| Course | NU800 DNP Project Proposal |
|---|---|
| Unit | Unit 4 |
| Paper type | Evidence table |
| Length | About 840 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 NU800 Unit 4
Eight Rows and a Column Most Tables Leave Out: An Evidence Table for a Glucocorticoid Hyperglycemia Project, Recording How Each Source Counted High Glucose Before Any Rates Are Compared
[Student Name]
Purdue University Global
NU800: DNP Project Proposal
Unit 4 Evidence Table
[Instructor Name]
[Date]
The sources are real; findings are summarized from each publication, and the project context is composite.
How the Table Is Built
Each row gives the citation, design, setting, sample, intervention or focus, counting method, key findings and a Johns Hopkins evidence level with a quality grade (Dang et al., 2021). Levels run from I, experimental studies such as randomized trials, through II, quasi-experimental, and III, nonexperimental, to IV, guidelines and consensus panels, and V, literature reviews, expert opinion and quality improvement reports. Quality is graded A, B or C.
The Rows
Row 1. American Diabetes Association Professional Practice Committee (2024). Design: clinical practice guideline. Setting: hospitalized adults. Focus: inpatient glucose management, including glucocorticoid-associated hyperglycemia. Counting method: targets expressed per reading, 140 to 180 mg/dL for most non-critically ill patients. Findings: recommends monitoring and adjusting insulin for patients on glucocorticoids and notes that intermediate-acting insulin may suit once-daily steroid doses. Level IV, quality A.
Row 2. The Endocrine Society guideline (Umpierrez et al., 2012). Design: clinical practice guideline. Setting: non-critical care. Focus: glucose management, including monitoring patients receiving therapies associated with hyperglycemia such as glucocorticoids. Counting method: targets per reading. Findings: recommends glucose monitoring for patients without known diabetes receiving such therapies and scheduled insulin rather than correctional insulin alone for persistent hyperglycemia. Level IV, quality A.
Row 3. The Joint British Diabetes Societies guideline (Roberts et al., 2018). Design: guideline, largely consensus. Setting: hospitalized adults. Focus: steroid-related hyperglycemia. Counting method: thresholds per reading. Findings: advises monitoring at least once daily, ideally before lunch or the evening meal, and adding or increasing morning intermediate-acting insulin or a sulfonylurea when readings remain above about 216 mg/dL; states that evidence is limited and much of the guidance is consensus. Level IV, quality B.
Row 4. A cohort of steroid-treated inpatients (Donihi et al., 2006). Design: retrospective cohort. Setting: one academic hospital, one month. Sample: [66] patients on high-dose corticosteroids, [50] with glucose readings. Counting method: per patient, with hyperglycemia defined as any reading of 200 mg/dL or more and multiple episodes as more than one. Findings: [64] percent of those checked had hyperglycemia and [52] percent had multiple episodes; many patients received no glucose monitoring. Level III, quality B.
Row 5. An audit of patients without diabetes (Fong & Cheung, 2013). Design: retrospective audit. Setting: one hospital, six months. Sample: [80] patients without diabetes on high-dose steroids for at least [48] hours. Counting method: per patient, any reading of 10 mmol/L, about 180 mg/dL, or more. Findings: [70] percent had at least one such reading; [94] percent of hyperglycemia appeared within [48] hours; with morning prednisone, glucose peaked in the afternoon and returned toward baseline by the next morning. Level III, quality B.
Row 6. A randomized NPH trial (Grommesh et al., 2016). Design: randomized, open-label trial. Setting: non-intensive care units. Sample: [61] patients with glucocorticoid-induced hyperglycemia. Intervention: NPH added to a basal, mealtime and correction regimen, compared with the standard regimen alone. Counting method: mean glucose and percent of readings in range, per reading. Findings: no overall difference in mean glucose, a lower mean on day three with NPH, and no difference in severe hypoglycemia. Level I, quality B, given the small sample.
Row 7. The RABBIT 2 trial (Umpierrez et al., 2007). Design: randomized trial. Setting: general medicine wards. Sample: patients with type 2 diabetes, not on steroids. Intervention: basal-bolus insulin compared with sliding-scale insulin alone. Counting method: per patient, share reaching a target below 140 mg/dL, and mean daily glucose. Findings: basal-bolus achieved the target in [66] percent against [38] percent with sliding scale, without more hypoglycemia. Level I, quality A, indirect for this population.
Row 8. A narrative review (Clore & Thurby-Hay, 2009). Design: narrative review. Focus: mechanisms and management of glucocorticoid-induced hyperglycemia. Counting method: not applicable. Findings: describes the afternoon and evening peak after morning doses and the rationale for intermediate-acting insulin timed to the steroid. Level V, quality B.
The two studies that describe the problem count patients, the trial that tests a steroid regimen counts readings, and the guidelines set targets per reading; none counts patient-days, which is why the project defines its own.
What the Table Shows
The strongest evidence on the problem itself comes from two observational studies that agree: steroid hyperglycemia is common, often unmonitored, and peaks in the afternoon. The strongest evidence on treatment is indirect: a randomized trial in patients with type 2 diabetes not on steroids shows that scheduled insulin outperforms sliding scale, and a small trial in patients on steroids shows only a modest benefit from adding NPH. The guidelines translate this into consensus advice. No source tests the specific intervention this project proposes, nurse-driven afternoon monitoring with an escalation rule, so the project will translate guidance rather than replicate a study.
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
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.
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
Fong, A. C., & Cheung, N. W. (2013). The high incidence of steroid-induced hyperglycaemia in hospital. Diabetes Research and Clinical Practice, 99(3), 277-280. https://doi.org/10.1016/j.diabres.2012.12.023
Grommesh, B., Lausch, M. J., Vannelli, A. J., Mullen, D. M., Bergenstal, R. M., Richter, S. A., & Fish, L. H. (2016). Hospital insulin protocol aims for glucose control in glucocorticoid-induced hyperglycemia. Endocrine Practice, 22(2), 180-189. https://doi.org/10.4158/EP15818.OR
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
Umpierrez, G. E., Hellman, R., Korytkowski, M. T., Kosiborod, M., Maynard, G. A., Montori, V. M., Seley, J. J., & Van den Berghe, G. (2012). Management of hyperglycemia in hospitalized patients in non-critical care setting: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 97(1), 16-38. https://doi.org/10.1210/jc.2011-2098
Umpierrez, G. E., Smiley, D., Zisman, A., Prieto, L. M., Palacio, A., Ceron, M., Puig, A., & Mejia, R. (2007). Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT 2 trial). Diabetes Care, 30(9), 2181-2186. https://doi.org/10.2337/dc07-0295
What the NU800 Unit 4 assignment asks for
For Unit 4 you build an evidence table for the sources your search retained. Most versions ask for each source's citation, design, setting, sample, intervention, outcomes, findings and an evidence level with a quality grade, using a named hierarchy. Around four pages, often printed sideways, is typical. Faculty reward tables that apply one hierarchy consistently, label indirect evidence honestly, report findings accurately with the source's own numbers, and add columns that the project's question needs, such as how an outcome was counted. A short summary beneath the table should say what the body of evidence shows as a whole and where it is weakest, since that paragraph feeds directly into the synthesis that follows.
How the NU 800 Unit 4 example is put together
The table's construction and the Johns Hopkins levels are explained first. Eight rows follow. The three guidelines are graded Level IV, with their thresholds and advice on monitoring and insulin. Two observational studies of steroid-treated inpatients report how common hyperglycemia was and when it appeared, each counted per patient at a different threshold. A small randomized trial of NPH is graded Level I with a note on sample size. The basal-bolus trial is marked indirect because its patients were not on steroids, and a narrative review explains the afternoon peak. The highlighted sentence notes that no source counts patient-days, and the summary separates problem evidence from treatment evidence.
Where the points sit in the NU800 Unit 4 rubric
Evidence tables are frequently scored on completeness, accuracy, appraisal, organization and synthesis. Completeness earns credit when every retained source appears with all columns filled. Accuracy is judged on correct reporting of design, sample and findings. Appraisal rewards consistent use of a named hierarchy and quality grading, with indirect evidence labeled. Organization is credited when the table can be read row by row and column by column. Synthesis scores well when a short summary identifies the strength and gaps of the body of evidence. An added column that addresses a problem specific to the project, such as counting methods, often earns credit for critical thinking.
NU800 Unit 4 help: mistakes that cost points
A common weakness is grading sources by design alone without considering quality or relevance. Another is omitting how outcomes were counted, which leads to comparing rates that measure different things. Some tables summarize findings in general terms rather than with the source's numbers. Others mix hierarchies or leave guidelines out. Many treat indirect evidence as if it were direct. And tables often end without any summary. Apply one hierarchy consistently, report each source's own figures, add the column your question needs, mark indirect evidence as indirect, and write a paragraph on what the table as a whole can and cannot support. Finally, check each row against the full text rather than the abstract, since abstracts often omit the counting details your added column needs.
Get an NU800 Unit 4 example written to your instructions
One row per study, the counting method each used, levels, grades and a notes block: the free first custom sample delivers all of it within 24-48h. It works from the studies you retained, or their citations if full texts are still coming, plus the evidence hierarchy your program names and the Unit 4 rubric. 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 4 questions, answered
Which evidence hierarchy should an NU800 table use?
Whichever your program or section names; Johns Hopkins, Melnyk and Fineout-Overholt, and others all appear in doctoral nursing courses. What matters is naming it and applying it consistently. The sample uses the Johns Hopkins levels with quality grades because the appraisal tools accompanying them make each grade traceable to specific questions about the study.
Where can I find a free NU800 Unit 4 sample paper?
This page presents the complete NU800 Unit 4 evidence table, with its construction, eight rows each with design, sample, counting method, findings and level, and a summary of what the evidence shows, plus nine references. A table for your own sources can be requested.
Why add a counting-method column in NU800 Unit 4?
Because the sources count high glucose differently, per patient or per reading, at 180 or 200 mg/dL. Without that column, their percentages look comparable when they are not.
Why is the basal-bolus trial marked indirect in NU800 Unit 4?
Its patients had type 2 diabetes and were not receiving steroids. It shows scheduled insulin outperforms sliding scale in hospital, which supports the project's escalation step, but not directly in the project's population.
Which hierarchy does NU800 Unit 4 use?
The Johns Hopkins evidence levels, from I for experimental studies to V for reviews and expert opinion, with quality graded A to C. Your section may name another hierarchy; what matters is applying one consistently.