| Course | NUR 391 Professional Nursing Theory |
|---|---|
| Module | Module 5 |
| Paper type | Discussion post with peer reply |
| Length | About 467 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 391 Module 5
Discussion: Quality and Patient Safety
Audits, Feedback and Chlorhexidine: What a Dialysis Clinic Can Learn From a National Bloodstream Infection Collaborative
Initial Post
The safety problem I chose is bloodstream infection in patients who dialyze through a central venous catheter. In our clinic, about one in five patients still has a tunneled catheter while waiting for a fistula or graft to mature. Each time a catheter is connected or disconnected, the hub is opened to the bloodstream, and an infection can mean hospitalization, a lost access or death. Our reading this module describes quality as doing the right thing well and consistently (Friberg & Saewert, 2023), and catheter care is a clear example of a task where small lapses add up.
A national project shows what is possible. In 2009, the Centers for Disease Control and Prevention sponsored a collaborative of 17 outpatient hemodialysis facilities that adopted a package of interventions: chlorhexidine for catheter exit-site care, staff training and competency checks in catheter care and aseptic technique, monthly audits of hand hygiene and access care, and feedback of infection and adherence rates to staff (Patel et al., 2013). Modeled rates of access-related bloodstream infection dropped by more than half when the intervention began. A follow-up analysis found that the reduction in access-related infections was sustained for up to four years, although overall bloodstream infections returned to baseline (Yi et al., 2016). That second finding matters: gains last only if the practices are kept up.
In my clinic we already use chlorhexidine and have annual competency checks, but we do not audit catheter connections or share results with staff. I would propose that the charge nurse observe five catheter connections and disconnections each week using a short checklist, and that results be posted monthly beside our infection rate. Audits take about ten minutes each and require no new supplies.
This fits a systems view of safety. Instead of blaming the nurse or technician who was involved when an infection occurs, audits and feedback show the whole team where steps are skipped and why. A technician might skip a hub scrub when three alarms are sounding, which is a workload problem as much as a technique problem.
Reply to a Classmate
Jordan, your post on insulin errors during shift change made a good case for independent double checks. One question is how you would know whether the checks are working. Error reports alone may rise at first because people notice more, which can look like failure. In the dialysis collaborative I described, facilities tracked both outcomes, the infection rates, and process measures, how often staff followed the steps (Patel et al., 2013). You might track the percentage of insulin doses with a documented second check alongside error reports, so the team can see whether the practice is happening before judging whether it reduces harm.
References
Friberg, E. E., & Saewert, K. J. (Eds.). (2023). Conceptual foundations: The bridge to professional nursing practice (8th ed.). Elsevier.
Patel, P. R., Yi, S. H., Booth, S., Bren, V., Downham, G., Hess, S., Kelley, K., Lincoln, M., Morrissette, K., Lindberg, C., Jernigan, J. A., & Kallen, A. J. (2013). Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: A quality improvement report. American Journal of Kidney Diseases, 62(2), 322-330. https://doi.org/10.1053/j.ajkd.2013.03.011
Yi, S. H., Kallen, A. J., Hess, S., Bren, V. R., Lincoln, M. E., Downham, G., Kelley, K., Booth, S. L., Weirich, H., Shugart, A., Lines, C., Melville, A., Jernigan, J. A., Kleinbaum, D. G., & Patel, P. R. (2016). Sustained infection reduction in outpatient hemodialysis centers participating in a collaborative bloodstream infection prevention effort. Infection Control & Hospital Epidemiology, 37(7), 863-866. https://doi.org/10.1017/ice.2016.22
What the NUR 391 Module 5 instructions ask for
The class syllabus groups this 5-point board with Module 5's reading on quality and patient safety and a library quiz. Prompts for this discussion typically ask you to identify a quality or safety concern in your practice, explain it with the module's concepts, support your points with evidence, and propose an improvement, then respond to peers. The library quiz in the same module is a hint that instructors expect a peer-reviewed source found through ASU Library, not only the textbook. Read the Canvas instructions for the required number of sources and replies and for any required framework, such as a systems approach or the national patient safety goals.
How the NUR 391 Module 5 example is put together
The post opens with a specific safety problem in a specific setting and explains why each catheter connection carries risk. It ties the problem to the module's view of quality in one sentence, then summarizes a real quality improvement project with its intervention package and results, adding a follow-up study that shows which gains lasted. The writer compares the clinic's current practice with the package and proposes one small, measurable change, weekly audits with posted feedback. A paragraph links the change to a systems approach to safety. The reply to a classmate offers a process measure, supported by the same study, to judge a different safety intervention. Both studies are cited where their findings appear.
Where the marks sit in the NUR 391 Module 5 rubric
Graders tend to look for a clearly described safety problem, accurate use of the module's concepts, evidence from a scholarly source, and a realistic improvement, plus a reply that adds something. Proposals that name what would be measured often score higher, since quality work depends on measurement. APA citations in the post and a reference list under it are expected. Because the board is short, clarity and focus usually matter more than length. Posts that describe a problem without a proposal, or that propose a change without evidence, tend to lose points in the content rows. A sentence on how the change would be sustained, not only launched, is a useful addition.
NUR 391 Module 5 help from the desk
The biggest weakness in safety posts is blaming a person rather than examining the system that made the error likely. Another is proposing a large program, such as new software, when the prompt asks for something you could influence. Use numbers carefully: report what the study found, including results that did not last. Do not include patient details or name your facility. A proposal reads stronger with a measure attached, such as an audit rate. For a draft built on your own unit's safety concern, send the prompt and a short description to the desk. Also report both the good and the disappointing findings from any study you cite, because selective reporting is easy for a grader to spot. Finally, keep the reply as specific as the initial post.
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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NUR 391 Module 5 questions, answered
Where can I find a free NUR 391 Module 5 sample paper?
The quality and safety discussion is shown in full on this page: an initial post on catheter infections at a dialysis clinic with a proposed audit change, a reply to a classmate, and references.
What safety topic should I choose for NUR 391 Module 5?
Pick a problem you see at work that nurses can affect, such as infections, falls, medication errors, handoffs or alarms, and find a peer-reviewed study that addresses it.
Do I need a library source for the NUR 391 safety discussion?
Most instructors expect at least one peer-reviewed source, and the module's library quiz is meant to prepare you to find one through ASU Library.
How do I make a NUR 391 safety proposal realistic?
Keep it small and specific, explain who would do it and how often, and name what you would measure. Low-cost changes that use existing staff are easier to defend.
What is a systems approach to patient safety in NUR 391?
It looks at how processes, workload, equipment and culture make errors likely, rather than blaming the individual involved, and it designs changes that make the safe action easier.