| Course | EDN 820 Evidence-Based Practice and Quality Improvement |
|---|---|
| Module | Module 7 |
| Paper type | PDSA cycle report |
| Length | About 1,031 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Education |
| Updated | September 2026 |
Free sample paper for EDN 820 Module 7
Four Cycles, One Warm Patient at a Time: Plan-Do-Study-Act Testing of Preoperative Warming
Student Name
Doctor of Education Program, Aspen University
EDN 820: Evidence-Based Practice and Quality Improvement
Instructor Name
Month Day, Year
Four Cycles, One Warm Patient at a Time: Plan-Do-Study-Act Testing of Preoperative Warming
The quality improvement plan in Module 6 set an aim of reducing perioperative hypothermia at Allerton Community Hospital from 22% to 10% and identified change ideas from a driver diagram. This paper reports the first four plan-do-study-act cycles, which tested how to deliver 20 minutes of prewarming and continue warming into the operating room. Every cycle opened with a written prediction, ran on a small scale and closed with a choice to keep, change or drop the idea.
Why Small, Linked Cycles
The PDSA method is designed for learning, not merely for implementing. Taylor et al. (2014) found that published projects rarely documented iterative cycles, predictions or frequent data, and that many treated a single rollout as a cycle. The team therefore committed to cycles small enough to fail cheaply, each informed by the last. Starting with one nurse and a few patients meant that a flawed idea affected few people and could be improved within days.
Cycle 1: Gowns Connected Before Arrival
Plan: one holding area nurse would connect a forced-air warming gown to its unit in each bay before the patient arrived and start warming as soon as the patient changed. The team predicted that four of five first-case patients would receive at least 20 minutes of warming. Do: the test ran on one Tuesday with five patients. Study: only two of five received 20 minutes; three arrived late for their appointments and were taken to the operating room after 8 to 14 minutes. Act: adapt. Warming began too late in the patient's stay in holding, so the next cycle moved it earlier.
Cycle 2: Warming at the Preoperative Interview
Plan: the nurse would start warming as the preoperative interview began, rather than after it ended, since the interview and consent took 15 to 25 minutes. The prediction was that eight of ten patients would receive 20 minutes. Do: the test ran over two days with ten first-case patients. Study: nine of ten received 20 minutes or more; one patient declined the gown after feeling warm, and the nurse noted that the interview flowed normally with the gown in place. Act: adopt for first cases, with a check on patient comfort.
Cycle 3: A Week of First Cases
Plan: extend the adopted change to all first cases for one week, across all holding area nurses, and track first-case start times as a balancing measure. The prediction was that at least 85% of patients would receive 20 minutes, with no increase in delayed starts. Do: 41 first-case patients over five days. Study: 34 of 41, 83%, received 20 minutes, slightly below prediction; first-case on-time starts were 90%, unchanged from baseline; recovery arrival temperatures for these patients were below 36 degrees in 4 of 41, about 10%. Act: adopt for all first cases and adapt for later cases, where turnover time is shorter.
Cycle 4: Keeping the Heat On in Transfer
Plan: recovery data showed that orthopedic patients still arrived cold even after prewarming, and observation found that gowns were disconnected for transport and not reconnected until after positioning. The change was a portable warming unit on the transport stretcher for orthopedic cases and a one-line handoff script, 'warming in place since,' with the time. The team predicted that at least 80% of orthopedic patients would arrive in the operating room still warming. Do: 12 orthopedic cases over one week. Study: 10 of 12 arrived with warming in place; the two failures involved a borrowed stretcher without the portable unit. Act: adopt, and add portable units to all orthopedic transport stretchers.
The Cycles at a Glance
The table summarizes the four cycles.
| Cycle | Change tested | Prediction | Result | Decision |
|---|---|---|---|---|
| 1 | Gown connected before arrival | 4 of 5 warmed 20 minutes | 2 of 5 | Adapt: start earlier |
| 2 | Warming started at preoperative interview | 8 of 10 | 9 of 10 | Adopt for first cases |
| 3 | All first cases for one week | 85% or more; no delays | 83%; on-time starts 90% | Adopt; adapt for later cases |
| 4 | Portable warming and handoff for orthopedic transfer | 80% or more still warming | 10 of 12 | Adopt; equip all stretchers |
What the Team Learned
The cycles taught lessons no plan could have supplied. The binding constraint was time in the holding area, not equipment or willingness, which is why starting warming at the interview worked. Staff were more willing to adopt a change they had tested and shaped. Short prewarming was feasible for first cases but harder later in the day, when patients arrived closer to their procedure times. And gains from prewarming could be lost in transfer, which the original plan had not anticipated. The result of the third cycle, about 10% hypothermia among first cases, was consistent with the lower rates reported with 20 minutes of prewarming in a randomized trial (Horn et al., 2012).
Balancing and Safety
No cycle increased first-case delays, and patient discomfort was rare; one patient declined warming and two reported mild sweating, managed by lowering the gown's setting. No skin injuries were reported. The team will keep tracking these measures as the changes spread, because larger scale can reveal problems that small tests do not.
Next Cycles and Spread
The next cycles will test ways to prewarm patients whose procedures follow others, such as starting warming when the patient is called to the holding area and using the pre-procedure phone call to ask patients to arrive earlier. Once process measures reach their targets for later cases, the team will spread the changes to all eligible patients and monitor the outcome on the run chart, using standard rules to judge whether apparent improvement is a real signal (Perla et al., 2011).
Conclusion
Four small, linked cycles moved Allerton from an untested idea to a set of changes that deliver prewarming to most first-case patients and keep orthopedic patients warm in transfer, without delaying surgery. Each began with a prediction and ended with a decision, and each built on the last. The early result, about 10% hypothermia among first cases, suggests the aim is within reach, and the remaining work is to extend what worked to cases later in the day.
References
Horn, E.-P., Bein, B., Böhm, R., Steinfath, M., Sahili, N., & Höcker, J. (2012). The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia, 67(6), 612-617. https://doi.org/10.1111/j.1365-2044.2012.07073.x
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895
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
What the EDN 820 Module 7 instructions ask for
Quality improvement plans in Aspen's EDN 820 are meant to be tested, not only written, and plan-do-study-act cycles are the test. With the seventh module's prompt kept for enrolled students, this example reports a series of cycles from one project. Each cycle needs a written plan with a prediction, a small test, a comparison of results against that prediction and a clear choice to keep, rework or drop the change. Start small, with one person and a few patients, and let each cycle build on the last. Record balancing measures as well as the main result. Explain what the team learned that the plan could not have predicted. Finish with the next cycles and how successful changes will spread.
How this EDN 820 Module 7 example is built
The report opens by recalling the aim and change ideas from the plan, then explains why small, linked cycles matter, drawing on evidence that published projects rarely document them. The four cycles follow in order, each described through plan, do, study and act. In the first, only two of five patients reached 20 minutes; in the second, starting at the interview raised this to nine of ten; in the third, a week of first cases reached 83% with no change in on-time starts; in the fourth, portable units kept 10 of 12 orthopedic patients warming in transfer. A five-column table summarizes them. Sections on lessons, including time as the binding constraint, balancing and safety findings, and the next cycles close the report.
Where the marks sit in the EDN 820 Module 7 rubric
PDSA reports are judged on true iteration, written predictions, small-scale testing, data used to make decisions and honest reporting of failures. This example shows each of those features: every cycle has a prediction, the first cycle fails and changes the second, and decisions are stated explicitly. It cites three APA sources: the BMJ Quality and Safety review of how PDSA is applied, a randomized trial of prewarming durations and a practical guide to run charts. Comparing the third cycle's hypothermia rate with the published trial connects local learning to evidence. Reporting a missed prediction and a failure caused by a borrowed stretcher shows the candor that makes improvement reports credible.
EDN 820 Module 7 help: mistakes that cost marks
The commonest problem in PDSA assignments is a single large implementation described as a cycle. Start with a test small enough to run in a day, write your prediction first, and report what actually happened even if it disappoints. Link each cycle to the one before by explaining what the earlier result changed. Track at least one balancing measure. State a clear decision at the end of each cycle. Keep a simple log with dates, numbers and decisions; it makes the write-up far easier. If you are designing cycles for the first time, a tutor can help you size the first test and phrase a prediction you can actually check.
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 820 Module 7 questions, answered
What does EDN 820 Module 7 usually ask for?
Aspen's EDN 820 includes quality improvement plans for patient outcomes, so designing and reporting plan-do-study-act cycles is a typical seventh assignment. Follow your classroom prompt.
Why write a prediction before a PDSA cycle?
Comparing the result with a prediction shows what the team learned about the process, which is the purpose of the cycle, rather than simply recording what happened.
How small should a first PDSA cycle be?
Small enough to fail cheaply, such as one nurse, one day and a few patients, so problems can be found and fixed quickly before wider testing.
Where can I find a free EDN 820 Module 7 sample paper?
The whole report is above: four linked PDSA cycles testing preoperative warming, each with a prediction, a result and a decision, summarized in a five-column table.
What decisions end a PDSA cycle?
Adopt the change, adapt it and test again, or abandon it, based on how the results compared with the prediction.