| Course | DNP 850A Project Planning |
|---|---|
| Module | Module 5 |
| Paper type | Preliminary literature search |
| Length | About 1,266 words, 7 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | DNP |
| Updated | September 2026 |
Free sample paper for DNP 850A Module 5
Before Committing to an Intervention: A Preliminary Literature Search on Nurse-Managed Home Blood Pressure Monitoring
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP 850A: Project Planning
Instructor Name
Month Day, Year
Before Committing to an Intervention: A Preliminary Literature Search on Nurse-Managed Home Blood Pressure Monitoring
A DNP project should not rest on an intervention that the literature does not support. Before the full review that will become chapter two, a preliminary search asks a narrower question: is there enough good evidence to justify the planned change, and where are the gaps? This paper reports that search for my project, in which registered nurses at one health center clinic will manage patients' home blood pressure readings and adjust medication under a signed protocol. It sets out the search question, the strategy and its yield, the screening rules, the core sources and what they show, and the gaps that the full review must close.
The Search Question
The search question was drawn directly from the project's PICOT question, stripped of the local details that no study would share. In adults with uncontrolled hypertension in primary care, does self-measured blood pressure monitoring combined with team-based medication management lower office blood pressure and raise the share of patients at goal, compared with usual care? Two parts of that question mattered most. The first was the combination: monitoring at home is a measurement strategy, and it can only lower blood pressure if someone acts on the readings. The second was the team: the project gives the titration role to nurses, so the search had to find out whether evidence for that role exists or whether it has been borrowed from pharmacists and physicians.
Search Strategy and Yield
PubMed was searched in September 2026 with three concept blocks. The first captured the monitoring itself, using the title and abstract phrases self-measured blood pressure, home blood pressure, blood pressure telemonitoring and self-monitoring of blood pressure. That block alone returned 2,857 records. The second block captured who acts on the readings, using nurse, team-based, titration and pharmacist; combining the two blocks left 275 records. Limiting publication to 2014 onward, so that the evidence would reflect current devices and guidelines, left 184. A publication-type filter for trials and evidence syntheses cut the set to 41, and an English-language limit left 40.
Each step was recorded with its count so the search can be repeated and audited, which is the standard a full review will have to meet. The same concept blocks, translated into subject headings, will be run in CINAHL and the Cochrane Library for the full review, because nursing trials are sometimes indexed there and not in PubMed. Two older sources published before 2014 were added by hand after they appeared repeatedly in the reference lists of the newer reviews, a technique known as backward citation searching.
Screening
Titles and abstracts were screened against four rules. Studies had to enroll adults with hypertension in outpatient or primary care; studies in pregnancy, dialysis or hospital settings were set aside. The intervention had to include home or self-measured readings, not only office or ambulatory measurement. There had to be a comparison with usual care or with less intensive support. Finally, the outcomes had to include office blood pressure or blood pressure control. Device validation studies and cost analyses without clinical outcomes were noted for later chapters but not used here. The sources that survived screening were sorted by design, and the five that carry the most weight for the project's question form the core of this preliminary review.
What the Core Sources Show
The five sources are summarized in the table and discussed below.
| Source | Design | Main finding | Relevance to the project |
|---|---|---|---|
| Uhlig et al. (2013) | Systematic review and meta-analysis, 52 comparative studies | Home monitoring alone lowered blood pressure at 6 months but not at 12; paired with added support, one-year systolic falls ranged from 3.4 to 8.9 mm Hg | Support, not monitoring alone, drives the effect |
| Tucker et al. (2017) | Individual patient data meta-analysis of 25 trials | Effect grew with the intensity of co-intervention, from none for monitoring alone to 6.1 mm Hg with intensive support | The project's titration protocol is the intensive support |
| Margolis et al. (2013) | Cluster randomized trial, 450 adults in 16 clinics | Telemonitoring plus pharmacist management: sustained control in 57.2% of patients against 30.0% with usual care | Closest model to the project, but led by pharmacists |
| McManus et al. (2018) | Randomized trial, 1,182 patients in 142 practices | Self-monitoring used for titration lowered systolic pressure by 3.5 to 4.7 mm Hg at 12 months | Titration based on home readings works in primary care |
| Proia et al. (2014) | Systematic review of 80 studies of team-based care | Median 12 percentage point increase in control and 5.4 mm Hg lower systolic pressure | Supports shifting management to nonphysician team members |
Read together, the sources agree on a point that shapes the whole project: home readings lower blood pressure only when they lead to action. Uhlig et al. (2013) found that monitoring without added support had an effect that faded by 12 months, while monitoring with support produced lasting reductions. Tucker et al. (2017) reached the same conclusion with stronger methods, pooling data on individual patients and showing that the benefit rose step by step with the intensity of the co-intervention. The two trials show what that intensity looks like in practice. In the trial by Margolis et al. (2013), pharmacists reviewed transmitted readings and adjusted medication, and blood pressure control nearly doubled. In the trial by McManus et al. (2018), patients' own readings guided titration by their practices, and systolic pressure fell further than with usual care whether or not the readings were sent electronically. Proia et al. (2014) widen the lens, showing across 80 studies that moving management work to team members other than physicians improves control.
Does the Evidence Support the Intervention?
The answer is yes, with one qualification. The evidence strongly supports home monitoring combined with active, protocol-driven medication management in primary care, and it supports giving that management to members of the team other than physicians. The qualification concerns who those team members are. The most direct trial evidence involves pharmacists, and the individual patient data analysis includes trials where physicians or patients themselves did the titrating. Trials in which registered nurses held the titration role appear in the team-based care literature, but this preliminary search did not isolate them. The project can proceed on the strength of the combined evidence, but the full review must search specifically for nurse-led titration trials and report what they show, because a committee will ask whether the nursing role has been tested and not only assumed.
Gaps the Full Review Must Close
Three gaps remain. The first is the nurse-specific evidence just described. The second is the population: most trials enrolled insured, English-speaking patients, while the project clinic serves many patients who are uninsured or prefer Spanish, so the full review should look for trials in safety-net settings and for studies of language-concordant support. The third is durability. Most trials report outcomes at 6 or 12 months, while the project runs for 12 weeks, so the review should say what short-term results can and cannot show. Each gap will become a subsection of chapter two, and together they will shape how cautiously the project's results are reported.
Conclusion
The preliminary search supports the planned intervention. Home blood pressure monitoring lowers blood pressure when it is paired with active medication management, and team-based care that shifts that management beyond physicians improves control. The search also showed that the strongest trials used pharmacists rather than nurses and enrolled populations unlike the project clinic's. The project will therefore go forward, and the full review will focus on nurse-led titration, safety-net populations and what a 12-week result can claim.
References
Margolis, K. L., Asche, S. E., Bergdall, A. R., Dehmer, S. P., Groen, S. E., Kadrmas, H. M., Kerby, T. J., Klotzle, K. J., Maciosek, M. V., Michels, R. D., O'Connor, P. J., Pritchard, R. A., Sekenski, J. L., Sperl-Hillen, J. M., & Trower, N. K. (2013). Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: A cluster randomized clinical trial. JAMA, 310(1), 46-56. https://doi.org/10.1001/jama.2013.6549
McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J., Bradburn, P., Farmer, A., Grant, S., Greenfield, S. M., Heneghan, C., Jowett, S., Martin, U., Milner, S., Monahan, M., Mort, S., Ogburn, E., Perera-Salazar, R., Shah, S. A., . . . Banerjee, T. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): An unmasked randomised controlled trial. The Lancet, 391(10124), 949-959. https://doi.org/10.1016/S0140-6736(18)30309-X
Proia, K. K., Thota, A. B., Njie, G. J., Finnie, R. K. C., Hopkins, D. P., Mukhtar, Q., Pronk, N. P., Zeigler, D., Kottke, T. E., Rask, K. J., Lackland, D. T., Brooks, J. F., Braun, L. T., & Cooksey, T. (2014). Team-based care and improved blood pressure control: A community guide systematic review. American Journal of Preventive Medicine, 47(1), 86-99. https://doi.org/10.1016/j.amepre.2014.03.004
Tucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Earle, K., George, J., Godwin, M., Green, B. B., Hebert, P., Hobbs, F. D. R., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., . . . McManus, R. J. (2017). Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLOS Medicine, 14(9), Article e1002389. https://doi.org/10.1371/journal.pmed.1002389
Uhlig, K., Patel, K., Ip, S., Kitsios, G. D., & Balk, E. M. (2013). Self-measured blood pressure monitoring in the management of hypertension: A systematic review and meta-analysis. Annals of Internal Medicine, 159(3), 185-194. https://doi.org/10.7326/0003-4819-159-3-201308060-00008
Reading the DNP 850A Module 5 assignment instructions
The fifth module of Project Planning turns from the site to the literature. Aspen's own module wording is available only to enrolled students, and this example was shaped by the course summary, which lists an outline of the literature chapter among the course outputs. A preliminary search assignment typically asks you to state a search question, describe databases, terms and limits, report what the search returned, and judge whether the evidence supports your intervention. Some faculty want a PRISMA-style flow of counts, an evidence table or a published scale for grading evidence. Others ask for a short annotated bibliography instead. Check the required number of sources, whether they must be recent, and whether your committee chair must approve the search terms before you run them.
How this DNP 850A Module 5 example is built
Roughly 1,270 words make up this example, organized in eight parts. It opens by explaining what a preliminary search is for and how it differs from the full review. The search question section shows how the PICOT was stripped of local details so studies could match it. Search strategy and yield gives the concept blocks and the count at every step, with the date the search was run, and notes the plan to repeat it in CINAHL and the Cochrane Library. Screening lists four inclusion rules. The evidence table then summarizes design, main finding and relevance for five sources, followed by a synthesis paragraph. A section on whether the evidence supports the intervention gives a qualified yes, and the gaps section turns those qualifications into the plan for chapter two.
DNP 850A Module 5 rubric: what earns full marks
When faculty grade a search paper, the weight usually falls on reproducibility, the quality of the sources and the judgment drawn from them. Reproducibility is covered by reporting every term, limit and count, and the margin notes explain why the date of the search matters. Source quality is covered by leaning on two meta-analyses and two randomized trials rather than on single-site reports. Judgment is where many papers lose marks, and this one earns them by naming a real qualification: most trials used pharmacists, not nurses, to titrate medication. The table satisfies organization and presentation criteria in a small space. The final rows of any rubric concern APA format, so check that each study in the table is cited in the text and appears in the reference list.
DNP 850A Module 5 help from the desk
The first trap is running a search without recording it, then being unable to explain how the sources were found. Write down every term, limit and count as you go. A second is choosing sources because they agree with you; a preliminary search is meant to test the intervention, so report findings that limit it too. Students also confuse the preliminary search with the full review and try to cover everything, which makes the paper long and shallow. Five to eight strong sources are enough at this stage. Another mistake is citing reviews without saying what they pooled, which hides the size of the evidence. Finally, end with gaps. A search that finds nothing missing has usually not looked hard enough, and your chapter two plan depends on knowing what is still unknown.
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.
More DNP 850A and DNP sample papers
- DNP 850A Module 1: Selecting and Testing a DNP Project Topic
- DNP 850A Module 2: Problem Statement and Purpose Statement
- DNP 850A Module 3: The PICOT Question and Its Definitions
- DNP 850A Module 4: Needs Assessment of the Project Site
- DNP 850A Module 6: Choosing the Project Design
- DNP 850A Module 7: Stakeholders, Site Support and Feasibility
- DNP 850A Module 8: Draft of Chapter One
- DNP855 Module 7: Change Strategy Paper
- DNP845 Module 5: Theory Concept Mapping Paper
- DNP 820 Module 2: Health Care Economics and Cost Drivers
- DNP 835 Module 5: Business Case and Return on Investment
DNP 850A Module 5 questions, answered
What does DNP 850A Module 5 usually ask for?
Aspen's DNP 850A description includes preparing the outline of the project's literature chapter, so a preliminary search that tests whether evidence supports the intervention is a typical assignment. Check your classroom for the prompt.
How many sources does a preliminary DNP literature search need?
Enough to answer whether the intervention is supported. Five strong sources, including systematic reviews, can do that at the planning stage; the full review later covers the literature in depth.
Why report the number of records at each search step?
Counts at each step make the search reproducible and show how the final set was reached, which is the standard a committee and a full review will expect.
Where can I find a free DNP 850A Module 5 sample paper?
The whole preliminary literature search is on this page, including the evidence table, the search counts and a margin note on each section. It is open to read. The same home blood pressure project runs through Modules 1 to 8 of this course, so the papers can be read in order.
Do I need a PRISMA diagram for DNP 850A Module 5?
Not usually at the preliminary stage, unless your faculty asks for one. Reporting the count after each search step in the text, as this example does, gives the same information in a form that fits a short paper.