DNP 704 Module 3 Evidence Table Paper Example

Course	DNP 704 Principles of Evidence-based Care in Advanced Practice
Module	Module 3
Paper type	Revised review with completed evidence evaluation table
Length	About 872 words, 6 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 3

What Twelve Sources Say About Nurse-Coordinated Fracture Care: A Revised Review and Completed Evidence Table

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

What this page is doingThe title names the evidence base and the two parts of the assignment, a revised review and a completed table.

What Twelve Sources Say About Nurse-Coordinated Fracture Care: A Revised Review and Completed Evidence Table

Revised Background and Significance

A fragility fracture is the clearest warning of future fracture, yet most adults leave fracture care untreated for osteoporosis. Fewer than three in ten hip fracture patients in national claims data used osteoporosis medication within a year, and the share halved over a decade (Solomon et al., 2014). My clinic's own review of 60 charts showed a bone health plan for 15% of patients and treatment started for 7%. Fracture liaison services, coordinated programs that ensure evaluation and treatment after fracture, are a recommended system response. Faculty feedback on Paper 1 asked me to state the clinic's ownership gap more directly: no clinician role in our workflow is responsible for bone health after the cast comes off.

What this page is doingThe revised background is tighter than the first paper's, a sign that feedback was used rather than the original text being resubmitted.

Revised Search Narrative

I searched PubMed, CINAHL, Embase and the Cochrane Library using subject headings and keywords for fragility fracture, fracture liaison or coordinator models, and treatment or bone density outcomes, limited to English-language studies of adults published from 2010 onward. Of 1,214 records, 816 remained after duplicates were removed; 72 full texts were assessed and 12 sources retained, including three systematic reviews with meta-analyses. I updated the search one month later and found no new eligible studies, and I added a saved alert in PubMed so new trials will reach me during the project.

Completed Evidence Evaluation Table

The six added rows complete the table. The three trials test the coordinator idea directly, and the third compares a nurse case manager with a lighter mix of teaching and reminders, the closest match to the model proposed for the clinic. The three cohorts carry the comparison to fracture outcomes and death and show that even a minimal resource service raises treatment.

Source	Design, level	Who and where	What was done	Outcomes measured	Results	Strengths, limits
Wu et al. (2018)	Systematic review with meta-analysis; I	57 studies, adults 50 and older	FLS by coordinator type	Testing, treatment	Higher testing and treatment with FLS	Broad; heterogeneous models
Li et al. (2021)	Systematic review and meta-analysis; I	16 studies	FLS versus no FLS	Refracture, mortality	Odds ratio 0.70 for subsequent fracture	Many before-after designs
Danazumi et al. (2024)	Systematic review and meta-analysis with GRADE; I	37 studies	FLS versus non-FLS	Secondary fracture	Lower risk at 2 or more years, moderate certainty	Low certainty at 1 year
Solomon et al. (2014)	Retrospective cohort; IV	96,887 U.S. claims, hip fracture	None (usual care)	Medication use	28.5% treated within 12 months, declining	Claims data; insured only
US Preventive Services Task Force (2025)	Recommendation statement; VII	Adults 40 and older without fracture	Screening	Fracture prevention	Screen women 65 and older	Applies before, not after, fracture
Graham et al. (2006)	Conceptual framework; VII	Not applicable	Knowledge-to-action cycle	Not applicable	Steps for moving evidence into practice	Not tested as an intervention
Majumdar et al. (2007)	Randomized controlled trial; II	220 adults 50 and older after hip fracture, Alberta	Case manager educated, ordered bone density tests, prescribed and informed the primary care physician	Bisphosphonate use at 6 months, testing	51% vs 22% treated; 80% vs 29% tested	Strong design; hip fracture only
Majumdar et al. (2008)	Randomized controlled trial; II	272 adults over 50 after wrist fracture	Telephone education plus physician reminders and guidelines	Bisphosphonate use at 6 months	22% vs 7% treated	Blinded outcomes; treatment still low
Majumdar et al. (2011)	Randomized pilot trial; II	46 wrist fracture patients still untreated at 1 year	Nurse case manager vs teaching plus physician reminders	Treatment, testing, cost	43% vs 12% treated; 81% vs 52% tested; $44 vs $12 per patient	Small sample; closest match to a nurse-led model
Huntjens et al. (2014)	Cohort, two hospitals; IV	3,322 adults 50 and older with nonvertebral fracture, Netherlands	FLS hospital vs standard fracture care	Subsequent fracture, mortality over 2 years	Mortality HR 0.65; refracture HR 0.44 at 24 months	Hospitals may differ in other ways
Nakayama et al. (2015)	Historical cohort, two hospitals; IV	931 adults 50 and older with minimal trauma fracture, Australia	FLS vs no FLS	Refracture over 3 years	Any refracture HR 0.67; 20 patients needed per fracture prevented	Intention-to-treat; not randomized
Axelsson et al. (2016)	Before-after cohort; IV	5,329 adults over 50 with fracture, Sweden	Minimal resource FLS using existing secretaries	Testing, treatment, refracture	Testing 7.6% to 39.6%; treatment 12.6% to 31.8%	Shows a low-cost model; historic controls

What this page is doingThe table grades each source by level and adds a strengths and limits column, which is where appraisal shows inside an evidence table.

What the Completed Table Shows

Three Level I reviews agree that FLS improves testing and treatment and reduces subsequent fractures over longer follow-up, though many included studies used before-and-after designs. Lower-level studies are consistent in direction. The national cohort documents the size of the gap, and the framework guides implementation. The evidence is sufficient to justify a practice change, with careful local evaluation. Two gaps remain. Few studies tested nurse-coordinated models in outpatient orthopedic clinics like mine, and few reported outcomes separately for men, who are treated least often after fracture. These gaps argue for measuring treatment initiation by sex and fracture site in my project, and for reporting results in a way that could add to the literature. The final paper will appraise each review's methods in more depth and explain how the knowledge-to-action framework guides implementation.

References

Axelsson, K. F., Jacobsson, R., Lund, D., & Lorentzon, M. (2016). Effectiveness of a minimal resource fracture liaison service. Osteoporosis International, 27(11), 3165-3175. https://doi.org/10.1007/s00198-016-3643-2

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

Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13-24. https://doi.org/10.1002/chp.47

Huntjens, K. M., van Geel, T. A., van den Bergh, J. P., van Helden, S., Willems, P., Winkens, B., Eisman, J. A., Geusens, P. P., & Brink, P. R. (2014). Fracture liaison service: Impact on subsequent nonvertebral fracture incidence and mortality. Journal of Bone and Joint Surgery, 96(4), e29. https://doi.org/10.2106/JBJS.L.00223

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

Majumdar, S. R., Beaupre, L. A., Harley, C. H., Hanley, D. A., Lier, D. A., Juby, A. G., Maksymowych, W. P., Cinats, J. G., Bell, N. R., & Morrish, D. W. (2007). Use of a case manager to improve osteoporosis treatment after hip fracture: Results of a randomized controlled trial. Archives of Internal Medicine, 167(19), 2110-2115. https://doi.org/10.1001/archinte.167.19.2110

Majumdar, S. R., Johnson, J. A., Bellerose, D., McAlister, F. A., Russell, A. S., Hanley, D. A., Garg, S., Lier, D. A., Maksymowych, W. P., Morrish, D. W., & Rowe, B. H. (2011). Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: Randomized controlled pilot study. Osteoporosis International, 22(1), 223-230. https://doi.org/10.1007/s00198-010-1212-7

Majumdar, S. R., Johnson, J. A., McAlister, F. A., Bellerose, D., Russell, A. S., Hanley, D. A., Morrish, D. W., Maksymowych, W. P., & Rowe, B. H. (2008). Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: A randomized controlled trial. Canadian Medical Association Journal, 178(5), 569-575. https://doi.org/10.1503/cmaj.070981

Nakayama, A., Major, G., Holliday, E., Attia, J., & Bogduk, N. (2015). Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporosis International, 27(3), 873-879. https://doi.org/10.1007/s00198-015-3443-0

Solomon, D. H., Johnston, S. S., Boytsov, N. N., McMorrow, D., Lane, J. M., & Krohn, K. D. (2014). Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. Journal of Bone and Mineral Research, 29(9), 1929-1937. https://doi.org/10.1002/jbmr.2202

US Preventive Services Task Force. (2025). Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA, 333(6), 498-508. https://doi.org/10.1001/jama.2024.27154

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 3 assignment instructions

The posted syllabus describes Paper 3 as a continuation of Paper 2 that includes the revised background and significance, the search strategy narrative and a completed evidence evaluation table. Like the other papers, it builds toward the final evidence-based practice paper and the DNP project, and it counts toward the 80% of the grade carried by papers. Expect faculty feedback on Papers 1 and 2 to be incorporated, so keep a record of changes. The completed table should cover every source you will appraise in the final paper. Canvas lists the table columns your section uses. Bring faculty feedback from Papers 1 and 2 into this paper. Allow a week for revisions.

How the DNP 704 Module 3 example is put together

The paper condenses the earlier sections and shows how faculty feedback changed them, which demonstrates revision rather than repetition. The search narrative is shortened but keeps the numbers that make it replicable and notes an updated search. The completed table adds a column on strengths and limits and levels each source consistently, including a guideline and a framework at Level VII. A closing section summarizes what the table shows, setting up appraisal and synthesis in the final paper. The closing section names remaining gaps and explains how they will shape the project's measures. Twelve rows fill the table, from three reviews and three trials down to the framework. Revisions are explained briefly so faculty can see what changed and why it changed.

Reading the DNP 704 Module 3 grading rubric

Faculty grade this paper on genuine revision of earlier sections, a complete and accurate evaluation table with consistent leveling, appropriate inclusion of all sources needed for the final paper, and a plain account of what the body of evidence shows. Faculty look for revisions that respond to feedback, not just rearranged text. Strength and limits recorded for each source make the table useful for synthesis. Accurate leveling of nonresearch sources, such as guidelines and frameworks, shows careful judgment. Papers that explain how feedback changed earlier sections show growth across the scaffolded sequence. A rerun of the search is noted favorably. Consistent leveling across all rows matters.

DNP 704 Module 3 help with common mistakes

Students often paste Papers 1 and 2 unchanged. Revise them in response to feedback and say what changed. Another weakness is a table missing studies that will appear in the final paper. Keep columns consistent and level every source. Note limitations in the table, not only in the text. Rerun your search before submitting. If you would like help completing your evidence table, send your table and PICOT question to the desk. Keep a short change log of revisions in response to faculty comments, which makes your growth easy to show. Check every citation against its table row. Level each source the same way throughout. Include every source you will appraise later.

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.

More DNP 704 and Doctor of Nursing Practice sample papers

DNP 704 Module 3 questions, answered

Where can I find a free DNP 704 Module 3 sample paper?

Paper 3 is shown above in full: a revised background and search narrative and a completed evidence evaluation table on fracture liaison services, with what the table shows.

What goes in DNP 704 Paper 3?

The revised background and significance, the search strategy narrative and a completed evidence evaluation table.

How do I level guidelines in an evidence table?

Most hierarchies place guidelines and expert reports at Level VII unless they are based on systematic reviews.

Should I revise Papers 1 and 2 for Paper 3?

Yes. The papers are scaffolded, and faculty expect revisions based on feedback.

Why add a strengths and limits column?

It makes the table useful for synthesis and appraisal in the final paper.

DNP 704 Module 3 Evidence Table Paper (Paper 3) Example