| Course | NUR 464 Capstone The Synthesis of Professional Nursing |
|---|---|
| Module | Module 6 |
| Paper type | Capstone project final paper (key assignment) |
| Length | About 978 words, 6 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 464 Module 6
Hearing the Plan of Care: Results of a Personal Hearing Amplifier Project for Older Adults on a Medical Unit
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 464: Capstone: The Synthesis of Professional Nursing
Instructor Name
Month Day, Year
Hearing the Plan of Care: Results of a Personal Hearing Amplifier Project for Older Adults on a Medical Unit
Introduction and Problem
Hearing loss is common among older adults and makes hospital communication difficult. On our 30-bed medical unit, many older patients could not hear their nurses, who compensated by speaking louder or speaking to family. Shukla et al. (2019) found in their review that hearing loss disrupted communication in every inpatient study they examined, and that inexpensive amplifiers helped in the studies that tried them. This project tested whether offering personal hearing amplifiers would improve older patients' reported understanding of their care and discharge plans.
Evidence Base
The intervention rests on a scoping review that found consistent improvement in speech understanding and high satisfaction with personal amplifiers, along with inconsistent staff use (Koerber et al., 2024); a randomized emergency department pilot in which older veterans given amplifiers reported easier understanding (Chodosh et al., 2021); and an acute care feasibility study in which nearly all hard-of-hearing patients were satisfied with the device (Kimball et al., 2018). The Iowa Model guided the work, with a single-unit pilot coming before any wider rollout (Iowa Model Collaborative, 2017).
Implementation
Implementation followed the revised timeline. During a three-week baseline, nurses screened patients aged 65 and older with one question about difficulty hearing conversation and asked screened-positive patients two understanding statements at discharge. During the six-week implementation phase, nurses offered one of four personal amplifiers for teaching, consent and discharge conversations, using a one-page guide reviewed by a speech-language pathologist. Two adjustments were made: the screening question was moved within the admission assessment after nurses skipped it on busy nights, and a device sign-out bin with a daily count was added after a trial device went missing. For Spanish-speaking patients, the amplifier microphone was placed beside the interpreter cart's speaker, a setup worked out with interpreter services.
Results
The outcome measure rose from 50% to 73% of screened-positive patients agreeing that they understood their care and discharge plan. Among the 34 patients who used an amplifier, 27 (79%) agreed with both statements, compared with 3 of the 7 who were not offered one. Screening completion improved after the question was moved. No devices were lost during implementation. Most nurses reported that conversations took the same time or less; three reported they took longer, mainly when interpreters were also used.
| Measure | Baseline (3 weeks) | Implementation (6 weeks) |
|---|---|---|
| Discharges aged 65 and older | 102 | 214 |
| Screening completed | 71% | 92% |
| Screened positive for hearing difficulty | 18 | 41 |
| Offered an amplifier (process) | not applicable | 34 of 41 (83%) |
| Agreed with both understanding statements (outcome) | 9 of 18 (50%) | 30 of 41 (73%) |
| Devices lost or damaged (balancing) | 1 before baseline | 0 |
| Nurses reporting longer teaching time (balancing) | not applicable | 3 of 22 surveyed |
Staff Feedback
At the end of implementation, 22 of the unit's nurses completed a five-question survey. Most said the screening question was easy to ask once it was in the communication section of the admission form. Nurses valued the amplifiers most for discharge teaching and for consent discussions, when accuracy matters. The most common complaint was finding the bin empty because devices had not been returned, which the daily count partly solved. Several nurses suggested a fifth device for busy weekend discharges, and two asked for a short card in Spanish explaining the device to patients.
Cost
The project's direct costs were four amplifiers, a replacement for the one lost before baseline, disposable ear covers, batteries and cleaning wipes, all within the under-,000 estimate in the proposal. Staff time was limited to one huddle session and about one minute per screening. No additional staffing was needed. Given the low cost and the absence of harm, the unit manager judged the practice worth continuing even with modest, composite evidence of benefit.
Interpretation and Limitations
The results suggest that offering amplifiers was associated with better reported understanding among hard-of-hearing older patients. The improvement is consistent in direction with the published pilot and feasibility studies. However, the project has important limits. The numbers are small, and the comparison is between two periods, not randomized groups, so other changes on the unit could explain part of the difference. The outcome is self-reported. Patients who were not offered an amplifier may have differed from those who were, for example in how ill or how alert they were. The project did not measure falls or readmissions, so it cannot say whether better understanding changed those outcomes, although hearing loss without hearing aids has been linked to inpatient falls (Tiase et al., 2020). These results justify continuing the practice on the unit and evaluating it further, not claiming that amplifiers improve clinical outcomes.
Sustainability
Three steps support sustainability. The screening question is now part of the electronic admission assessment. Orientation for new nurses now includes the devices. A named champion keeps the bin stocked and gives the unit council a monthly count of screens and offers. The manager agreed to replace devices from the supply budget.
Dissemination
Results will be presented to the unit council and the hospital's nursing practice council, with a recommendation that two other medical units with many older patients pilot the same approach. I will also submit a poster to the hospital's yearly showcase of nursing projects. The capstone presentation in Module 7 will share the project with classmates.
Reflection on Program Outcomes
This project drew on every part of the RN to BSN program: evidence appraisal, leadership and change, interprofessional collaboration, cultural context and quality measurement. Its most important lesson was that implementation is as much about systems and people as about evidence.
Conclusion
On one medical unit, pocket amplifiers for older patients with hearing trouble proved practical and cheap, and went along with better self-reported understanding. With sustainability steps in place, the practice will continue, and its wider adoption will be guided by further evaluation.
References
Chodosh, J., Goldfeld, K., Weinstein, B. E., Radcliffe, K., Burlingame, M., Dickson, V., Grudzen, C., Sherman, S., Smilowitz, J., & Blustein, J. (2021). The HEAR-VA pilot study: Hearing assistance provided to older adults in the emergency department. Journal of the American Geriatrics Society, 69(4), 1071-1078. https://doi.org/10.1111/jgs.17037
Iowa Model Collaborative. (2017). Iowa model of evidence-based practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175-182. https://doi.org/10.1111/wvn.12223
Kimball, A. R., Roscigno, C. I., Jenerette, C. M., Hughart, K. M., Jenkins, W. W., & Hsu, W. (2018). Amplified hearing device use in acute care settings for patients with hearing loss: A feasibility study. Geriatric Nursing, 39(3), 279-284. https://doi.org/10.1016/j.gerinurse.2017.10.009
Koerber, R. M., Kokorelias, K. M., & Sinha, S. K. (2024). The clinical use of personal hearing amplifiers in facilitating accessible patient-provider communication: A scoping review. Journal of the American Geriatrics Society, 72(7), 2195-2205. https://doi.org/10.1111/jgs.18784
Shukla, A., Nieman, C. L., Price, C., Harper, M., Lin, F. R., & Reed, N. S. (2019). Impact of hearing loss on patient-provider communication among hospitalized patients: A systematic review. American Journal of Medical Quality, 34(3), 284-292. https://doi.org/10.1177/1062860618798926
Tiase, V. L., Tang, K., Vawdrey, D. K., Raso, R., Adelman, J. S., Yu, S. P., Applebaum, J. R., & Lalwani, A. K. (2020). Impact of hearing loss on patient falls in the inpatient setting. American Journal of Preventive Medicine, 58(6), 839-844. https://doi.org/10.1016/j.amepre.2020.01.019
NUR 464 Module 6 instructions, in plain terms
Module 6, Evaluating Change and Communicating Results, holds the Capstone Project Final Paper, which the syllabus names as the key assignment used to judge program outcomes. A 70% threshold on its competencies applies before late penalties, with one resubmission allowed and capped at 70%. A practice project log is due in the same module. The paper usually asks you to summarize the problem and evidence, describe implementation, present results for your measures, interpret them with limitations, and explain sustainability and dissemination. Check Canvas for required headings, length and the rubric's competencies. Keep the paper consistent with your resubmitted proposal, and explain any change in measures.
How this NUR 464 Module 6 example is built
The paper follows the structure of a quality improvement report. Brief sections restate the problem, the evidence and the model used. Implementation is described with the two adjustments made along the way. A results table reports baseline and implementation figures for outcome, process and balancing measures with denominators, followed by a paragraph that reads the numbers. A limitations section names the design's weaknesses plainly and states what the results do and do not support. Sustainability and dissemination plans are specific, and a short reflection ties the project to the program's outcomes. All data are labeled composite. Beside every sheet, a margin comment names the competency on the rubric that the section is meant to show.
NUR 464 Module 6 rubric: what earns full marks
As the key assignment, the final paper is graded against program competencies: synthesis of evidence, implementation of a change, measurement and interpretation of results, leadership and collaboration, and professional communication in APA format. Graders look for results reported with numbers and denominators, honest limitations, and conclusions that do not overstate what a small project shows. Sustainability and dissemination plans should be concrete. Because the 70% threshold applies, a missing section, such as limitations or sustainability, can cost more than on ordinary papers. Graders also compare the final paper with the proposal, so explain any change in measures or timeline. Staff feedback and cost information, while not always required, strengthen the evaluation.
NUR 464 Module 6 help: mistakes that cost marks
The most common problem is reporting results as percentages without the numbers behind them, which makes small projects look larger than they are. Always give denominators. Another is claiming that the intervention caused the improvement; use careful language such as "was associated with." Report what did not work. Make sure your measures match those in your proposal, or explain changes. Never include identifiable patient data. Leave time to revise before the deadline. The desk can shape your data and proposal into the final paper format if you send both. Have someone outside the project read your results table cold and say what they think it shows. Keep the practice project log consistent with the dates in the paper.
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 464 Module 6 questions, answered
Where can I find a free NUR 464 Module 6 sample paper?
The capstone final paper is on this page in full: a hearing amplifier project with implementation, a results table for outcome, process and balancing measures, interpretation, limitations, sustainability and references.
What is the key assignment in NUR 464?
The syllabus identifies the Capstone Project Final Paper in Module 6 as the key assignment, with a 70% threshold on its competencies before late deductions.
How should I report results in the NUR 464 capstone paper?
Present each measure with numbers and denominators for baseline and implementation, then interpret them in a paragraph that notes limitations.
Can I say my NUR 464 project caused an improvement?
Use careful wording such as "was associated with," because comparing two periods on a single unit cannot establish cause.
What if my NUR 464 capstone results were disappointing?
Report them honestly and explain possible reasons and what you would change. Faculty grade the quality of evaluation, not just positive results.