| Course | EDN 818 Innovation and Technology in Health Care |
|---|---|
| Module | Module 5 |
| Paper type | Evidence-based innovation paper |
| Length | About 1,022 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Education |
| Updated | September 2026 |
Free sample paper for EDN 818 Module 5
Borrowing an Innovation Wisely: Appraising the Evidence and Planning the Adoption of a Delirium Prevention Program
Student Name
Doctor of Education Program, Aspen University
EDN 818: Innovation and Technology in Health Care
Instructor Name
Month Day, Year
Borrowing an Innovation Wisely: Appraising the Evidence and Planning the Adoption of a Delirium Prevention Program
On Kingsmere Regional Hospital's two general medical units, about one in five patients aged 70 or older develops delirium during the stay, and those who do tend to stay longer, fall more and leave for a nursing facility rather than home. A geriatrician has proposed adopting the Hospital Elder Life Program, a structured delirium prevention program developed at Yale and used widely since. The course asks leaders to embrace evidence-based practice in innovation. This paper appraises the evidence behind the program, judges its fit with Kingsmere's units, and plans an adoption that keeps what makes it work while adapting what must change.
Why Delirium Is Worth Preventing
Delirium, a sudden disruption of attention and thinking, is common among older inpatients and often goes unrecognized. It is associated with longer stays, falls, loss of function and discharge to institutional care, and it frightens patients and families. Much of it is preventable, because it arises from risk factors the hospital can influence: sleep disruption, immobility, dehydration, sensory impairment and cognitive disorientation.
The Foundational Trial
The program grew from a controlled clinical trial by Inouye et al. (1999), who assigned 852 hospitalized patients aged 70 or older to an intervention unit or usual care using prospective matching. The intervention targeted six risk factors: cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment and dehydration. Delirium affected 9.9% of patients on the intervention unit against 15.0% of those receiving usual care, and total days of delirium and episodes of delirium were also lower. Severity and recurrence did not differ, and adherence to the intervention was 87%.
The Wider Evidence
Later studies tested the approach in other settings. A meta-analysis by Hshieh et al. (2015) pooled 14 studies of multicomponent nonpharmacological interventions. Delirium incidence fell substantially across the studies that reported it, with an odds ratio of 0.47, and by 44% in the four randomized or matched trials; falls fell as well, by 64% in the two randomized or matched trials that measured them. Length of stay and discharge to institutions trended lower, but those differences were not statistically significant.
Appraising the Evidence
The table summarizes the appraisal.
| Question | Finding | Judgment |
|---|---|---|
| Is there a clear effect on the main outcome? | Delirium incidence lower in the original trial and across pooled studies | Yes, consistent across settings |
| How strong are the designs? | A matched controlled trial and a meta-analysis including randomized or matched trials | Moderate to strong; some pooled studies weaker |
| Are secondary benefits shown? | Falls reduced; length of stay and institutionalization not significantly changed | Partly; do not promise savings from shorter stays |
| Does it fit Kingsmere's patients? | Older general medical patients, like the trial populations | Yes |
| What does it require? | Trained staff and volunteers, geriatric expertise, protocol adherence | Feasible with investment |
Fit With Local Conditions
Evidence from elsewhere must meet local reality. Kingsmere's medical units already run hourly rounding and have a volunteer program that serves the emergency department, but they have no dedicated elder life specialist and limited evening staffing. Most nurses have not been trained to screen for delirium, and the units' sleep conditions are poor: vital signs at 2 a.m. and hallway noise are routine. These conditions affect several of the risk factors the program targets and would limit its effect unless addressed.
What Predicts Whether It Will Spread
The systematic review of innovation spread by Greenhalgh et al. (2004) identified attributes that make adoption more likely. The program has a clear relative advantage, preventing harm that staff see every week. It is compatible with nursing values, though it adds tasks. It is moderately complex, with several components and a volunteer role. It can be tried on one unit first, and its results, fewer confused patients, are visible to staff. The review also emphasized that innovations are more likely to be sustained when they can be adapted locally and when the receiving system has the resources and readiness to absorb them.
Keeping the Core, Adapting the Rest
Adapting an evidence-based program without losing its effect requires distinguishing its core components from its adaptable features. The core components are the targeted risk factor protocols: orientation, therapeutic activities, early mobilization, nonpharmacological sleep enhancement, vision and hearing aids, and hydration. Adaptable features include staffing roles, schedules and how volunteers are recruited. Kingsmere will keep every core protocol, assign an elder life specialist from its existing nursing staff at 0.8 full-time equivalent, recruit volunteers from a local college's nursing and pre-health programs, and move routine overnight vital signs for stable patients to reduce sleep disruption.
Costs
The first-year cost is about $142,000: $98,000 for the specialist position, $18,000 for a geriatric nurse consultant's time, $14,000 for volunteer coordination and training and $12,000 for supplies such as hearing amplifiers, reading glasses and activity materials. Because the evidence does not show consistent reductions in length of stay, the business case will rest mainly on fewer falls and fewer patients with delirium, not on bed days, and leaders should be told so plainly.
Fidelity and Evaluation
The pilot will run on one medical unit for a year, with the second unit as a comparison. Measures will include delirium incidence among patients aged 70 or older using a validated screening tool, falls, length of stay, discharge destination and adherence to each protocol. Adherence matters: the original trial achieved 87%, and a program run at low fidelity cannot be expected to produce the published results. Monthly reports will pair outcomes with adherence, so that if results disappoint, the team can tell whether the program or its delivery fell short.
Conclusion
The Hospital Elder Life Program rests on a controlled trial and a meta-analysis that show fewer cases of delirium and fewer falls, although not consistent reductions in length of stay. It fits Kingsmere's patients, and its attributes favor adoption, but local conditions such as poor sleep and thin evening staffing must be addressed for it to work. By keeping the core protocols, adapting roles, stating costs and benefits honestly and measuring fidelity as well as outcomes, Kingsmere can borrow an innovation wisely rather than import it and hope.
References
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581-629. https://doi.org/10.1111/j.0887-378X.2004.00325.x
Hshieh, T. T., Yue, J., Oh, E., Puelle, M., Dowal, S., Travison, T., & Inouye, S. K. (2015). Effectiveness of multicomponent nonpharmacological delirium interventions: A meta-analysis. JAMA Internal Medicine, 175(4), 512-520. https://doi.org/10.1001/jamainternmed.2014.7779
Inouye, S. K., Bogardus, S. T., Jr., Charpentier, P. A., Leo-Summers, L., Acampora, D., Holford, T. R., & Cooney, L. M., Jr. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients. New England Journal of Medicine, 340(9), 669-676. https://doi.org/10.1056/NEJM199903043400901
What the EDN 818 Module 5 instructions ask for
Aspen's EDN 818 description says leaders must embrace evidence-based practice when they pursue innovation, and because the fifth module's prompt appears only to enrolled students, this example appraises the evidence for one innovation and plans its adoption. Papers of this kind ask you to identify an innovation that addresses a real problem, appraise the evidence behind it, judge whether it fits your setting and plan how to adopt it. Report the benefits the evidence supports alongside the outcomes it left unchanged. Assess fit honestly by naming local conditions that could weaken the effect. Distinguish the components that produce the effect from those you can adapt. Build a cost estimate on the benefits the evidence supports. Plan to measure fidelity as well as outcomes.
How the EDN 818 Module 5 example is put together
The paper starts with delirium's burden on two medical units and a geriatrician's proposal. It explains why delirium is worth preventing, then summarizes the foundational trial, where delirium fell from about one patient in seven with usual care to about one in ten with the intervention, and a meta-analysis in which delirium incidence and falls fell while length of stay did not change significantly. A three-column appraisal table follows. Sections on local fit, including poor sleep conditions and thin evening staffing, and on attributes that predict spread lead into the adoption plan, which keeps every core protocol while adapting staffing and volunteer roles. A cost section itemizes $142,000 and warns against promising savings from shorter stays. A one-unit pilot with a comparison unit and adherence tracking closes the paper.
EDN 818 Module 5 rubric: what earns full marks
Evidence-based innovation papers are graded on accurate appraisal, honest reporting of limits, thoughtful fit analysis and a plan that protects fidelity. This example reports both the benefits and the nonsignificant results, which is the honesty instructors look for first. It cites three APA sources: the New England Journal of Medicine trial that established the program, a JAMA Internal Medicine meta-analysis of multicomponent delirium interventions and Greenhalgh and colleagues' synthesis of how new practices diffuse. The distinction between core and adaptable components shows an understanding of implementation that goes beyond adopting or rejecting an innovation whole. Basing the business case on outcomes the evidence supports, and measuring adherence alongside outcomes, makes the plan credible to a doctoral reader.
EDN 818 Module 5 help from the desk
Students often choose an innovation they already like and then collect evidence that supports it. Appraise the evidence first, and report findings that did not favor the innovation. Another weakness is copying a published program without asking whether local conditions match those of the studies; name the conditions that differ. Identify the core components, the ones the evidence depends on, and protect them. Estimate costs realistically and tie savings only to outcomes the research supports. Plan to measure whether the program is delivered as designed, since low adherence explains many disappointing results. Reading a meta-analysis for the first time is easier with help; a tutor can explain odds ratios and confidence intervals using the studies you chose.
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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EDN 818 Module 5 questions, answered
What does EDN 818 Module 5 usually ask for?
Aspen's EDN 818 says leaders must embrace evidence-based practice when exploring innovation, so a paper appraising the evidence for an innovation and planning its adoption is a typical fifth assignment. Follow your classroom prompt.
What is the Hospital Elder Life Program?
A multicomponent program that prevents delirium in hospitalized older adults by targeting risk factors such as disorientation, sleep loss, immobility, sensory impairment and dehydration.
What are core components in an evidence-based innovation?
The elements that produce the effect and must be kept intact when adopting it, as opposed to adaptable features such as staffing roles and schedules that can change to fit local conditions.
Where can I find a free EDN 818 Module 5 sample paper?
The full paper appears above, appraising the evidence for a delirium prevention program in a table and planning its adoption with core components kept intact.
Does the Hospital Elder Life Program shorten hospital stays?
A meta-analysis found fewer cases of delirium and fewer falls, but the reductions in length of stay were small and not statistically significant.