A surgical unit adopts a new two-nurse verification step for high-alert infusions. Six weeks later the day shift completes it about ninety percent of the time and the night shift almost never does, and the reason turns out to be simple: nights runs with one fewer nurse and the second verifier has to walk from the far end of the hall while a pump alarms. The night nurses are not resistant. They are responding rationally to a design that costs them minutes they do not have. Week 7 of NR-587 is where change stops being announced and starts being engineered, and resistance is read as information rather than as an obstacle. Your section may print this as NR 587 or NR587; it is the same course. Chamberlain publishes no syllabi outside Canvas. The placement here is our teaching judgment from the course's catalog arc; your section's rubric decides what your week actually asks.
What NR-587 Week 7 asks for
Late in an eight-week leadership session the writing usually turns to implementation: how a decision becomes a practice, who has to be brought along, and what happens when they are not. This is the stage where two very different papers get written from the same prompt. One announces a change and describes a communication plan. The other treats adoption as a design problem, identifies what the change costs the people asked to make it, and builds the plan around lowering that cost. Only the second one is doing graduate work.
Change models are the usual scaffolding, and they are useful when applied rather than recited. Stage models describe the arc from preparation through implementation to sustainment. Force-based models ask what is pushing for the change and what is holding it in place, which is the more analytically productive question because it directs attention to the restraining side. Diffusion frameworks explain why adoption spreads unevenly across a staff group and why the people who adopt last are often the people whose workflow the change disrupts most. Pick one, name it with its originator and year, and use its categories to organize evidence rather than to organize headings.
Conflict content frequently lands in this same stage, and it should be written as structure rather than as personality. Most durable conflict in a clinical environment is not interpersonal. It is two roles held accountable for outcomes that compete: a charge nurse rewarded for throughput and a bedside nurse rewarded for completeness, a unit that gains capacity from a change and a department that absorbs the extra work. Naming the competing accountability is the analytic move. Describing someone as difficult is not.
Expect a written implementation plan or a case with an implementation component, and read the verbs on your rows carefully. Develop a plan and evaluate a plan produce different papers. If your section runs a posted discussion alongside, remember that posts do not reopen once submitted in Canvas.
The NR-587 Week 7 method, step by step
Six moves for writing an implementation plan that would survive contact with a real unit.
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Write the change as a behavior, not as a goal
Name exactly what a specific person will do differently, at what moment in their shift. Improve verification is a goal. The second nurse scans the bag at the bedside before the pump is programmed is a behavior somebody can either do or not do.
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Count what the new behavior costs in seconds and steps
Time it, or estimate it and say you did. Ninety seconds and forty paces, twelve times a shift, is a real number that explains adoption better than any attitude survey. This is the single most useful paragraph in most implementation papers.
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List the restraining forces before the driving ones
Everyone can write why the change is a good idea. The paper's value is in what holds the old practice in place: workload, layout, competing policy, an incentive pointing the other way, a previous initiative that was abandoned and taught staff to wait.
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Segment the staff group rather than treating it as one
Early adopters, the pragmatic middle whose behavior decides the outcome, and the group with the most to lose. Say what each needs, and be honest that the middle responds to convenience and visible use by peers rather than to rationale.
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Design the conflict conversation as a sequence
Where you address resistance, write the actual sequence: what is said first, what question opens the other person's constraint, what is conceded, what is non-negotiable and why. A named conflict approach helps, but the graded content is the sequence.
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Build sustainment and a decision point into the plan
Say who owns the practice after the launch attention fades, what will be audited, at what interval, and what result would cause you to modify or abandon the change. A plan with no stopping rule is advocacy in a schedule.
A layout and word budget for an implementation plan
Our frame for this stage, sized for roughly 1,500 to 1,900 words. It is our own outline rather than anything the university issues, and your week's rubric outranks it wherever they disagree.
| Section | What belongs in it | Word target |
|---|---|---|
| The behavior change | Who does what differently, at which point in the shift, how many times per shift. | 140 to 180 |
| Cost of compliance | Seconds, steps, cognitive load and what the new behavior displaces from the same minute. | 200 to 250 |
| Restraining and driving forces | Both sides, with the restraining side first and given the greater share of the words. | 260 to 310 |
| Staff segments | The three groups, what each needs, and which one determines whether the change holds. | 220 to 270 |
| Conflict and competing accountability | The roles whose measures point in opposite directions, and the conversation that reconciles them. | 230 to 280 |
| Sequence, sustainment and stopping rule | Timeline with owners, the audit and its interval, and the result that would change the decision. | 250 to 300 |
Evidence craft for implementation writing
Name the change model and use its own vocabulary. Give the originator and the year, then apply the model's categories consistently. A paper that names a model in the introduction and never uses it again has spent a citation on nothing, and graders read that as decoration.
Reach for implementation evidence, not just clinical evidence. The literature on why practice changes succeed or fail is its own body of work, and it is more relevant here than another study proving the clinical intervention works. Barriers, facilitators, audit and feedback, champions and fidelity are the concepts that carry this stage.
Report adoption as a proportion with a denominator. Compliance improved is unscorable. Verification documented in 34 of 61 eligible infusions over two weeks is evidence, and it lets you talk sensibly about which 27 were missed and why.
Treat resistance as data and say so explicitly. Where staff decline a change, write the reason as a finding about the design. This framing is both more accurate and better scoring than an account of attitudes, and it protects your paper from the tone problem that sinks so many implementation papers.
Keep colleagues and incidents de-identified. Conflict writing is where identifiable detail creeps in most easily, because the specifics feel necessary to the story. They are not. Write roles, positions and constraints, and remove anything that would let a reader name a person.
Five mistakes that cost points in this week's territory
- Education as the entire plan. An in-service and a poster change knowledge, not behavior, and staff who already know the rule are not failing for lack of information.
- Resistance treated as a character flaw. Papers that describe staff as set in their ways lose the analysis row and read badly to anyone who has led a unit.
- A timeline with no owners. Weeks one through four with no name attached to any step is a calendar, not a plan.
- No sustainment layer. Changes that depend on attention decay as soon as attention moves, and a plan that ends at go-live has ignored the part that actually determines success.
- No stopping rule. If no result would cause you to change course, you have written advocacy rather than a plan for a decision that could go either way.
Before you submit
- The change is written as a specific behavior at a specific moment
- The cost of compliance is quantified in seconds, steps or displaced tasks
- Restraining forces receive more attention than driving forces
- Staff are segmented, and the deciding middle group is addressed directly
- Conflict is analyzed as competing accountability rather than as personality
- The plan names an owner per step, an audit interval and a stopping rule
Building the implementation plan?
Send the rubric out of Canvas with the change you are proposing and where you expect it to stall. A premium original draft comes back in 24 to 48 hours with the restraining forces costed and the plan owned step by step, and revisions run until the grade lands.