| Course | DNP 704 Principles of Evidence-based Care in Advanced Practice |
|---|---|
| Module | Module 2 |
| Paper type | Exhaustive search narrative with partial evaluation table |
| Length | About 610 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 704 Module 2
From 1,214 Records to 12 Studies: An Exhaustive Search for Evidence on Nurse-Led Fracture Liaison Services
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 704: Principles of Evidence-based Care in Advanced Practice
Instructor Name
Month Day, Year
From 1,214 Records to 12 Studies: An Exhaustive Search for Evidence on Nurse-Led Fracture Liaison Services
PICOT Question
The question carried forward from Paper 1 is unchanged: for adults 50 and older treated in our orthopedic clinic after a low-energy fracture (P), would a fracture liaison service run by a nurse (I), compared with current care (C), raise the share who begin osteoporosis treatment (O) within six months (T)?
Search Terms
| PICOT element | Keywords | Subject headings |
|---|---|---|
| Population | fragility fracture, osteoporotic fracture, low-trauma fracture | Osteoporotic Fractures (MeSH); Fractures, Bone (CINAHL) |
| Intervention | fracture liaison service, care manager, nurse-led, coordinator | Case Management; Nurse's Role |
| Outcome | osteoporosis treatment, bone density testing, secondary prevention | Bone Density Conservation Agents; Secondary Prevention |
Databases and Strategy
I searched PubMed, CINAHL, the Cochrane Library and Embase on the same day, combining keywords and subject headings with Boolean operators, for example: ("Osteoporotic Fractures"[MeSH] OR "fragility fracture" OR "low-trauma fracture") AND ("fracture liaison" OR "case manager" OR coordinator OR "nurse-led") AND (treatment OR "bone density" OR "secondary prevention"). I restricted results to adults, English and the years since 2010, since FLS programs expanded after that period. I hand-searched reference lists of included reviews and checked trial registries for unpublished trials. The final searches were run on the same afternoon so that counts across databases reflect one point in time. Search dates and strings are kept in an appendix.
Results of the Search
After removing 398 duplicates, 816 titles and abstracts were screened; 744 were excluded as off-topic, not FLS, or without a usual care comparison. Seventy-two full texts were assessed; 60 were excluded for reasons including no treatment outcome, inpatient-only design, or commentary format. Twelve sources were retained: three systematic reviews and meta-analyses, four randomized trials and five quasi-experimental or cohort studies.
| Database | Records |
|---|---|
| PubMed | 486 |
| CINAHL | 212 |
| Embase | 471 |
| Cochrane Library | 45 |
| Total | 1,214 |
Inclusion and Exclusion Criteria
Included: adults aged 50 or older with fragility fracture; an FLS or coordinator model; a comparison with usual care; and a treatment, testing or subsequent fracture outcome. Excluded: studies limited to hip fracture inpatients without outpatient follow-up, case reports, and studies without original data.
Evaluation Table, Part 1
The remaining nine rows, including the randomized trials, will be completed in Paper 3.
| Citation | Design and level | Sample and setting | Intervention | Outcomes | Key findings |
|---|---|---|---|---|---|
| Wu et al. (2018) | Systematic review with meta-analysis; Level I | 57 high-quality studies, adults 50 and older with osteoporotic fracture | FLS models by coordinator type | BMD testing, treatment initiation | FLS increased testing and treatment; dedicated coordination and multidisciplinary care key |
| Li et al. (2021) | Systematic review and meta-analysis; Level I | 16 studies, 18 FLS versus no-FLS comparisons | FLS versus usual care | Subsequent fracture, mortality | Lower odds of subsequent fracture with FLS (odds ratio 0.70), stronger with follow-up beyond 2 years |
| Danazumi et al. (2024) | Systematic review and meta-analysis with GRADE; Level I | 37 studies, 22 meta-analyzed, adults 50 and older | FLS versus non-FLS | Secondary fragility fracture | Lower risk with FLS at 2 or more years, moderate certainty |
Reflection on the Search
The search confirmed a strong review-level evidence base for FLS but fewer trials testing nurse-led models specifically in outpatient orthopedic settings, which will shape how I weigh the evidence. Two lessons from the process will carry into Paper 3. First, the term fracture liaison service is not a subject heading in every database, so keyword searching was essential, and I saved each string so the search can be rerun. Second, several promising studies measured only bone density testing, not treatment, so the outcome in my PICOT question narrowed the set more than I expected. I kept a log of every exclusion decision so a classmate could audit them.
References
Danazumi, M. S., Lightbody, N., & Dermody, G. (2024). Effectiveness of fracture liaison service in reducing the risk of secondary fragility fractures in adults aged 50 and older: A systematic review and meta-analysis. Osteoporosis International, 35(7), 1133-1151. https://doi.org/10.1007/s00198-024-07052-1
Li, N., Hiligsmann, M., Boonen, A., van Oostwaard, M. M., de Bot, R. T. A. L., Wyers, C. E., Bours, S. P. G., & van den Bergh, J. P. (2021). The impact of fracture liaison services on subsequent fractures and mortality: A systematic literature review and meta-analysis. Osteoporosis International, 32(8), 1517-1530. https://doi.org/10.1007/s00198-021-05911-9
Wu, C.-H., Chen, C.-H., Chen, P.-H., Yang, J.-J., Chang, P.-C., Huang, T.-C., Bagga, S., Sharma, Y., Lin, R.-M., & Chan, D.-C. (2018). Identifying characteristics of an effective fracture liaison service: Systematic literature review. Osteoporosis International, 29(5), 1023-1047. https://doi.org/10.1007/s00198-017-4370-z
Reading the DNP 704 Module 2 assignment instructions
The posted syllabus describes Paper 2 as a continuation of Paper 1 that reports an exhaustive search, including the search strategy and results, to answer the final PICOT question. It should show how systematically databases were explored and allow colleagues to replicate the search, and it includes part of the evaluation table, which the syllabus describes as a synthesis tool that shows the strength of evidence to change practice. Collectively, the four papers make up four fifths of the course grade. Expect to report databases, terms, limits and numbers at each screening stage, with criteria for inclusion and exclusion. Use the PICOT question from Paper 1, revised after faculty feedback, so the search answers the final version of the question.
Inside the DNP 704 Module 2 example
The paper restates the PICOT question, then maps each element to keywords and subject headings in a table. A sample search string shows Boolean logic, and limits are stated with reasons. Results are reported by database and through each screening stage, so the numbers add up from records to retained studies. Inclusion and exclusion criteria are explicit. The first three rows of the evaluation table cover the highest-level evidence, and a short reflection notes a gap the search revealed. A reflection on the process records lessons that will shape the next paper, which shows the search was a learning step, not a box to check. Tables keep the numbers easy to verify. Criteria are stated before results are discussed, which lets a reader check that each exclusion followed the rules.
Reading the DNP 704 Module 2 grading rubric
Search papers are commonly graded on replicability, use of multiple appropriate databases, combined subject headings and keywords, justified limits, clear reporting of results through screening, explicit inclusion and exclusion criteria, and accurate leveling in the evaluation table. Faculty look for numbers that reconcile at each step. A reflection that notes where evidence is thin shows critical thinking that carries into later papers. Accurate leveling of systematic reviews and trials is essential. Saving and reporting exact search strings is often noted as a strength. Clear criteria also earn credit. Accurate counts that reconcile are essential.
DNP 704 Module 2 help with common mistakes
The most common weakness is a search described in general terms that no one could repeat. Give the actual strings, dates and counts. Another is numbers that do not add up between stages. Use at least three databases and hand-search reference lists. Level each source correctly. Keep the evaluation table consistent with your PICOT outcomes. If you would like help documenting an exhaustive search, send your PICOT question to the desk. Work with a health sciences librarian on subject headings, since ASU librarians can help you build strings for each database. Log every exclusion decision. Report the date each database was searched.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DNP 704 Module 2 questions, answered
Where can I find a free DNP 704 Module 2 sample paper?
Paper 2 is above in full: an exhaustive, replicable search on nurse-led fracture liaison services with terms, databases, counts at each stage, criteria and the first rows of the evaluation table.
What makes a search exhaustive in DNP 704?
Multiple databases, subject headings plus keywords, stated limits, hand-searching and full reporting of results at each screening stage.
What is the evaluation table in DNP 704?
A synthesis tool that records each source's design, level, sample, intervention, outcomes and findings to show the strength of evidence for practice change.
How many databases should I search for DNP 704?
The syllabus asks for a systematic exploration; most students search at least three, such as PubMed, CINAHL and Cochrane.
Why report counts at each screening step?
So readers can follow how records were narrowed to included studies and replicate the process.