| Course | NUR 405 Professional Nurse Concepts Advanced |
|---|---|
| Module | Module 4 |
| Paper type | Group APA paper |
| Length | About 744 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BSN in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 405 Module 4
Two Quiet Hours: Techniques for Starting, Supporting and Sustaining a Rest Period on a Medical-Surgical Unit
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 405: Professional Nurse Concepts: Advanced
Instructor Name
Month Day, Year
Two Quiet Hours: Techniques for Starting, Supporting and Sustaining a Rest Period on a Medical-Surgical Unit
Introduction
Most nurses can name a change that started with enthusiasm and faded within months. The reason is rarely that the idea was bad; it is that the work of starting a change, supporting people through it and keeping it going was not planned. This paper explains techniques for each of those phases using one example: a daily quiet period on a 32-bed medical-surgical unit.
The Example: A Daily Quiet Period
Hospitals are noisy and patients sleep poorly. During the quiet period, lights dim, staff lower their voices, televisions are muted, nonurgent tasks such as linen changes wait, and visitors are asked to return after 3:30. In a non-randomized trial on orthopedic wards in two Australian hospitals, a quiet time period was associated with lower noise levels and more patients asleep during the quiet time than on the comparison ward, and patients, staff and visitors rated it favorably (Gardner et al., 2009). The evidence is promising but comes from one design, which is one more reason to plan the change carefully and measure it.
Initiating Change
Lewin (1951) described three stages: unfreezing, moving and refreezing, so that new behavior becomes the settled routine. Initiating change is unfreezing, and its main tool is a reason people feel. Kotter (1996) calls this creating a sense of urgency and argues that most failed changes skip it.
Techniques for this phase:
1. Show the problem with local data. The group proposes a two-week noise audit at 2 p.m. and a short patient survey on sleep, shared at a staff meeting.
2. Tell a patient's story. A quote from a patient who could not rest after surgery often moves staff more than decibel readings.
3. Build a guiding coalition. Kotter's second step is a team with the credibility to lead, here a charge nurse, a respected night nurse who works days twice a month, a physical therapist and the unit manager.
4. Involve the people most affected. Environmental services, therapy and pharmacy all have afternoon tasks, so they must help design the rules.
Supporting Change
Moving to the new practice requires people to change habits while still doing their jobs. Rogers (2003) describes attributes that speed adoption, including relative advantage, compatibility with existing values, simplicity, the chance to try an innovation on a small scale and visible results.
Techniques for this phase:
1. Make it simple. A one-page list of what pauses and what never pauses, such as pain medication, assessments of unstable patients and call lights, answers the first question every nurse will ask.
2. Start small. A two-week trial on one hallway lets staff test the rules and suggest changes.
3. Make it visible. A sign at each door and dimmed hallway lights remind everyone, including visitors, without a nurse having to explain.
4. Remove barriers. If therapy sessions are often scheduled at 2 p.m., the schedule must move before the change can work.
5. Expect resistance and listen to it. Concerns about missed tasks or upset visitors often point to rules that need adjusting.
Sustaining Change
Refreezing is the phase most often neglected. Kotter (1996) warns against declaring victory too soon and urges anchoring changes in the culture.
Techniques for this phase:
1. Keep measuring. Monthly noise readings and a quarterly patient survey item on rest show whether the practice is holding.
2. Share results. A chart at the staff huddle board showing quieter afternoons keeps the change in view.
3. Build it into structures. Add the quiet period to orientation, the visitor policy and the unit's daily schedule so it does not depend on its first champions.
4. Recognize the people who protect it. Thanking staff who redirect visitors or reschedule tasks reinforces the new norm.
Measures of Success
| Phase | Measure | Target |
|---|---|---|
| Initiating | Staff attending the kickoff meeting; coalition formed | 75% of staff; coalition by week 2 |
| Supporting | Afternoons with quiet period observed during the trial | 4 of 5 weekdays |
| Sustaining | Mean noise level at 2 p.m.; patients reporting they could rest | Lower than baseline at 6 and 12 months |
Conclusion
A quiet period is a small change, but it shows the same pattern as large ones. It needs a reason people feel, support that makes the new habit easy and structures that keep it going after the first enthusiasm fades. The techniques in this paper apply whether the change is a quiet hour or a new documentation system.
References
Gardner, G., Collins, C., Osborne, S., Henderson, A., & Eastwood, M. (2009). Creating a therapeutic environment: A non-randomised controlled trial of a quiet time intervention for patients in acute care. International Journal of Nursing Studies, 46(6), 778-786. https://doi.org/10.1016/j.ijnurstu.2008.12.009
Kotter, J. P. (1996). Leading change. Harvard Business School Press.
Lewin, K. (1951). Field theory in social science: Selected theoretical papers. Harper & Row.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press.
NUR 405 Module 4 instructions, in plain terms
Worth 12 points in the posted syllabus, the Group Paper has a one-line description: students work in a small group to write a paper explaining techniques for initiating, supporting and sustaining change in health care. A group projects check-in earlier in the term lets faculty see your progress. Canvas sets the length, format and rubric. Expect to explain change theory, but the heart of the paper is techniques: concrete actions a nurse leader takes to start a change, help people through it and keep it from fading. Using one example throughout makes the techniques specific. Divide the writing early, then have one member edit for a single voice, since group papers lose points when sections read as if written by different people.
How this NUR 405 Module 4 example is built
The paper introduces the problem of changes that fade and states its example, a daily quiet period on a medical-surgical unit, supported by a non-randomized trial whose design is named. Three main sections follow the assignment's phases. Each opens with the relevant change theory, Lewin for the phase structure, Kotter and Rogers for specific steps and attributes, and then lists numbered techniques applied to the example. A table gives one measure and target for each phase, and a short conclusion generalizes the lesson. Four sources support the paper, three of them foundational change texts and one a research study. Each technique is written as an action someone on the unit could take next week.
Reading the NUR 405 Module 4 grading rubric
Group papers on change are likely graded on accurate explanation of change theories, specific and practical techniques for each phase, application to a health care example, use of evidence, organization, a consistent voice and APA format. Techniques earn more credit than theory summaries, so most of the paper should describe actions. Applying each technique to the same example shows understanding. Including measures shows the group knows how to tell whether change worked. Citing the original change theorists demonstrates scholarship. Smooth transitions between members' sections affect the writing score. Every member should be able to explain any part of the paper. A paper that a nurse manager could actually follow tends to score well on application.
NUR 405 Module 4 help from the desk
Groups often spend pages on Lewin and Kotter and a single paragraph on techniques. Reverse the balance. Another is listing techniques without an example, which makes them sound generic; choose one change and apply every technique to it. Plan who writes which section and set an internal deadline for a full draft. If your group would like help structuring the paper around its chosen change, describe the change and the rubric to the desk. Have one person read the whole draft aloud to catch shifts in voice. Check that every theorist you name appears in the reference list.
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 405 Module 4 questions, answered
Where can I find a free NUR 405 Module 4 sample paper?
The group paper on this page is a full NUR 405 sample, on initiating, supporting and sustaining a daily quiet period on a medical-surgical unit.
How many points is the NUR 405 group paper worth?
The posted syllabus lists the Group Paper at 12 of 100 points.
What change theories fit a nursing change paper?
Lewin's three stages, Kotter's steps for leading change and Rogers's diffusion of innovations are common choices.
How do you sustain a change in nursing practice?
Keep measuring, share results, build the change into orientation and policy and recognize staff who protect it.
What is a hospital quiet time intervention?
A scheduled period when lights dim, noise is reduced and nonurgent care pauses so patients can rest.