| Course | NUR-8050 Scholarly Inquiry The Basis for Evidence-Based Practice |
|---|---|
| Module | Module 1 |
| Paper type | Practice problem and PICOT question |
| Length | About 1,043 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for NUR 8050 Module 1
Fourteen Pneumonias Nobody Counted: Framing a Practice Problem and a PICOT Question on Oral Care and Non-Ventilator Hospital-Acquired Pneumonia
Student Name
Doctor of Nursing Practice, Thomas Edison State University
NUR-8050: Scholarly Inquiry: The Basis for Evidence-Based Practice
Mentor Name
Month Day, Year
Fourteen Pneumonias Nobody Counted: Framing a Practice Problem and a PICOT Question on Oral Care and Non-Ventilator Hospital-Acquired Pneumonia
Introduction
Hospitals have spent two decades reducing pneumonia in patients on ventilators, with bundles, audits and public reporting. Pneumonia that develops in patients who are not ventilated has received far less attention, though it is more common. When infection prevention pulled a year of records for my 34-bed unit, they found 14 patients whose pneumonia began two or more days into the stay with no breathing tube at any point. None of these cases appears on the hospital's quality dashboard, because the condition is not a publicly reported measure. This paper frames the problem, explains why it matters and writes the question that will guide my DNP project.
The Problem Stated
The problem is that non-ventilator hospital-acquired pneumonia occurs on my unit at a rate of about 1.2 cases per 1,000 patient-days, based on 14 cases over roughly 11,700 patient-days, and that the basic care thought to prevent it, especially oral care, is not delivered reliably. A spot audit of 30 patients' records last month found documented toothbrushing in fewer than half of the expected shifts. The patients most affected are older adults admitted with stroke, heart failure or after surgery, who are often too weak, sedated or confused to clean their own mouths.
Several features of the unit make the gap understandable rather than careless. Toothbrushes and toothpaste are stocked only on request, the electronic record has a single checkbox labeled oral care that does not say what was done, and nursing assistants care for up to eleven patients on day shift. When staff were asked informally why oral care was missed, the most common answers were time, a belief that mouth swabs were enough and uncertainty about whether patients with swallowing problems could have toothpaste. Each answer points to a part of the system that the project can change, which is a better starting point than a problem blamed on individual effort.
Why It Matters
National data show that this is not a local quirk. Baker and Quinn (2018) reviewed records from 21 hospitals and identified 1,300 cases, with rates ranging from 0.12 to 2.28 per 1,000 patient-days. More than 70 percent of cases occurred outside intensive care units, nearly one in five patients needed transfer to intensive care, and in the 24 hours before diagnosis most patients had not received the basic care associated with prevention. The condition lengthens stays, raises costs and kills some patients who were admitted for unrelated problems.
The proposed mechanism is aspiration of oral bacteria. Dental plaque in a hospitalized patient can be colonized by respiratory pathogens within days, and patients who cough weakly or swallow poorly aspirate small amounts of saliva. Removing plaque mechanically should lower the bacterial load that reaches the lungs. Quinn et al. (2014) put the idea into practice across a Sacramento medical center and saw cases per 100 patient-days drop from just under half a case to under a third after the initiative, which they estimated spared eight lives in a year.
This reasoning matters for the choice of intervention. Foam swabs, which many units use, freshen the mouth but do little to disrupt plaque, so a protocol built on swabs alone would leave the proposed mechanism untouched.
Choosing the Target
Several prevention strategies have been proposed, including mobility, head-of-bed elevation, dysphagia screening and oral care. The 2022 prevention compendium from the Society for Healthcare Epidemiology of America and partner organizations includes recommendations for pneumonia outside the ventilator setting and notes that the evidence base is smaller than for ventilated patients (Klompas et al., 2022). I chose oral care as the focus for three reasons: it is within nursing's control, it is inexpensive, and my audit showed the largest gap there. A narrow focus also makes it easier to measure whether the change was delivered as intended.
The PICOT Question
Among adults on my 34-bed unit (P), will brushing every patient's teeth with a soft brush and toothpaste morning and night, done by staff when the patient cannot (I), lower hospital pneumonia in patients never ventilated, counted per 1,000 patient-days (O), below the rate under today's routine (C) in the year after the protocol begins (T)?
Each element is specific. Each part holds up: the patients are the ones I manage, an auditor could verify the brushing, the baseline year supplies the comparison, the outcome divides cases by exposure, and twelve months gives a monthly event time to move.
| Element | Content |
|---|---|
| Population | Adults on a 34-bed medical-surgical unit |
| Intervention | Twice-daily assisted toothbrushing protocol |
| Comparison | Current practice in the baseline year |
| Outcome | Cases among never-ventilated patients for every 1,000 patient-days |
| Time | 12 months after implementation |
Search Strategy and Evidence Hierarchy
Three databases, CINAHL, PubMed and Cochrane, will be searched with one block of words for hospital pneumonia in unventilated patients and another for brushing and mouth care, restricted to adults and to papers from 2011 on. Practice guidelines will be searched in the professional societies' publications. The evidence will be graded with a hierarchy that places systematic reviews and randomized trials above quasi-experimental and observational studies, with guidelines appraised separately. Because the literature is dominated by before and after studies in single systems, I expect to find mostly moderate to low-level evidence, and the appraisals in the next two modules will need to weigh that honestly.
Studies will be included if they enrolled hospitalized adults who were not ventilated, tested an oral care intervention and reported pneumonia as an outcome. Studies limited to ventilated patients, nursing home residents or dental outcomes alone will be excluded, though nursing home trials may be read for background because their populations overlap with older inpatients. Each record screened will be logged with the reason for any exclusion, so the search can be reported in a flow diagram.
Conclusion
Non-ventilator hospital-acquired pneumonia affects patients on my unit at a measurable rate and is linked to a care gap that nursing can close. National data show the problem is common, and one health system's experience suggests that reliable oral care can reduce it. The PICOT question defines the intervention, the measure and the time frame that will shape the design, analysis and evaluation in the modules that follow.
References
Baker, D., & Quinn, B. (2018). Hospital Acquired Pneumonia Prevention Initiative-2: Incidence of nonventilator hospital-acquired pneumonia in the United States. American Journal of Infection Control, 46(1), 2-7. https://doi.org/10.1016/j.ajic.2017.08.036
Klompas, M., Branson, R., Cawcutt, K., Crist, M., Eichenwald, E. C., Greene, L. R., Lee, G., Maragakis, L. L., Powell, K., Priebe, G. P., Speck, K., Yokoe, D. S., & Berenholtz, S. M. (2022). Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 update. Infection Control and Hospital Epidemiology, 43(6), 687-713. https://doi.org/10.1017/ice.2022.88
Quinn, B., Baker, D. L., Cohen, S., Stewart, J. L., Lima, C. A., & Parise, C. (2014). Basic nursing care to prevent nonventilator hospital-acquired pneumonia. Journal of Nursing Scholarship, 46(1), 11-19. https://doi.org/10.1111/jnu.12050
NUR 8050 Module 1 instructions, in plain terms
The NUR-8050 catalog entry runs from the research process to judging a change in practice, and as TESU offers no outside syllabus, this first module starts where DNP evidence courses usually start, with a local problem turned into a question the literature can answer. Expect a paper that states the problem with local data, shows its significance with published evidence, justifies the focus you chose and writes a PICOT question, often with a search plan. Read your directions for length, required elements and whether the question must use a particular template. Choose a problem in a setting you can access, because the later modules will ask you to design and evaluate a change there.
Inside the NUR 8050 Module 1 example
The paper begins with a contrast between attention to ventilator pneumonia and neglect of pneumonia in other patients, then gives the unit's 14 cases and the hospital's blind spot. The problem statement includes a rate, a denominator and an audit of oral care. A significance section uses a 21-hospital study and a single-system initiative, and explains the aspiration mechanism. A section on choosing the target weighs four strategies against the 2022 compendium and the audit. The PICOT question follows with a five-row table, then a search strategy and evidence hierarchy, and the conclusion links the question to the later modules. A margin note explains why the outcome is written as a rate with its denominator.
Reading the NUR 8050 Module 1 grading rubric
In a problem and PICOT paper, the reader wants local numbers that show the gap, published data that show it matters elsewhere and a question whose five parts can each be checked. The outcome should have a numerator, denominator and time frame that the project can actually collect. A justified choice among possible interventions, rather than an assumed one, shows scholarly reasoning. The search plan should name databases, terms and limits. Honest anticipation of the evidence level adds credibility. Recent literature reported with its real figures, in APA, finishes the marks, and a PICOT table lets the mentor tick each element off. Some mentors also ask whether the problem fits the organization's priorities, so a sentence on that fit is worth adding.
NUR 8050 Module 1 help from the desk
The most common problem in first DNP papers is a topic rather than a problem, such as "oral care" instead of "pneumonia occurring at this rate with this care gap." State a measurable gap. Another frequent weakness is a PICOT question with no time frame or an outcome that cannot be measured with available data. Check now that you can get the numbers. Students also choose the intervention before reviewing alternatives; show why you chose it. Report study findings with their figures and settings. Keep the question narrow enough to evaluate in one unit. Describe your unit and paste your NUR-8050 prompt, and the desk will frame the problem and PICOT question for that setting; the first draft costs nothing.
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 Thomas Edison 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 NUR 8050 and Doctor of Nursing Practice sample papers
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- NUR 8050 Module 3: Guideline Appraisal: The 2022 SHEA Compendium Read With AGREE II
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- NUR 8050 Module 5: Data Analysis Paper: Control Charts for a Rare Hospital Infection
- NUR 8050 Module 6: Evaluation Paper: RE-AIM, Implementation Outcomes and Sustainability
- NUR 8320 Module 3: Work Environment Paper: The Practice Environment Scale, Magnet Outcomes and an Improvement Plan
- NUR 7630 Module 1: Frequency and Association Paper: An Aspirin Trial Worked by Hand
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- NUR 8000 Module 3: Clinical Inquiry Paper: Building Evidence-Based Practice on a Unit
NUR 8050 Module 1 questions, answered
Where can I find a free NUR 8050 Module 1 sample paper?
This page has the whole paper. It frames non-ventilator hospital pneumonia on a medical-surgical unit as a practice problem and writes a PICOT question on oral care.
What is non-ventilator hospital-acquired pneumonia?
A lung infection that starts two or more days into a hospital stay in someone who has never been on a breathing machine during it. It is more common than ventilator pneumonia but less often tracked.
How do I write a measurable PICOT outcome?
Give it a count on top, an exposure underneath and a window of time, as in hospital pneumonias per thousand patient-days across a year.
How common is non-ventilator hospital pneumonia?
A study of 21 U.S. hospitals found 1,300 cases with rates of 0.12 to 2.28 per 1,000 patient-days, most outside intensive care units.
Why focus a DNP project on oral care?
Oral care is within nursing's control, inexpensive and often missed, and removing dental plaque is thought to reduce the bacteria aspirated into the lungs.