Course Context and FlexPath Architecture
NURS-FPX 9901 is the first in a four-course doctoral project sequence at Capella University’s School of Nursing and Health Sciences. Within the FlexPath learning format, learners progress through assessments at their own pace within a 12-week billing session, receiving detailed scoring guide feedback from faculty on each submission. There are no mandatory login times or weekly deadlines; instead, each assessment is submitted when the learner is ready, and faculty provide written feedback to guide revision toward a Distinguished score before the learner advances to the next assessment.
At Capella, the doctoral project is a quality improvement (QI) or performance improvement (PI) initiative situated in a real practicum setting. It is not original research involving human subjects as defined by federal regulation; rather, it applies evidence-based practice to address a documented practice gap within a healthcare organization. The practicum experience for FlexPath DNP students involves a professional site where learners, supported by program faculty and an on-site preceptor, design and participate in a practice change initiative — such as a quality improvement project, program evaluation, or evaluation of a new practice model — that is aligned with the 2021 AACN Essentials competencies.
Capella’s DNP FlexPath program requires 1,000 total post-baccalaureate practicum hours. Up to 300 of those hours may be integrated with course assignments and assessments in coursework prior to the doctoral project courses. The remaining hours are completed within NURS-FPX 9901 through 9904. All practicum hours must be documented and verified through Capella’s practicum tracking system before they count toward program completion.
For this assignment brief, the chosen practice topic is the implementation of a nurse-led fall risk assessment and prevention program for older adults enrolled in an adult day care setting — a quality improvement initiative that addresses a documented gap in fall prevention screening and protocol-based care at the learner’s practicum site.
Assessment Overview — NURS-FPX 9901
NURS-FPX 9901 contains three graded assessments that build sequentially toward the full doctoral project. Each assessment is evaluated using a detailed scoring guide with four performance levels. Study the scoring guide for each assessment carefully before writing; faculty score each criterion independently, and a single Non-Performance score on any criterion will prevent progression to the next course until the assessment is revised to at least a Proficient level.
All written assessments in this course follow APA 7th edition formatting, use evidence-based sources published within the last five years, and are written in a scholarly, doctoral-level voice. Capella’s MEAL plan (Main point, Evidence, Analysis, Link back) is a recommended organizational strategy for body paragraphs. Avoid writing in first person unless the assessment instructions explicitly permit it.
Purpose and Instructions
The purpose of Assessment 1 is to introduce your proposed doctoral project topic, identify the specific practice problem at your practicum site, and obtain faculty approval to proceed with the project. This assessment establishes the foundation for all subsequent work in the four-course doctoral project sequence.
Write a 2–3 page paper (excluding the title page and reference list) that addresses all of the following criteria as outlined in the scoring guide:
- Describe the practice problem at your practicum site in specific terms: identify the population affected, the care setting, and the observable or data-supported evidence that the problem exists at this location. For a fall prevention project in adult day care, this means documenting what fall-related data, incident observations, or staff reports confirm a gap in current screening and prevention practice.
- Explain why this problem is a quality or performance improvement issue rather than a research question. Distinguish clearly between QI/PI and human subjects research by referencing applicable federal definitions or AHRQ guidance.
- Identify the proposed intervention or practice change: describe the nurse-led fall risk assessment and prevention program at a conceptual level, naming the components planned (validated screening tool, care planning protocol, staff education, environmental modification).
- State the anticipated project outcomes: what will be measured, and what does improvement look like in quantifiable terms (e.g., a 25% reduction in fall incident rate over 10 weeks; 80% of at-risk participants with active individualized fall prevention care plans by project close)?
- Identify the QI/PI framework or model that will guide the project. The Plan-Do-Study-Act (PDSA) cycle is most commonly used in Capella DNP projects for this type of iterative practice change; however, learners may also choose the Iowa Model, the Lean methodology, or another faculty-approved framework and must justify the selection.
- Cite a minimum of three peer-reviewed scholarly sources current within five years to support the problem description and proposed intervention.
Assessment 1 requires faculty approval before you may submit Assessment 2. Do not begin Assessment 2 until you have received written approval on your topic and practice problem from your course faculty or doctoral project coordinator. Proceeding without approval may result in a Non-Performance score on Assessment 2.
Purpose and Instructions
Assessment 2 requires a 4–6 page paper (excluding title page and references) that formally situates your doctoral project within a QI/PI framework, conducts a gap analysis, and describes the data collection and evaluation plan for the proposed practice change. This assessment builds directly on the approved topic from Assessment 1 and demonstrates doctoral-level integration of evidence, organizational context, and quality improvement methodology.
Your paper must address all of the following scoring guide criteria:
- Practice Problem and Root Cause Analysis: Expand on the Assessment 1 problem description with a structured root cause analysis. For a fall prevention project, identify the root causes of the gap: absence of a validated screening tool; staff reliance on incident-based observation rather than proactive assessment; no documented fall prevention protocol; inconsistent interdisciplinary communication about fall risk status. Use fishbone (Ishikawa) diagrammatic thinking or a 5-Whys analysis to organize the root cause discussion. Reference local or organizational data where available alongside national prevalence statistics.
- Gap Analysis: Systematically compare current practice at the site against evidence-based standards from peer-reviewed guidelines. The World Guidelines for Falls Prevention and Management for Older Adults (Montero-Odasso et al., 2022) and the USPSTF updated systematic review (Guirguis-Blake et al., 2024) provide the benchmark for what a validated, multifactorial fall risk program requires. Articulate specifically what the site lacks relative to these standards.
- QI/PI Framework Application: Apply the PDSA model (or your approved alternative) to each phase of the proposed project. Map the Plan phase to the gap analysis and intervention design; the Do phase to program implementation; the Study phase to data collection and pre/post comparisons; the Act phase to sustainability planning and protocol revision based on findings.
- Data Collection and Measurement Plan: Specify the data sources, collection intervals, and outcome metrics. For a fall prevention project, data may include: fall incident rates (pre and post), staff knowledge pre-test and post-test scores, percentage of at-risk participants who received individualized care plans, and participant or caregiver satisfaction survey scores. Identify who collects the data, when, and how it will be stored and analyzed.
- Stakeholder Analysis: Identify key stakeholders at the practicum site (director of nursing, care aides, activity staff, participants, and family members) and describe their roles in the project. Note potential barriers to implementation — such as staff turnover, scheduling limitations, or resource constraints — and propose mitigation strategies.
- Cite a minimum of six peer-reviewed sources current within five years. No direct quotes; all sources must be paraphrased and cited per APA 7th edition.
Purpose and Instructions
Assessment 3 is a 6–8 page formal implementation plan that translates the QI/PI framework from Assessment 2 into a specific, actionable project design. This document serves as the operational blueprint for your doctoral project and will be reviewed by your practicum faculty and preceptor before implementation begins. University approval is required before any project activities may occur at the practicum site.
The implementation plan must address all of the following scoring guide criteria:
- Project Overview and PICOT/PICO Question: Restate the practice problem, proposed intervention, and anticipated outcomes in PICO(T) format. For a fall prevention project: In older adults aged 65 and older enrolled in an adult day care program (P), does the implementation of a nurse-led, multifactorial fall risk assessment and prevention program (I) compared to current observation-based practice (C) reduce fall incidence rates and increase the proportion of at-risk participants with active care plans (O) within a 10-week implementation period (T)?
- Evidence-Based Intervention Design: Describe each component of the nurse-led fall prevention program with specificity. Name the validated screening instrument selected (Morse Fall Scale or STEADI protocol), justify the choice with evidence, describe the frequency and process of administration, outline the staff education curriculum (session format, duration, content, delivery method), specify the environmental hazard audit process, and describe how individualized care plans will be developed, documented, and updated.
- Implementation Timeline: Provide a week-by-week or phase-by-phase timeline covering all project activities from site preparation and IRB/QI review through data collection, staff training, program launch, monitoring, and final evaluation. Include specific milestones and responsible parties for each activity.
- Ethical Considerations and IRB Determination: Confirm that the project has been submitted to Capella’s Institutional Review Board for a quality improvement determination and state the IRB outcome. Describe any additional ethics review required at the practicum site. Address how participant privacy and data confidentiality will be maintained throughout the project.
- Evaluation Plan and Sustainability: Describe how project outcomes will be evaluated at the close of the implementation period. Specify the statistical or descriptive analysis approach for each outcome metric. Address sustainability: what structural changes, documentation updates, or staff practice modifications will ensure the nurse-led program continues after the project period ends?
- Budget and Resource Justification: Identify all resources required for implementation — staff time for training, screening tool materials, educational handouts, any software or tracking tools — and provide a cost justification. Even in-kind resources provided by the facility must be noted with their estimated value attributed to the relevant cost center.
- Cite a minimum of eight peer-reviewed sources current within five years. No direct quotes. APA 7th edition formatting throughout.
Scoring Guide — Assessment 2: QI/PI Framework (Representative Criteria)
| Criterion | Distinguished | Proficient | Basic | Non-Performance |
|---|---|---|---|---|
| Practice Problem Description and Root Cause Analysis | Provides a thorough, site-specific problem description supported by local and national data; conducts a structured root cause analysis identifying multiple contributing process and system factors; demonstrates doctoral-level critical analysis of why the gap persists. | Describes the practice problem with supporting evidence and identifies root causes; analysis is adequate but may not fully address systemic or organizational factors. | Problem is described without structured root cause analysis; relies primarily on national statistics without site-level grounding; analysis is surface-level. | Practice problem is absent, generic, or entirely unsupported by scholarly evidence; no root cause analysis attempted. |
| Gap Analysis Against Evidence-Based Standards | Systematically compares current site practice to two or more peer-reviewed evidence-based guidelines; identifies specific process and resource gaps; clearly articulates the consequences of each gap for patient safety and care quality. | Gap analysis references at least one evidence-based guideline and identifies primary practice gaps; consequences are noted but may lack specificity. | Gap is mentioned but comparison to evidence-based standards is missing or superficial; consequences are not addressed. | No gap analysis present; or analysis is entirely generic and not connected to the specific practicum site or evidence base. |
| Application of QI/PI Framework to Project Phases | Applies the selected QI/PI model (e.g., PDSA) accurately and specifically to each phase of the project; each phase is described with concrete activities tied to the fall prevention intervention; application demonstrates deep familiarity with the model’s logic and use in healthcare QI. | QI/PI model is identified and applied to the project phases with adequate specificity; some phases may lack concrete detail. | QI/PI model is named but application to project phases is superficial or inaccurate; the connection between the model and specific project activities is unclear. | No QI/PI framework identified or applied; or the model named is a research methodology rather than a QI model. |
| Data Collection and Outcome Measurement Plan | Specifies multiple, concrete data sources, collection intervals, and measurable outcome metrics aligned with the project’s aims; identifies who collects each data point and how data will be managed; metrics are meaningful and directly measure the intended practice change. | Data collection plan identifies main outcome metrics and data sources; collection process is described with some specificity; minor gaps in operational detail. | Data collection plan is present but vague; metrics are not specific or are poorly aligned with the stated outcomes; collection process is not described. | No data collection or evaluation plan; or plan is entirely generic and unrelated to the practice problem. |
| Scholarly Writing, APA, and Source Quality | Writing is doctoral-level in clarity, precision, and objectivity; all six or more sources are peer-reviewed and current within five years; APA 7th edition is applied flawlessly; no direct quotes; MEAL plan organization evident in body paragraphs. | Writing is mostly scholarly with minor lapses; meets source minimum; mostly correct APA with minor errors; rare direct quote present. | Writing lacks doctoral-level precision; fewer than six sources or sources outside the five-year window; frequent APA errors; direct quotes used. | Writing is not at doctoral level; fewer than three peer-reviewed sources; APA largely absent; direct quotes throughout. |
Sample Assessment Writing Guide Response Excerpt — Assessment 2
Fall prevention in adult day care settings represents a quality improvement opportunity that sits squarely within the competency domains outlined in the 2021 AACN Essentials, particularly those addressing person-centered care, population health, and quality and safety, yet most adult day care organizations continue to rely on observation-based, incident-triggered responses to falls rather than the proactive, protocol-driven screening that evidence now clearly supports. At the project practicum site, an adult day care center serving 70 to 85 older adults per session in the mid-Atlantic United States, a root cause analysis conducted in collaboration with the director of nursing and three senior care aides identified four primary contributing factors to the current gap: the absence of any validated fall risk screening instrument, no written fall prevention protocol governing staff response to identified risks, inconsistent documentation of near-miss events that limits the organization’s ability to track fall risk trends, and a lack of formal staff education on fall risk identification since the center’s founding in 2018. A comparison of current practice against the World Guidelines for Falls Prevention and Management for Older Adults (Montero-Odasso et al., 2022) reveals that the site meets none of the three core recommendation categories: annual multifactorial risk assessment, individualized fall prevention care planning, and structured staff training on evidence-based prevention strategies. The Plan-Do-Study-Act (PDSA) cycle was selected as the guiding QI framework because its iterative structure accommodates the short implementation window and small practicum team size; the Plan phase encompasses the gap analysis, intervention design, and staff readiness assessment; the Do phase covers the 8-week program rollout; the Study phase involves weekly fall incident monitoring and pre/post staff knowledge comparison; and the Act phase determines which program elements warrant continuation, modification, or expansion based on the data. Outcome metrics include fall incidence rate per 100 participant-days, percentage of at-risk participants with completed individualized fall prevention care plans, and staff knowledge assessment scores on a validated fall prevention knowledge instrument administered before and after the education sessions.
A common misconception among learners completing NURS-FPX 9901 Assessment 2 is that a gap analysis consists primarily of citing national statistics about fall prevalence among older adults. While national data from sources such as the CDC (2023) and Kakara et al. (2023) in the MMWR are appropriate for contextualizing the significance of the problem, a Capella-level gap analysis requires the learner to move beyond prevalence statistics and instead compare current organizational practice — at the specific practicum site — against a clearly articulated evidence-based standard, then name what the site lacks in terms of process, protocol, staffing, or resource allocation. Learners who submit Assessment 2 with a gap analysis that reads as a literature review rather than an organizational comparison consistently receive Basic or Non-Performance scores on that criterion, requiring resubmission, which delays progression to Assessment 3 and extends the billing session.
For learners completing NURS-FPX 9901 Assessment 3, the most common scoring guide feedback on the implementation plan concerns the specificity of the intervention design and the feasibility of the timeline. A Distinguished score on the evidence-based intervention criterion requires naming the specific validated screening tool selected, explaining why that tool is appropriate for the adult day care population rather than a different setting, describing the frequency and process of administration, and connecting each program component back to a peer-reviewed source that supports its inclusion. Describing the intervention as a “nurse-led fall prevention program” without specifying the tool, the education curriculum content, or the environmental audit protocol will typically yield a Proficient at best, since the scoring guide distinguishes between general descriptions and the specific, operationalized detail that characterizes doctoral-level project planning. Strini et al. (2021), in a systematic literature review of fall risk assessment scales published in Nursing Reports, found that tool selection should be driven by validated sensitivity and specificity data in the target population rather than convenience, which is a point that learners who receive Distinguished scores on Assessment 3 consistently demonstrate in their instrument justification paragraphs.
References
- Agency for Healthcare Research and Quality. (2021). Preventing falls in hospitals: A toolkit for improving quality of care. https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/index.html
- Centers for Disease Control and Prevention. (2023). Important facts about falls. https://www.cdc.gov/falls
- Guirguis-Blake, J. M., Perdue, L. A., Coppola, E. L., & Bean, S. I. (2024). Interventions to prevent falls in older adults: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 332(1), 58–69. https://doi.org/10.1001/jama.2024.9946
- Kakara, R., Bergen, G., Burns, E., & Stevens, M. (2023). Nonfatal and fatal falls among adults aged 65 years and older — United States, 2020–2021. MMWR Morbidity and Mortality Weekly Report, 72(35), 938–944. https://doi.org/10.15585/mmwr.mm7235a1
- Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., & Masud, T. (2022). World guidelines for falls prevention and management for older adults. Age and Ageing, 51(9), afac205. https://doi.org/10.1093/ageing/afac205
- Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430–443. https://doi.org/10.3390/nursrep11020041
- American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf