| Course | NU753 Transforming the Health Care Organization |
|---|---|
| Unit | Unit 6 |
| Paper type | Gap analysis |
| Length | About 890 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NU753 Unit 6
Nothing by Mouth After Midnight and Eleven Other Rows: A Gap Analysis Setting Twelve Enhanced Recovery Elements Against Current Colorectal Practice on 5 West, With an Owner and a Cost for Each
[Student Name]
Purdue University Global
NU753: Transforming the Health Care Organization
Unit 6 Gap Analysis
[Instructor Name]
[Date]
The unit, practices and costs are composite; percentages, hours and costs are bracketed.
Method
Twelve elements were drawn from the ERAS Society's 2018 colorectal recommendations (Gustafsson et al., 2019). For each, current practice was established from order sets, a review of [30] consecutive colorectal charts from the past six months, and interviews with the preoperative clinic, two surgeons, an anesthesiologist and 5 West staff. Each gap was rated none, partial or wide, and each was assigned the person or body that would have to act and a rough cost in hours, supplies or approvals.
Two Elements Already Met
Thromboprophylaxis. The guideline recommends mechanical and pharmacological prophylaxis. Current practice: compression devices and [enoxaparin] are in the order set and were given in [29] of [30] charts. Rating: none. Owner: none needed.
Antibiotic prophylaxis. The guideline recommends intravenous antibiotics within an hour before incision. Current practice: given on time in [30] of [30] charts. Rating: none.
Four Wide Gaps
Preoperative fasting. The guideline allows clear liquids up to two hours before induction and a light meal up to six hours before. Current practice: every patient is told to take nothing by mouth after midnight, from the clinic's standard instruction sheet. Rating: wide. Owner: director of perioperative services and the anesthesia group. Cost: revising the instruction sheet and clinic script, about [12] hours, plus anesthesia agreement.
Multimodal, opioid-sparing analgesia. The guideline recommends combining non-opioid medicines and limiting opioids. Current practice: the order set defaults to an opioid patient-controlled analgesia pump, used in [26] of [30] charts. Rating: wide. Owner: department of surgery, anesthesia, pharmacy and therapeutics committee. Cost: a new order set, about [20] hours of pharmacy and informatics time, and committee approval.
Nasogastric tubes. The guideline recommends against routine nasogastric decompression. Current practice: two of four surgeons leave a tube routinely, seen in [11] of [30] charts. Rating: wide. Owner: the two surgeons and the department chair. Cost: no money, but discussion and agreement among surgeons.
Compliance audit. The guideline emphasizes auditing adherence and outcomes. Current practice: no audit exists; nobody measures how many elements each patient receives. Rating: wide. Owner: 5 West nurse manager and the quality department. Cost: about [4] hours a week of data abstraction, or a coordinator's time.
The widest gaps sit in other people's order sets and instruction sheets, while most of what 5 West controls is already partly in place.
Six Partial Gaps
Preadmission counseling. Required: structured education on what to expect. Current: the clinic gives a general surgery handout; nothing describes early walking or eating. Rating: partial. Owner: clinic nurses and 5 West's clinical nurse specialist. Cost: a new handout and [20] minutes of counseling per patient.
Carbohydrate loading. Required: a carbohydrate drink before surgery for patients without diabetes. Current: one surgeon's patients receive it. Rating: partial. Owner: clinic, anesthesia. Cost: about $[12] per patient.
Balanced fluids. Required: avoid fluid overload. Current: practice varies by anesthesiologist. Rating: partial. Owner: anesthesia group. Cost: agreement on a protocol.
Early oral intake. Required: food within the first day. Current: clear liquids on day one, solids usually day three. Rating: partial. Owner: surgeons, 5 West. Cost: order set change.
Early mobilization. Required: up from bed within hours of the operation and walking by day one. Current: [41] percent walk within [24] hours, and weekend support is thin. Rating: partial. Owner: 5 West nurse manager, rehabilitation. Cost: a weekend mobility aide.
Early urinary catheter removal. Required: remove within a day for most patients. Current: median removal on day [two]. Rating: partial. Owner: 5 West, surgeons. Cost: a nurse-driven removal protocol.
What the Pattern Shows
The gaps divide into those 5 West can close itself and those it cannot. Mobilization, catheter removal and part of early feeding lie mostly within nursing's reach. Fasting, analgesia, nasogastric tubes and fluids depend on the clinic, surgeons, anesthesia and committees. An implementation framework such as the Consolidated Framework for Implementation Research emphasizes that the inner setting, including the structures, networks and readiness of the organization, shapes whether an intervention succeeds (Damschroder et al., 2009). Here the inner setting is split: the unit that will do most of the work does not own most of the gaps.
Why Ratings Rest on Charts
Ratings were based on what the charts showed rather than on what order sets or policies say should happen. One of the two surgeons who use nasogastric tubes told me he leaves them only occasionally, but the charts showed a tube in most of his patients. Chart review is slower than asking, but it prevents a gap analysis from measuring intentions.
Recommended Sequence
Begin with the gaps nursing owns, mobilization, catheter removal and the compliance audit, in the first two months. Take the fasting change to perioperative services and anesthesia at the same time, since it needs no committee vote. Bring the order set and nasogastric tube changes to the department of surgery, led by the surgeon who already gives carbohydrate drinks, with evidence on outcomes, which enhanced recovery programs have linked to shorter stays and fewer complications (Ljungqvist et al., 2017).
References
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, Article 50. https://doi.org/10.1186/1748-5908-4-50
Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., Hill, A. G., Soop, M., de Boer, H. D., Urman, R. D., Chang, G. J., Fichera, A., Kessler, H., Grass, F., Whang, E. E., Fawcett, W. J., Carli, F., . . . Ljungqvist, O. (2019). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World Journal of Surgery, 43(3), 659-695. https://doi.org/10.1007/s00268-018-4844-y
Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced recovery after surgery: A review. JAMA Surgery, 152(3), 292-298. https://doi.org/10.1001/jamasurg.2016.4952
NU753 Unit 6 instructions, in plain terms
For Unit 6 you compare current practice with a standard your proposed change requires. Most versions ask for the standard to be named, each element set against current practice with the source of evidence, a rating of the gap, an owner who would have to act, and a cost of closing it. Around 1,800 words wrapped around a table is typical. Faculty reward analyses that measure practice from charts or observation rather than from policy alone, rate gaps consistently, assign realistic owners and costs, and draw implications from the pattern of gaps. Cost can mean staff hours, supplies or approvals, and naming which kind is part of the analysis. State how many charts or observations you used and over what period.
How the NU 753 Unit 6 example is put together
The analysis opens with its method. Two met elements, thromboprophylaxis and antibiotic timing, come first with chart evidence. Four wide gaps follow: fasting instructions from the clinic, a patient-controlled opioid pump as the order set default, routine nasogastric tubes from two surgeons, and no audit, each with owner and cost; the highlighted sentence observes that the widest gaps sit in other people's order sets. Six partial gaps cover counseling, carbohydrate drinks, fluids, early feeding, mobilization and catheter removal. A section groups gaps by owner and cites an implementation framework on the inner setting. A short section explains why ratings rest on charts, and the recommended sequence starts with nursing-owned gaps.
Reading the NU753 Unit 6 grading rubric
Gap analyses are generally marked on the standard, measurement of current practice, rating, ownership and cost, and implications. The standard earns credit when it is named and cited. Measurement rewards evidence from charts, order sets or observation, with sample sizes stated. Rating is judged on consistency and on whether ratings follow from the evidence. Ownership and cost are credited when each gap has a realistic owner and a cost stated in hours, supplies or approvals. Implications score well when the pattern of gaps shapes a sequence or strategy. A table that a reader can scan, with the narrative focusing on the widest gaps, usually earns the presentation points as well.
Common NU753 Unit 6 mistakes, and how to avoid them
A common weakness is measuring practice from policies or interviews alone, which records intentions rather than practice. Another is rating every gap wide, which makes prioritization impossible. Some analyses omit owners, leaving no one responsible for closing each gap. Others give costs only in money, missing the approvals and time that often decide the timeline. Many present the table without analysis, leaving the reader to find the pattern. And the standard is sometimes paraphrased so loosely that ratings cannot be checked. Name your standard, check practice against records, rate consistently, assign an owner and a cost, and let the pattern tell you where to start.
Get an NU753 Unit 6 example written to your instructions
Tell us the change your gap analysis measures and the standard your section expects it measured against, a guideline, a regulation or an accreditation requirement, and add the rubric. Within 24-48h a free first custom sample, written to those instructions, arrives with the standard cited row by row and every gap given an owner. 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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NU753 Unit 6 questions, answered
What standard should the gap analysis measure against?
Whatever the proposed change requires: a clinical guideline, a regulatory rule, an accreditation standard or a published model. The key is naming one and citing it at the level of specific recommendations. The sample uses the ERAS Society guideline for colorectal surgery because its elements are discrete and graded, which makes each row of the table checkable.
How is current practice measured without formal data?
Order set defaults, policy documents, a short chart review and direct observation all count, as long as the paper states how many and over what period. Staff interviews can add context but should not stand alone for a measurable element. The sample combines four such sources and says plainly where its measurement is thin.
Does every gap need a cost?
In most prompts, a rough one. Cost here can mean staff hours, supplies, capital or simply an approval and the time it takes, and naming which kind prepares the business case that typically follows. The sample gives each row a cost category and a figure where one can be estimated, leaving the full pricing to the next assignment.
Where can I find a free NU753 Unit 6 sample paper?
This page carries the full NU753 Unit 6 gap analysis, with its method, two met elements, four wide and six partial gaps each with owner and cost, the pattern by owner, why ratings rest on charts and a recommended sequence, plus three references. A gap analysis for your own change can be requested.
What does NU753 Unit 6 recommend doing first?
Begin with the gaps nursing owns, mobilization, catheter removal and the compliance audit, while taking the fasting change to perioperative services and anesthesia. Order set and nasogastric tube changes follow through the department of surgery and committees.