| Course | NU800 DNP Project Proposal |
|---|---|
| Unit | Unit 1 |
| Paper type | Practice problem statement |
| Length | About 610 words, 5 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 NU800 Unit 1
Checked at 0600, Highest at 1600: A Practice Problem Statement on Missed Afternoon Hyperglycemia in Patients Started on High-Dose Glucocorticoids on Two Composite Medical Units
[Student Name]
Purdue University Global
NU800: DNP Project Proposal
Unit 1 Practice Problem Statement
[Instructor Name]
[Date]
The hospital, units and every figure are composite; numbers are bracketed placeholders for local data.
The Concern as Staff Describe It
Nurses on 4 North and 4 South describe the problem in their own words: a patient admitted with a COPD exacerbation, started on [40] mg of prednisone each morning, feels fine at breakfast and is thirsty and passing urine often by late afternoon. If the patient has no history of diabetes, there is often no glucose order at all. If there is an order, it is commonly a single fasting check at [0600]. One nurse put it plainly: "We check them when the steroid is at its weakest."
The Measure
The point-of-care testing coordinator's export for the last [four] quarters shows about [90] glucocorticoid patient-days a week across the two units, counting patients receiving the equivalent of [20] mg of prednisone or more each day. Among patient-days with at least one afternoon reading, [28 to 34] of every 100 included a reading above 250 mg/dL. Among patients without known diabetes, [46] percent had no glucose check at all in the first [48] hours of treatment.
Consequences
A chart review of [30] recent patients found that [12] had their first reading above 250 mg/dL on the third day of treatment or later; [9] received only correctional insulin, with no scheduled dose, for more than [two] days of readings above 250; [1] developed a hyperosmolar state requiring transfer; and [8] of the [14] patients who were newly hyperglycemic went home with no plan for checking glucose after discharge.
These findings match published experience. In a hospital study of patients receiving high-dose corticosteroids, many had no glucose measurements at all, and among those who did, most had at least one reading of 200 mg/dL or higher, including many without known diabetes (Donihi et al., 2006). Glucocorticoids raise glucose mainly in the afternoon and evening after a morning dose, so a fasting check alone can miss the peak entirely (Clore & Thurby-Hay, 2009).
The units are not ignoring steroid hyperglycemia; they are checking for it at the one time of day when it is least likely to show.
The Gap
Current guidance advises monitoring glucose in patients receiving glucocorticoids, including those without diabetes, with checks timed to the expected afternoon rise, and adjusting insulin when readings stay high (Roberts et al., 2018; American Diabetes Association Professional Practice Committee, 2024). The gap sentence the proposal rests on is this: patients started on high-dose glucocorticoids on 4 North and 4 South are not monitored when steroid hyperglycemia peaks, and hyperglycemia that is found is managed with correctional insulin alone.
What Is Set Aside
Two related problems are named and set aside. The first is hyperglycemia in patients with known diabetes who are not on steroids, which has different causes and is already covered by the hospital's basal-bolus order set. The second is hypoglycemia after steroid doses are tapered, which matters and will be tracked as a balancing measure, but which is not the problem this project is designed to solve.
Why This Problem, Here
The problem is frequent, measurable from existing data, and within nursing's reach: glucose checks can be ordered by protocol, and escalation can follow a defined rule. It also carries real harm, from hyperosmolar states to discharges without a plan, and it affects patients who often do not know that their steroid can raise their glucose.
References
American Diabetes Association Professional Practice Committee. (2024). 16. Diabetes care in the hospital: Standards of care in diabetes 2024. Diabetes Care, 47(Suppl. 1), S295-S306. https://doi.org/10.2337/dc24-S016
Clore, J. N., & Thurby-Hay, L. (2009). Glucocorticoid-induced hyperglycemia. Endocrine Practice, 15(5), 469-474. https://doi.org/10.4158/EP08331.RAR
Donihi, A. C., Raval, D., Saul, M., Korytkowski, M. T., & DeVita, M. A. (2006). Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocrine Practice, 12(4), 358-362. https://doi.org/10.4158/EP.12.4.358
Roberts, A., James, J., Dhatariya, K., & Joint British Diabetes Societies for Inpatient Care. (2018). Management of hyperglycaemia and steroid (glucocorticoid) therapy: A guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. Diabetic Medicine, 35(8), 1011-1017. https://doi.org/10.1111/dme.13675
What the NU800 Unit 1 assignment asks for
The first NU800 assignment asks you to state the practice problem your DNP project will address. Most versions expect the concern as staff experience it, a local measure with its source and period, consequences drawn from local data, evidence that the problem matters beyond your site, a single gap sentence, and a note on what is out of scope. Two to three pages under clear headings is common. Faculty reward statements that rest on one measurable rate, name the department that owns the data, and resist the temptation to address several problems at once. Keep any figure you report at the aggregate level, and leave the site's name out unless your program allows it, since the proposal may be read beyond your committee.
Inside the NU800 Unit 1 example
The statement opens with nurses describing a patient on prednisone who is thirsty by late afternoon and has no glucose order, or a single fasting check. The measure section reports weekly steroid patient-days and the rate of readings above 250 mg/dL among monitored days, plus the share of patients without diabetes left unchecked. A chart review of thirty patients gives consequences, from delayed detection to a hyperosmolar transfer. Two published studies and a review of steroid pharmacology show the pattern elsewhere, and the highlighted sentence explains that the units check at the wrong time. The gap sentence follows, cited to British and American guidance. Two related problems are set aside, and a closing section explains why this problem suits a nursing project.
NU800 Unit 1 rubric: what earns full points
Problem statements for the DNP proposal are commonly judged on clarity, measurement, significance, scope and feasibility. Clarity earns credit when the problem can be stated in one gap sentence. Measurement rewards a local rate with its source, period and definition. Significance is judged on consequences for patients and on evidence that the problem is recognized in the literature. Scope is credited when related problems are named and set aside deliberately. Feasibility scores well when the statement shows that the problem is within reach of nursing practice and can be measured from existing data. APA citation and a formal but plain tone round out the rubric in most sections.
NU800 Unit 1 help: mistakes that cost points
A frequent weakness is describing a broad problem, such as poor glucose control, that no single project can change. Another is giving a national statistic without a local one. Some statements rely on anecdotes without a rate, or a rate without saying how it was counted. Others propose a solution in the problem statement. Many try to include several problems to show their importance, which leaves the committee unsure what is being tested. And the data source is often unnamed. Lead with one rate from a named source, show its consequences locally, connect it to published evidence, write one gap sentence, and say in writing what you are leaving out.
Get an NU800 Unit 1 example written to your instructions
Share whatever figure first made the problem visible at your site, a quality report, an audit or an incident log, along with the Unit 1 instructions and rubric. The first custom sample, free and ready within 24-48h, narrows that concern to one population, one outcome and one window, and names what it leaves out. 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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NU800 Unit 1 questions, answered
Where can I find a free NU800 Unit 1 sample paper?
The complete NU800 Unit 1 problem statement is on this page, with the concern as staff describe it, the local measure, consequences from a chart review, supporting studies, a gap sentence, what is set aside and why this problem fits a nursing project, plus four references. A statement for your own project can be drafted.
Why focus on afternoon checks in NU800 Unit 1?
Because glucose rises after a morning steroid dose and peaks in the afternoon and evening. A fasting check at 0600 measures glucose when the steroid's effect is lowest, so the units were missing the hours that matter.
Can a problem statement use unpublished local data in NU800 Unit 1?
Usually yes, if the figures are aggregate and the department that owns them agrees to their use. Glucometer exports and chart review counts identify no patient, and bracketed figures in a sample show where your own data would go.
Why set aside hypoglycemia after tapering in NU800 Unit 1?
It matters, but it is a different problem with a different cause. The project tracks it as a balancing measure, so any harm from insulin that outlasts a falling steroid dose will be seen without making it a second aim.
What makes a gap sentence strong in NU800 Unit 1?
It names the population, the setting and the specific failure, here both detection at the wrong time and response with correctional insulin alone, in one sentence that every later chapter can point back to.