| Course | DNP 810 Evidence-based Practice for Quality Improvement |
|---|---|
| Module | Module 7 |
| Paper type | Implementation planning paper |
| Length | About 1,007 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | DNP |
| Updated | September 2026 |
Free sample paper for DNP 810 Module 7
Planning for What Could Go Wrong: Using the Updated CFIR to Anticipate Barriers to an Antibiotic Redosing Change
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP 810: Evidence-based Practice for Quality Improvement
Instructor Name
Month Day, Year
Planning for What Could Go Wrong: Using the Updated CFIR to Anticipate Barriers to an Antibiotic Redosing Change
Good evidence and a sound improvement design do not guarantee that a change will be adopted. Implementation science studies the factors that help or hinder the use of evidence in practice and the strategies that address them. This paper uses the updated Consolidated Framework for Implementation Research to identify likely barriers to the new redosing process, in which a pharmacist and nurse keep the second antibiotic dose on time after the decision to admit, reports what interviews with staff revealed, and selects implementation strategies matched to each barrier.
The Framework
The Consolidated Framework for Implementation Research was published in 2009 to bring together constructs from many implementation theories into a single framework for assessing the factors that influence implementation (Damschroder et al., 2009). An update in 2022, based on feedback from users, organized it into five domains: the innovation itself; the outer setting, such as policies and external pressures; the inner setting, such as culture, resources and communication; the individuals involved, including their roles and motivations; and the implementation process. The update also better centered the people receiving the innovation and added determinants related to equity (Damschroder et al., 2022). The framework is used here as a checklist for anticipating barriers before implementation.
Using a recognized framework also makes the assessment easier for others to follow and compare with their own settings.
Assessing Barriers
The student interviewed 14 staff members, six emergency nurses, four pharmacists, two hospitalists and two emergency physicians, using questions drawn from the framework's constructs, and coded their responses by domain. Findings are summarized below.
Facilitators emerged as well. Every group agreed that late doses were a real problem once shown the audit, the emergency pharmacists were eager for a clearer role, and the hospital's recent sepsis work had built relationships between emergency and inpatient leaders. The implementation plan builds on these strengths as deliberately as it addresses the barriers.
| Domain | Barrier identified | Illustrative comment |
|---|---|---|
| Innovation | Uncertainty about who owns the second dose once admission orders exist | Nobody wants two teams ordering the same antibiotic |
| Outer setting | Sepsis reporting rewards first-dose timing only | We get measured on the first hour, not the tenth |
| Inner setting | One pharmacist covers the whole hospital overnight | At 3 a.m. I cannot watch the emergency department list |
| Individuals | Nurses fear another alert among many | My screen already beeps all shift |
| Process | No agreed way to hand off the dose plan at transfer | The inpatient nurse doesn't know when it was last given |
Selecting Strategies
Implementation strategies are the methods used to overcome barriers. The Expert Recommendations for Implementing Change project compiled and defined 73 discrete strategies, such as conducting local consensus discussions, changing record systems, auditing and providing feedback, and identifying and preparing champions (Powell et al., 2015). Matching strategies to barriers is not straightforward: when experts were asked which strategies best address specific framework barriers, their recommendations varied considerably, which led the researchers to advise that choices be tailored to context rather than drawn from a fixed list (Waltz et al., 2019).
The project therefore selected strategies for each barrier through discussion with the team. For unclear ownership, a local consensus discussion among emergency, hospitalist and pharmacy leaders will produce a written rule: the emergency pharmacist orders the second dose, and the admission order set suppresses a duplicate first scheduled dose when one is already active. For the outer setting, the sepsis committee will add second-dose timeliness to its internal dashboard, so that the measure receives attention alongside first-dose timing. For overnight pharmacy coverage, the record system will be changed so that the second dose is entered automatically as a pending order with the first dose, requiring only verification. For alert concerns, the nurse reminder will be a task on the work list rather than a pop-up alert, tested with nurses before launch. For handoffs, the transfer report template will add two fields, when the most recent antibiotic was given and when the next one is due.
Two further strategies cut across barriers. Nurse and pharmacist champions on each shift will be identified and prepared, and audit and feedback will give each shift its own on-time rate every two weeks during the pilot.
Monitoring Implementation
The framework also guides evaluation of implementation. Beyond the outcome of late doses, the team will track fidelity, the proportion of eligible patients for whom the process was followed as designed; reach, the proportion of eligible patients who received it; and staff perceptions at three months, using a short survey based on the same domains. If a barrier proves stronger than expected, the team will return to the strategy list rather than conclude that the intervention failed.
Staff who raised barriers in the interviews will be invited to review the three-month results, which closes the loop and shows that their concerns shaped the change. Their feedback will decide whether any strategy is kept, modified or dropped as the process moves from pilot to routine practice.
Equity Considerations
The updated framework asks whether some groups might benefit less from an innovation. Patients who board longest, often those awaiting beds in specialized units or with complex needs, are most exposed to late doses and should benefit most. The team will examine delays by length of boarding, age and preferred language to ensure that improvement reaches all groups, and will check whether patients boarding in hallway spaces, where task reminders may be missed, are served as well as those in rooms.
Results by subgroup will be reported alongside the overall figures at each review.
Conclusion
Using the updated Consolidated Framework for Implementation Research, the project identified barriers in every domain, from unclear ownership of the second dose to overnight pharmacy coverage and alert fatigue, and selected tailored strategies from a recognized compilation to address each one. Planning for barriers before launch, and monitoring fidelity and reach afterward, makes it more likely that the redosing process will be used as intended and that its results reflect the change itself.
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
Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Science, 17, Article 75. https://doi.org/10.1186/s13012-022-01245-0
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015). A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science, 10, Article 21. https://doi.org/10.1186/s13012-015-0209-1
Waltz, T. J., Powell, B. J., Fernández, M. E., Abadie, B., & Damschroder, L. J. (2019). Choosing implementation strategies to address contextual barriers: Diversity in recommendations and future directions. Implementation Science, 14, Article 42. https://doi.org/10.1186/s13012-019-0892-4
Reading the DNP 810 Module 7 assignment instructions
Aspen does not share DNP 810 Module 7 prompts publicly; this sample follows the catalog text about applying research concepts to validate and implement change. An implementation planning paper usually asks you to identify likely barriers and facilitators with a named framework, choose strategies to address them, and describe how you will know the change is being used as intended. Check whether your prompt names CFIR, PARIHS or another framework, whether it requires stakeholder input, and whether a table is expected. Some instructors ask you to address sustainability as well. Look up the length and the number of scholarly sources in the assignment details.
How this DNP 810 Module 7 example is built
About 1,010 words, the example has six sections. It introduces the updated CFIR and its five domains in one paragraph. The barrier assessment section explains how 14 staff were interviewed and places the findings in a table by domain, with a quotation for each. Strategy selection matches each barrier to a named strategy from the ERIC list, with a reason. Monitoring covers fidelity, reach and the measures that will show them. The equity section considers language, age and insurance status as factors that could leave some patients out. The conclusion connects the framework, the barriers and the strategies, and restates why monitoring implementation matters.
DNP 810 Module 7 rubric: what earns full marks
The rubric for this paper will weight the fit between barriers and strategies more than anything else, and the example makes that fit explicit barrier by barrier. The margin notes show how quotations from staff ground the analysis in local evidence, which moves the paper above generic lists. Monitoring earns application credit because it shows how the leader will know whether the plan works. The equity section often lines up with a rubric row on diversity or social determinants. Organization follows the framework's own logic. Formatting credit rests on citing the updated CFIR and the ERIC compilation, both of which have specific published sources.
DNP 810 Module 7 help from the desk
A common mistake is listing barriers everyone could guess, such as lack of time or resistance to change, with no local evidence. Gather input, even informally, and quote it. Students also pick strategies that do not match the barrier, such as education for a problem caused by workflow. Name the barrier's domain and choose a strategy that acts on it. Another gap is monitoring: without fidelity measures, a failed project cannot be told apart from an unused one. Some papers cite the original 2009 CFIR when the updated version from 2022 exists; use the current one. Finally, include equity. A change that works only for some patients is not finished. Ask whose care the redesign might miss, such as patients who speak another language, and plan a check for them.
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 Aspen 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.
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DNP 810 Module 7 questions, answered
What does DNP 810 Module 7 usually ask for?
Aspen's DNP 810 description includes implementing change in practice, so using an implementation framework to plan for barriers is a typical assignment. Check your classroom for the prompt.
What are the domains of the updated CFIR?
The innovation, the outer setting, the inner setting, the individuals involved and the implementation process.
How do I choose implementation strategies?
Identify specific barriers first, then select strategies from a recognized compilation such as ERIC, tailored through discussion with the team, since expert matching recommendations vary.
Where can I find a free DNP 810 Module 7 sample paper?
The whole paper is on this page: an implementation plan that uses the updated CFIR to anticipate barriers to an antibiotic redosing change, with title page, barrier table, references and margin notes. Read it free, or request a custom plan for your own project with the form above.
What framework should I use for DNP 810 Module 7?
The updated Consolidated Framework for Implementation Research is widely used for barrier assessment, and the ERIC compilation helps match strategies to barriers. Use whatever framework your prompt names; if it leaves the choice open, CFIR is a solid, well documented option.