| Course | DNP 850A Project Planning |
|---|---|
| Module | Module 6 |
| Paper type | Project design paper |
| Length | About 1,059 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | DNP |
| Updated | September 2026 |
Free sample paper for DNP 850A Module 6
Improvement, Not Proof: Choosing a Pre-Post Design With a Historical Comparison for a Home Blood Pressure Project
Student Name
Doctor of Nursing Practice Program, Aspen University
DNP 850A: Project Planning
Instructor Name
Month Day, Year
Improvement, Not Proof: Choosing a Pre-Post Design With a Historical Comparison for a Home Blood Pressure Project
A DNP project's design decides what its results can mean. Choose one that is too weak and the committee cannot tell whether the change made any difference; choose one that is too ambitious and the project cannot be completed at a single clinic in one semester. This paper settles the design for my project, where two nurse care managers in a single clinic will act on what patients measure at home, changing doses under protocol, over a 12-week period. It sets out what the design must do, compares five candidates, explains the choice, names the threats to validity with the steps that reduce them, and states how the project will be reported.
What the Design Must Do
Four requirements came from the project's purpose statement and the site's conditions. First, the design must match the project's aim, which is to implement a practice change and evaluate its effect at this clinic, not to prove that home monitoring works in general; that question has already been answered by trials. Second, it must be feasible with about 70 enrolled patients, one clinic, two nurses and a 12-week window. Third, it must be ethical: the clinic will not withhold a supported intervention from eligible patients who want it, so random assignment to usual care is off the table. Fourth, it must allow the project to learn while it runs, adjusting the workflow as problems appear, because a rigid protocol that cannot change would waste the nurses' early experience.
Designs Considered
Five designs were compared against those requirements, as the table shows.
| Design | Strength | Weakness for this project |
|---|---|---|
| Randomized controlled trial | Strongest protection against bias | Withholds the intervention; too large and too long for one clinic; answers a research question |
| Cluster randomized trial across the three clinics | Randomizes sites rather than patients | Only three clinics, far too few clusters to balance them |
| Interrupted time series | Separates a real change from an existing trend | Needs many data points before and after; 12 weeks is too short for monthly measures |
| Single-group pre-post | Simple and feasible | Cannot rule out change that would have happened anyway |
| Pre-post with a historical comparison group, plus run charts | Adds a usual-care benchmark and shows change week by week | Comparison group differs in time and possibly in measurement |
The Chosen Design
The project will use a pre-post design with a historical comparison group, supported by weekly run charts. Each enrolled patient's office blood pressure before enrollment will be compared with the reading at 12 weeks. A comparison group will be drawn from the clinic's records for the same months of the previous year: patients who met the same eligibility rules, had an elevated reading and then received usual care, with their office reading about 12 weeks later. The difference in change between the two groups is the project's main estimate of effect. Run charts will track process measures weekly, including the share of enrolled patients sending readings, the days from an elevated reading to a nurse contact and the number of medication changes. Plan-do-study-act cycles will use those charts to adjust the workflow, an approach whose value depends on documenting predictions and changes rather than simply labeling the work as cycles (Taylor et al., 2014).
Harris et al. (2006) place designs of this kind in a hierarchy of quasi-experimental studies. A single pre-post measurement without a comparison sits near the bottom, while adding a comparison group, or several measurements before and after, moves a study up. The chosen design takes one step up that ladder with the historical group and adds repeated measurement of process through the run charts. Portela et al. (2015) describe improvement studies as a family of designs chosen for the question at hand, and they note that designs which learn during implementation suit projects aimed at making a change work in one setting.
Threats to Validity and How They Are Reduced
Five threats matter most. Regression to the mean is the first: patients are enrolled because a reading was high, and a high single reading tends to be followed by a lower one even without any change. To reduce this, eligibility will require two elevated readings on separate days, and baseline will be the average of the two. The comparison group will be selected with the same rule, so any remaining regression affects both groups. History is the second threat: something else might change at the clinic during the project, such as a new medication formulary. The project log will record such events so they can be weighed.
Selection is the third. Patients who agree to monitor at home may be more motivated than those in the historical group. The project will compare the groups on age, baseline pressure, number of medications, insurance and preferred language, and will report any differences. Measurement is the fourth and the least obvious: the needs assessment led to training medical assistants in standardized office measurement, which improves this year's readings but means the comparison group's readings were taken less carefully. The effect could go either way, and the paper will say so rather than adjust for it. The fifth threat is attrition. Patients who stop sending readings will be kept in the analysis with their last office reading, and the number lost will be reported.
Reporting
The project will be reported under the SQUIRE 2.0 guidelines, under which an improvement report explains its setting, what was done and how that shifted during the work, how the change itself was studied, and how outcomes were judged (Ogrinc et al., 2016). Writing to those headings from the start will keep the project log useful. It will also discourage claims the design cannot support. The final report will describe the result as a change observed at one clinic under stated conditions, compared with usual care in the prior year.
Conclusion
A pre-post design with a historical comparison and weekly run charts fits a project that aims to implement a supported change at one clinic and learn from it. It cannot prove that the change caused every point of improvement, and it does not need to, because the trials have already answered that question. What it can do is show whether the change worked here, under these conditions, and how the workflow was adjusted to make it work.
References
Harris, A. D., McGregor, J. C., Perencevich, E. N., Furuno, J. P., Zhu, J., Peterson, D. E., & Finkelstein, J. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Informatics Association, 13(1), 16-23. https://doi.org/10.1197/jamia.M1749
Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986-992. https://doi.org/10.1136/bmjqs-2015-004411
Portela, M. C., Pronovost, P. J., Woodcock, T., Carter, P., & Dixon-Woods, M. (2015). How to study improvement interventions: A brief overview of possible study types. BMJ Quality & Safety, 24(5), 325-336. https://doi.org/10.1136/bmjqs-2014-003620
Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety, 23(4), 290-298. https://doi.org/10.1136/bmjqs-2013-001862
Reading the DNP 850A Module 6 assignment instructions
In this module the planning moves from what the project will change to how its effect will be judged. Aspen's catalog summary for DNP 850A names determining the project design as one of the course's tasks, and this example follows that summary because the classroom prompt itself is not public. A design paper usually asks you to identify candidate designs, compare them, choose one and justify it, and discuss validity and ethics. Your faculty may require you to classify the design with a named typology, to address the difference between research and quality improvement, or to state how the project will be reported. Look for a length limit and a source minimum, and ask your chair early whether your institution's review board will treat the project as quality improvement.
How this DNP 850A Module 6 example is built
The example is about 1,060 words in seven sections. The introduction explains why design decides what results can mean. What the design must do lists four requirements drawn from the purpose statement and the clinic's conditions. Designs considered compares five options in a table with a strength and a weakness for each. The chosen design section describes the pre-post comparison, how the historical group will be drawn from the same months of the prior year, and how weekly run charts and improvement cycles will track process. It places the design in a published hierarchy of quasi-experimental studies. Threats to validity are then taken one by one with a remedy for each. A short reporting section commits to SQUIRE 2.0, and the conclusion restates what the design can and cannot show.
Where the marks sit in the DNP 850A Module 6 rubric
A design paper is marked mainly on the fit between design and purpose, the fairness of the comparison and the handling of validity. This example earns the first by stating requirements before naming any design, so the choice follows from them. The comparison table treats each rejected design fairly, and the margin notes explain why dismissing a randomized trial requires reasons, not just a claim that DNP projects never use one. Validity is where the paper is strongest, since it names threats specific to this project, including regression to the mean from enrolling patients after a high reading. Committing to a reporting guideline shows awareness of how improvement work is published. Organization, APA style and clear writing account for the rest of the rubric.
DNP 850A Module 6 help: mistakes that cost marks
Students often choose a design by habit, writing that the project is a quality improvement pre-post study without explaining why. State the requirements first and show how the design meets them. Another common error is describing a comparison group without saying how it will be selected, which leaves a grader unable to judge bias. Give the selection rule. Many papers list generic threats to validity copied from a textbook; name the threats that apply to your project and what you will do about each. Some students also overclaim, promising that the project will prove effectiveness, which a pre-post design cannot do. Finally, do not forget ethics. If you reject a design because it would withhold care, say so, since that reasoning is part of the justification.
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 5: Preliminary Literature Search
- DNP 850A Module 7: Stakeholders, Site Support and Feasibility
- DNP 850A Module 8: Draft of Chapter One
- DNP 805 Module 3: High Reliability and Just Culture
- DNP880 Module 7: Final DNP Project Paper
- DNP 825 Module 4: Interoperability and Health Information Exchange
- DNP 840 Module 5: Break-Even and Cost Behavior Analysis
DNP 850A Module 6 questions, answered
What does DNP 850A Module 6 usually ask for?
Aspen's DNP 850A description includes determining the project design, so a paper that compares designs and justifies one is a typical assignment. Check your classroom for the prompt.
Can a DNP project use a randomized controlled trial?
Rarely. DNP projects implement and evaluate a practice change at a site, and withholding a supported intervention is usually neither ethical nor feasible, so quasi-experimental and improvement designs are the norm.
What is regression to the mean?
When people are selected because a measurement was unusually high, their next measurement tends to be lower even without any change. Requiring two elevated readings and using their average as baseline reduces the problem.
Where can I find a free DNP 850A Module 6 sample paper?
This page carries the full design paper for the home blood pressure project, including the comparison table and notes on each section, at no cost. The papers for the other modules of DNP 850A follow the same project, from topic selection to the chapter one draft.
Which design fits a DNP 850A Module 6 project?
Most DNP projects use quasi-experimental or improvement designs, such as pre-post comparisons, historical comparison groups, interrupted time series or run charts with improvement cycles. Choose the one your site, sample size and timeline can support, and explain its limits.