change, define measures with data sources, set a baseline, distinguish process from outcome indicators, establish a review schedule and owners, and state decision rules. Many versions ask you to use an evaluation framework, such as Donabedian's structure, process and outcome model or Proctor's implementation outcomes. Check whether the plan should evaluate the project from an earlier unit. Measures must be specific enough that someone else could collect them. Decision thresholds turn the plan into a tool leaders can use, so include what result would lead to continuing, revising or stopping the change.
How this NU 730 Unit 8 example is built
The plan opens with the change in one paragraph: what nurses do, when and for whom. The measures section uses the same five specifications for every measure, which keeps the table consistent and testable. A short section explains why process measures should move within weeks while mortality takes months, which prevents a team from abandoning a protocol too early. The cadence section assigns weekly and monthly reviews to named roles and links them to an existing meeting. The final section is the most practical: it states exactly what results lead to revising, stopping or continuing, with the likely causes to investigate when targets are missed. Each choice cites the Surviving Sepsis guidelines or implementation literature, so the timelines and targets have a basis.
Reading the NU 730 Unit 8 rubric
Herzing's evaluation plan rubric usually covers the description of the intervention, the evaluation design or framework, measures and data sources, data collection and analysis, decision criteria and writing. Measures earn full marks when each is defined with a numerator, denominator, data source and frequency. Framework points reward correct use of a named model. Data collection criteria look for realistic sources and named owners. Analysis points go to plans that specify how data will be displayed and compared with baseline, such as run charts. Decision criteria, where required, should be explicit thresholds. Some rubrics include a criterion on dissemination of results. The writing row covers concise organization, tables where useful and APA 7 citations for guidelines and evaluation methods.
NU 730 Unit 8 help before you submit
In Unit 8 students often lose points on measures named but not defined, such as sepsis outcomes, with no numerator or data source. Another frequent gap is no baseline, which makes improvement impossible to show. Plans also tend to measure only mortality, which moves slowly and is affected by many factors. Review schedules without owners rarely happen. Decision rules are frequently missing, leaving the plan without a clear use. Some papers repeat the implementation plan instead of evaluating it. Choosing measures the organization cannot collect weakens feasibility. Finally, connect each target to evidence or a benchmark, since a target of 90 percent with no basis looks arbitrary and invites questions from the grader.
Get a NU 730 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NU 730 classroom, plus the change your plan has to evaluate and the systems your data would come from. We write a custom example with fully defined measures, a collection method, an analysis approach and decision rules, and return it in 24 to 48 hours. The first custom sample is free.
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NU 730 Unit 8 questions, answered
How is an evaluation plan different from the improvement proposal?
The proposal argues that a change should happen and sketches how success would be measured. The evaluation plan assumes the change is running and specifies the monitoring in operational detail: definitions, sources, intervals, owners, reporting and the rules for acting on results. Submitting a condensed version of the earlier proposal is the common error and costs criteria in both.
How long should the evaluation run?
Long enough for the outcome to be capable of moving, which depends on how often the event you are measuring occurs. Rare outcomes need longer periods or a process measure standing in for them. State the reasoning in the plan, and set an interim review point so the organization gets information before the full period is finished.
What if the data I need is not collected anywhere?
Say so, and plan for it. Either specify the manual collection with its cost and its sampling method, or choose a proxy measure and state plainly what it misses. A plan built on data that does not exist fails silently once implementation begins, and a rubric reading for feasibility credits the writer who noticed the gap in advance.
Where can I find a free NU 730 Unit 8 sample paper?
This page shows the complete NU 730 Unit 8 sepsis evaluation plan for free, with fully specified measures, review cadence and decision rules. A custom plan can evaluate the change from your own earlier unit or a new project.
Which sepsis measures should move first after a protocol starts?
Process measures show whether staff carry out the change, such as screening completion or time to antibiotics. Outcome measures show its effect on patients, such as sepsis mortality. This sample tracks process measures weekly because they move first.