NU298 Unit 4 Capstone Annotated Bibliography Example

Course	NU298 Capstone
Unit	Unit 4
Paper type	Annotated bibliography
Length	About 860 words, 6 pages double-spaced
Format	APA 7 student paper
School	Purdue University Global
Program	BSN (prelicensure)
Updated	October 2026

Free sample paper for NU298 Unit 4

Ten Sources, Each Ending on One Line: A Capstone Annotated Bibliography on Unnecessary Fasting Orders, Where Every Entry Says What It Changes in the Plan and Two Entries Say Plainly That They Change Nothing

[Student Name]

Purdue University Global

NU298: Capstone

Unit 4 Annotated Bibliography

[Instructor Name]

[Date]

The capstone, unit and plan are composite; the sources are real and their findings are summarized from the published reports, and annotations are written for a student capstone.

What this part is doingEach annotation ends with what the source changes in the plan, which is what turns a reading list into project evidence.

How the Ten Were Chosen

The literature search produced eleven sources; this bibliography keeps the ten that a reader of the capstone needs, adds the two process texts and drops a systematic search guideline that shaped the search but not the plan. Entries are ordered by how much they shape the plan, not alphabetically, so the first three carry the most weight. Two kinds of source appear: research and practice guidance on fasting, and texts on how to carry out an evidence-based change. Keeping both in one list shows how the project will move from what is known to what the unit will do.

How to Read the Entries

Each entry gives: summary; appraisal in a clause; Johns Hopkins evidence level (Dang et al., 2022); and "Changes in the plan." A key at the end maps entries to plan elements.

1. Sorita et al. (2015)

Summary: retrospective review of fasting orders for adult medical inpatients at one academic center over a year; nearly half of admissions included a fasting order, the median order lasted about thirteen hours, about one in four orders was judged avoidable and nearly half of missed meals could have been avoided. Appraisal: large and clearly reported, single center, judgments of avoidability by reviewers. Level: III. Changes in the plan: sets the baseline measure (median fasting hours and missed meals) and supports reviewing whether each fasting order is needed at all.

2. Sorita et al. (2017)

Summary: analysis of fasting orders among medical inpatients by indication; about one in five fasting orders ended without the planned procedure being done, mostly because plans or schedules changed. Appraisal: relevant population, descriptive design. Level: III. Changes in the plan: adds the procedure-time confirmation call, because changed plans were the leading reason fasts were wasted.

3. Joshi et al. (2023)

Summary: national anesthesia practice guideline updating fasting recommendations, including clear liquids, with a modular review of evidence. Appraisal: authoritative, mainly surgical populations, applies to healthy patients having elective procedures. Level: IV. Changes in the plan: sets the two-hour clear-liquid window used in the protocol, with exclusions for patients outside its scope.

The guideline sets the window; the hospital studies show why the window is not being used; the plan has to connect the two.

4. Brady et al. (2003)

Summary: systematic review of randomized trials comparing preoperative fasting policies in adults; no evidence that a shortened fluid fast increased aspiration, regurgitation or related harm compared with fasting from midnight. Appraisal: strongest design in the set; trials mostly in surgical patients; older review. Level: I. Changes in the plan: supports the safety case for allowing clear liquids, while the balancing measure watches for harm on this unit.

What this part is doingThe appraisal clause names the limits of a strong source, which keeps its use proportionate.

5. Hepper et al. (2024)

Summary: scoping review of the psychosocial impact of being nil by mouth for adults; found psychological distress, thirst and social impacts for patients and caregivers. Appraisal: broad scope, mixed study types, little on short procedural fasts. Level: V. Changes in the plan: adds a patient comfort rating to the evaluation.

6. Iowa Model Collaborative (2017)

Summary: revised Iowa Model of evidence-based practice, describing steps from identifying a trigger through piloting and sustaining a change. Appraisal: widely used framework, validated by expert review. Level: not leveled as research; used as the process model. Changes in the plan: provides the decision points and the pilot structure.

7. Sparling and Yeh (2023)

Summary: commentary on implementing and sustaining reduced fasting times in hospitalized surgical patients. Appraisal: expert opinion, useful on barriers. Level: V. Changes in the plan: adds an audit at week eight to check whether the change is holding.

8. Dang et al. (2022)

Summary: the Johns Hopkins evidence-based practice model and its tools for appraising and leveling evidence. Appraisal: standard text in nursing programs. Level: not leveled as research. Changes in the plan: provides the leveling and appraisal tools used throughout.

9. A Review of Prolonged Preoperative Fasting

Summary: review of the metabolic effects of prolonged preoperative fasting, including insulin resistance and loss of lean mass (Pimenta & de Aguilar-Nascimento, 2014). Appraisal: narrative review focused on surgery. Level: V. Changes in the plan: nothing. It supports the problem's importance but adds no element to a medical unit's plan.

10. McNally (2025)

Summary: editorial calling for nil-by-mouth rules to be updated so surgical patients can sip clear fluids until called to theater. Appraisal: opinion, United Kingdom surgical context. Level: V. Changes in the plan: nothing. It reflects a current direction of practice but does not apply directly to medical inpatients awaiting procedures.

What this part is doingTwo entries are kept with an honest "nothing," which shows the bibliography was used to build the plan, not padded to reach a count.

Key to the Plan

Baseline measure: 1. Confirmation call: 2. Two-hour clear-liquid window: 3. Safety case and balancing measure: 4. Comfort rating: 5. Process model and pilot: 6. Sustainment audit: 7. Appraisal tools: 8.

References

Brady, M. C., Kinn, S., Stuart, P., & Ness, V. (2003). Preoperative fasting for adults to prevent perioperative complications. Cochrane Database of Systematic Reviews, 2003(4), Article CD004423. https://doi.org/10.1002/14651858.CD004423

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.

Hepper, E. C., Wilson, J., Drinnan, M., & Patterson, J. M. (2024). Psychosocial impacts of being nil-by-mouth as an adult: A scoping review. Journal of Advanced Nursing, 80(9), 3499-3515. https://doi.org/10.1111/jan.16100

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

Joshi, G. P., Abdelmalak, B. B., Weigel, W. A., Harbell, M. W., Kuo, C. I., Soriano, S. G., Stricker, P. A., Tipton, T., Grant, M. D., Marbella, A. M., Agarkar, M., Blanck, J. F., & Domino, K. B. (2023). 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: Carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration: A modular update of the 2017 American Society of Anesthesiologists practice guidelines for preoperative fasting. Anesthesiology, 138(2), 132-151. https://doi.org/10.1097/ALN.0000000000004381

McNally, S. (2025). Scarlett McNally: Nil-by-mouth rules need updating to implement SipTilSend. BMJ, 388, Article r306. https://doi.org/10.1136/bmj.r306

Pimenta, G. P., & de Aguilar-Nascimento, J. E. (2014). Prolonged preoperative fasting in elective surgical patients: Why should we reduce it? Nutrition in Clinical Practice, 29(1), 22-28. https://doi.org/10.1177/0884533613514277

Sorita, A., Thongprayoon, C., Ahmed, A., Bates, R. E., Ratelle, J. T., Rieck, K. M., Devalapalli, A. P., Issa, M., Shah, R. M., Lalama, M. A., Wang, Z., Murad, M. H., & Kashiwagi, D. T. (2015). Frequency and appropriateness of fasting orders in the hospital. Mayo Clinic Proceedings, 90(9), 1225-1232. https://doi.org/10.1016/j.mayocp.2015.07.013

Sorita, A., Thongprayoon, C., Ratelle, J. T., Bates, R. E., Rieck, K. M., Devalapalli, A. P., Ahmed, A., & Kashiwagi, D. T. (2017). Characteristics and outcomes of fasting orders among medical inpatients. Journal of Hospital Medicine, 12(1), 36-39. https://doi.org/10.1002/jhm.2674

Sparling, J. L., & Yeh, D. D. (2023). Hungry for change: How best to implement and sustain reduced fasting times in hospitalized surgical patients? The Joint Commission Journal on Quality and Patient Safety, 49(11), 579-580. https://doi.org/10.1016/j.jcjq.2023.07.001

Reading the NU 298 Unit 4 instructions

Unit 4 commonly asks students to prepare an annotated bibliography of the sources that will support the capstone. Prompts usually want each source summarized, appraised for quality and level, and connected to the project. Instructors look for annotations that do more than summarize, an appraisal that names a real strength or limitation, correct evidence levels and a clear statement of how each source will be used. Many programs value honesty about sources that turned out to be less useful than expected. Entries are often ordered by importance rather than alphabetically. Bibliographies typically include eight to twelve sources, each annotated in about one hundred words, with full APA 7 references at the end.

How the NU 298 Unit 4 example is put together

The bibliography opens by explaining how the ten were chosen and how to read the four-part entries. The first three entries, two hospital fasting studies and the anesthesia guideline, carry the most weight, and the highlighted sentence explains how they connect. The systematic review follows with an appraisal that names its limits, marked in the margin. A scoping review adds a comfort measure, and two process texts supply the model and appraisal tools. A commentary adds a sustainment audit. The last two entries, a metabolic review and an editorial, state that they change nothing, with a margin note on honesty. A key maps each entry to the plan.

Where the points sit in the NU298 Unit 4 rubric

Annotated bibliography rubrics in NU 298 tend to award marks for relevant sources, accurate summaries, meaningful appraisal, correct leveling, clear application to the project and APA formatting. Relevance marks depend on sources tied to the capstone question. Summary marks go to accurate reporting of what each source found. Appraisal marks are earned by naming a specific strength or limitation rather than calling a source good. Leveling marks require consistent use of one system. Application marks reward a clear statement of how each source shapes the plan, including when it does not. Formatting marks cover entries and references. Bibliographies that admit some sources change nothing usually earn credit for judgment.

Common NU298 Unit 4 mistakes, and how to avoid them

Annotated bibliographies often lose marks when annotations repeat the abstract without saying why the source matters. Another common weakness is calling every source high quality, or leveling a guideline as if it were a trial. Some students pad the list with sources they will not use. Others order entries alphabetically, which hides which sources matter most. Summarize what the source found, appraise it in one honest clause, assign its level, write one line on what it changes in your plan and be willing to say nothing. Put the most important sources first and add a key that links entries to plan elements. Revisit the key at the end of the term to see whether each entry still earns its place.

Get an NU298 Unit 4 example written to your instructions

Twelve sources or twenty, a hundred words each or two hundred: annotated bibliographies differ, and the prompt decides. Send the Unit 4 prompt, its rubric, your PICOT question, the appraisal scheme your course uses and any sources already found. Each annotation in the sample summarizes, appraises and states what its source changes in the plan. First custom sample free; returned within 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.

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NU298 Unit 4 questions, answered

Where can I find a free NU298 Unit 4 sample paper?

This page presents the full NU298 Unit 4 annotated bibliography of ten sources on hospital fasting orders, each with summary, appraisal, level and its effect on the plan, citing all ten. Bring us your sources and we can help you annotate them.

What should each annotation include in NU298 Unit 4?

A summary of what the source did, a brief appraisal, its evidence level and a line explaining what it changes in the capstone plan.

Can a source change nothing in the plan?

Yes. Saying so honestly shows judgment, and the source may still support the problem's importance without adding a plan element.

Why order entries by importance?

It shows the reader which sources carry the project and keeps the most useful evidence at the top.

How many sources should a capstone bibliography have?

Often eight to twelve, enough to support each part of the plan without padding the list.