| Course | NUR 548 Patient Safety, Health Care Quality and Informatics |
|---|---|
| Module | Module 4 |
| Paper type | Significant learning discussion post with peer reply |
| Length | About 457 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | MS in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 548 Module 4
Discussion Forum 4: Strategic Application (Part 2)
One Nurse, One Shift, Then the Whole Unit: PDSA Cycles and a Run Chart for Idle IVs
Individual Post
Last module I wrote an aim to reduce idle peripheral IV catheters on our orthopedic unit. This module taught me to test changes small before spreading them. I have organized my learning under application, foundational knowledge and learning how to learn (Fink, 2013).
Application. PDSA, short for plan, do, study and act, is a way to try a change small and learn from the result before going further (Langley et al., 2009). Cycle 1: I planned to ask one question about each of my own patients at the start of one day shift: "Does this patient still need the IV, and why?" I predicted I would find at least one idle catheter. I found two, and both patients' surgeons agreed to removal. I learned the question took less than a minute per patient. Cycle 2: two nurses tried the question on day and night shifts for three days. Night shift found it harder because surgeons were not available, so we adapted: night nurses flagged catheters for the morning huddle instead. Cycle 3: the charge nurse added the question to the morning huddle for all patients for two weeks.
Foundational knowledge. On a run chart, a team graphs its measure across time against a median, which shows whether improvement follows each change (Perla et al., 2011). Our weekly idle catheter percentage for ten weeks, four before testing and six during, read 38, 35, 37, 36, 30, 27, 24, 22, 21 and 19. The median is 28.5%. All six testing weeks sit below that median, enough to satisfy the shift rule and point to a real, nonrandom change. We also watched our balancing measure: IV restarts within 24 hours of removal stayed at one or two per week.
Learning how to learn. The lesson on leading improvement reminded me that I am not the expert on every shift. Night nurses improved the change more than I did. I also found that the problem is larger among older patients: a national study of patients 65 and older found that one in four catheters was idle and that nearly one in five showed complications (Ní Chróinín et al., 2023). Many of our joint replacement patients are older, which strengthens the case for spreading the change, and I will look at results by age as we expand.
Peer Post
Omar, your run chart for discharge before noon showed an encouraging trend, but I counted only four points above the median after your change. Would you wait for more data before declaring improvement? I also liked how you involved case managers early, since leading change across disciplines seems to be what keeps it going.
References
Fink, L. D. (2013). Creating significant learning experiences: An integrated approach to designing college courses (Rev. ed.). Jossey-Bass.
Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.
Ní Chróinín, D., Ray-Barruel, G., Carr, P. J., Frost, S. A., Rickard, C. M., Mifflin, N., McManus, C., & Alexandrou, E. (2023). The burden of peripheral intravenous catheters in older hospital inpatients: A national cross-sectional study part of the ONE MILLION GLOBAL PERIPHERAL INTRAVENOUS CATHETERS COLLABORATION. Australasian Journal on Ageing, 42(1), 98-107. https://doi.org/10.1111/ajag.13068
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895
Reading the NUR 548 Module 4 assignment instructions
The published syllabus places Discussion Forum 4, Strategic Application Part 2, in Course Module 4, with three IHI eLearning lessons: testing and measuring changes with PDSA cycles, interpreting data with run charts and control charts, and leading quality improvement, each with a certificate due that week. Like the earlier forums, it pairs an individual post built on Fink's categories with a later peer post. Plan to explain how you would test changes with PDSA cycles, how you would display and interpret data, and what you learned about leading improvement. Look up the required categories and whether a chart or data example is expected in Canvas. If your earlier forum set an aim, build on it here; faculty notice when the PDSA cycles test the same change ideas the student proposed a week before.
How this NUR 548 Module 4 example is built
The post links back to the previous forum's aim, then describes three PDSA cycles in order, each with a prediction, a result and an adaptation, which shows the logic of testing small and spreading. The foundational knowledge section explains a run chart, lists ten weekly data points, calculates the median and applies the shift rule correctly, while noting the balancing measure. The learning how to learn section reflects on leadership and adds evidence on older patients. The peer post questions whether a classmate's chart shows enough points to claim improvement. Listing the weekly values in the post lets a reader check the median and the shift rule, which makes the claim of improvement transparent.
Where the marks sit in the NUR 548 Module 4 rubric
Faculty usually grade this forum on accurate description of PDSA cycles, correct interpretation of run chart data, reflection on leading improvement, structure under Fink's headings, support from sources and a peer post with substance. Graders look for PDSA cycles that include predictions and show learning between cycles, rather than a single large rollout called a PDSA. Applying a run chart rule correctly shows foundational knowledge in action. Peer posts that check a classmate's data interpretation demonstrate the analytical skill the module builds. Citations and timeliness also count. Faculty also look for attention to balancing measures, because a run chart that improves while harm rises elsewhere is not a real gain.
NUR 548 Module 4 help from the desk
The most common mistake is describing one big change as a PDSA cycle. Show several small cycles that build on each other. Another is reading a run chart by eye without applying a rule. Learn the shift, trend and runs rules. Include predictions in each plan. Keep data realistic if you are using an example. Watch a balancing measure. If you would like help planning PDSA cycles or reading a run chart for your own project, send the forum prompt and your data to the desk. When you report data, give enough points to support your claim; four or five weeks rarely justify a conclusion about improvement.
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 548 Module 4 questions, answered
Where can I find a free NUR 548 Module 4 sample paper?
The Discussion Forum 4 sample is shown above in full: three PDSA cycles of an IV need question, a ten-week run chart read with the shift rule, leadership reflection, a peer post and references.
What is a PDSA cycle?
Plan, do, study, act: a small-scale test of a change that includes a prediction, a trial, a study of results and a decision about the next cycle.
How do I read a run chart for NUR 548?
Plot weekly or monthly values with a median line, then apply run chart rules, such as a shift, to tell real change from noise.
What is the difference between a run chart and a control chart?
A run chart uses the median and simple rules; a control chart adds statistical limits to separate common cause from special cause variation.
How many PDSA cycles should I describe?
Several linked cycles show learning best; start small with one person or shift and expand as confidence grows.