| Course | NU 760 Scholarship for Nursing Practice |
|---|---|
| Unit | Unit 1 |
| Paper type | Practice problem statement |
| Length | About 1,030 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU 760 Unit 1
Delayed First Ambulation After Hip Fracture Surgery on an Orthopedic Unit: A Practice Problem Statement
Student Name
Department of Nursing, Herzing University
NU 760: Scholarship for Nursing Practice
Instructor Name
January 21, 2026
Delayed First Ambulation After Hip Fracture Surgery on an Orthopedic Unit: A Practice Problem Statement
The Problem as I Met It
On the 28-bed orthopedic unit where I work as a staff nurse, older adults who have surgery for a hip fracture are often not walked for the first time until the second or third day after surgery. I noticed this first as a pattern in my own assignments: a patient who had surgery in the morning would still be in bed the next afternoon, waiting for physical therapy, while the surgeon's order read "weight bearing as tolerated." The problem is not that anyone disagrees that early walking is good. It is that the first walk depends on a sequence of people and conditions that often fails to come together in the first 24 hours.
The Problem, Bounded
Population: adults aged 65 and older admitted to the orthopedic unit after surgical repair of a hip fracture, with orders permitting weight bearing. Setting: one 28-bed orthopedic unit in a composite 250-bed community hospital. Outcome: the proportion of patients who walk at least a few steps with assistance within 24 hours of the end of surgery. The problem is bounded this way so that it can be measured with data the unit already collects and addressed with changes the unit could make.
Local Evidence That the Problem Exists Here
I reviewed the records of 50 consecutive patients meeting these criteria from July through December, using the physical therapy notes and the nursing mobility flowsheet. Nineteen of 50, or 38%, walked within 24 hours of surgery. The median time to first ambulation was 31 hours. Of the 31 who did not walk within 24 hours, the documented reasons were: physical therapy not available on the day after surgery, which occurred mainly on weekends, in 12; hypotension or dizziness at the first attempt in 7; pain limiting the attempt in 5; the patient declining in 3; and no documented reason in 4. These figures are partial. The mobility flowsheet was not completed on every shift, so some early walks by nursing staff may not have been recorded, and the true proportion could be somewhat higher. I did not have access to data on outcomes such as discharge destination or length of stay linked to time of first ambulation, and I state that gap rather than estimating it.
Significance
Hip fracture is common and consequential in older adults, and recovery of walking is one of the outcomes that matters most to patients and families. Getting these patients walking early is linked to better recovery; in one prospective study, patients who walked within 48 hours of surgery had faster functional recovery and were more likely to be discharged directly home than those whose first walk came later (Oldmeadow et al., 2006). The national clinical practice guideline for managing hip fractures in older adults issued by the national orthopedic surgeons' academy recommends early mobilization after surgery and interdisciplinary care to support it (AAOS, 2021). For this unit, each day in bed also adds risks the unit already tracks: pressure injuries, delirium, and deconditioning that lengthens the stay.
What the Problem Is Not
Bounding the problem also means saying what it excludes. It is not about patients whose surgeon has restricted weight bearing, a small group with a different pathway. It is not about the quality of physical therapy once it begins, which I have no evidence to criticize. And it is not a problem of staff attitudes: nurses on the unit consistently told me they want patients up sooner. The problem sits in the process that decides who takes the first walk and when.
Stakeholders, Feasibility, and Risks
Several groups have a stake in the answer. Patients and families want recovery of walking and a return home. Physical therapists are central to mobility after surgery and would need to agree on which patients nurses can safely walk first, and how the two roles would share the work. Surgeons write the weight-bearing orders and would need to endorse a protocol. The nurse manager controls staffing and would need to support the time a first walk takes, about 15 to 20 minutes with two staff members for many patients.
Feasibility is plausible but not certain. The unit already has walkers, gait belts, and a mobility flowsheet; what it lacks is a clear rule about when nurses should attempt the first walk and a screen for who is safe to try. The chief risk is harm from the attempt itself: orthostatic hypotension and falls are real concerns in older adults on the first day after surgery, and the seven patients in my review who became dizzy at the first attempt show that the risk is not theoretical. Any intervention would therefore need a safety screen before the first walk, and falls would need to be monitored as a balancing measure.
An Answerable Question
Stated in the PICOT format recommended for framing clinical questions (Melnyk & Fineout-Overholt, 2023): In adults aged 65 and older after surgical repair of a hip fracture on an orthopedic unit (P), does a nurse-led protocol for first ambulation within 24 hours of surgery (I), compared with current practice in which first ambulation usually waits for physical therapy (C), increase the proportion of patients who walk within 24 hours (O) during a three-month period (T)? The question is answerable because the outcome is already recorded, the comparison is current practice, and the intervention is one the unit's nurses could carry out within their scope. Secondary questions, such as the effect on length of stay and discharge destination, depend on data linkage I do not yet have and are held for later work.
What This Statement Commits the Rest of the Work To
The search in the next unit will look for evidence on early mobilization after hip fracture surgery and on nurse-led or protocol-driven mobilization in orthopedic and medical units. It will not broaden into mobility of all hospitalized older adults, because that literature, while relevant, would answer a different question. The local data collection method will be improved before any change is tried, so that nursing-led walks are recorded on every shift and the baseline is accurate.
References
American Academy of Orthopaedic Surgeons. (2021). Management of hip fractures in older adults: Evidence-based clinical practice guideline. American Academy of Orthopaedic Surgeons.
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Oldmeadow, L. B., Edwards, E. R., Kimmel, L. A., Kipen, E., Robertson, V. J., & Bailey, M. J. (2006). No rest for the wounded: Early ambulation after hip surgery accelerates recovery. ANZ Journal of Surgery, 76(7), 607-611. https://doi.org/10.1111/j.1445-2197.2006.03786.x
NU 760 Unit 1 instructions, in plain terms
Unit 1 has you write a practice problem statement that will anchor the scholarly project for the rest of the course. You will describe a problem from your practice, bound it by population and setting, show local evidence that it exists, explain its significance with literature, identify stakeholders and end with a clinical question, usually in PICOT form. Many versions ask about feasibility, meaning whether a project on this problem could actually happen in your setting. Check whether your section requires local data or accepts literature alone. A narrow problem on one unit is easier to carry through later units than a broad one. Write in a way that lets the next assignments, the search and the appraisal, follow directly from the question you set.
Inside the NU 760 Unit 1 example
The paper opens with a brief first-person account of how the problem appears on the unit, which shows the grader it is real. The bounding section names population, setting, timeframe and outcome in labeled lines. Local evidence comes from a small record review with a method stated in two sentences and results given as counts. Significance moves from national data to clinical consequences for patients. The section on what the problem is not is a useful move, since saying what is excluded keeps later units focused. Stakeholders are listed with what each wants, from physical therapists to families. The PICOT question is written out in full with each element labeled. The closing section says exactly what the next unit's search will look for.
Where the points sit in the NU 760 Unit 1 rubric
Herzing's rubric for the problem statement tends to cover problem identification, significance, local evidence, stakeholders and feasibility, the clinical question and writing. Problem identification earns points for a clear, specific issue in a defined setting. Significance criteria reward scholarly evidence on prevalence and consequences, such as the AAOS guideline cited here. Local evidence points go to data from the practice setting, even a small chart review. Stakeholder and feasibility criteria look for realistic assessment of who must be involved and what resources are needed. The clinical question is often the most important row, with full credit for a properly formed PICOT whose elements match the problem. The writing criterion covers organization, scholarly tone and APA 7, including Melnyk and Fineout-Overholt for the question format.
Common NU 760 Unit 1 mistakes, and how to avoid them
Problem statements in Unit 1 commonly lose credit for a problem too broad to study, such as falls in hospitals. Another frequent weakness is a PICOT question whose population or outcome does not match the problem described. Students often rely only on national statistics, when the rubric wants evidence that the problem exists on their own unit. Significance sections can turn into general background with no link to patient outcomes. Feasibility is often skipped. Some papers propose a solution in the problem statement, which narrows the search too early. Stakeholders listed by title without their interests add little. Finally, write the time element of PICOT clearly, such as within 24 hours of surgery, because a vague timeframe makes later measurement difficult.
Get a NU 760 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 760 classroom, plus the setting and the problem you want to work on for the rest of the course. We write a custom example that bounds it, evidences it locally and phrases it as an answerable question, returned in 24 to 48 hours. The first custom sample is free.
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NU 760 Unit 1 questions, answered
How narrow should the problem be?
Narrow enough that you could name the unit and the group affected in one sentence. Medication errors covers a hospital; medication errors during shift handover on one telemetry unit gives every later assignment something specific to work with. Narrow problems feel smaller and produce better papers, because the evidence can actually reach them.
What if I cannot get local data?
Use what you can obtain and say what you could not. A short chart review, a count from your own unit, or a month of incident data all establish that the problem exists where you work. Substituting a national rate and presenting it as local is the error that damages everything after it, because it makes every other figure questionable.
Does the problem have to be one I can fix?
It has to be one scholarship could address, which is a lower bar. You are not committing to solving it, only to investigating it in a way that could inform practice. What matters is that the question is answerable from evidence rather than a matter of preference, and that the answer would tell somebody in your setting what to do.
Where can I find a free NU 760 Unit 1 sample paper?
Read the whole NU 760 Unit 1 hip fracture ambulation statement free here, from the bounded problem to the PICOT question. A custom problem statement can be built from your own unit's issue and local data.
How do I write a PICOT question for a nursing project?
Name the population, the intervention, the comparison, the outcome and the time frame, each specific to your problem. This sample asks whether walking older adults within 24 hours of hip fracture repair, compared with later ambulation, improves walking at discharge.