| Course | NUR 4053 Research Methods and Evidence-Based Practice in Nursing |
|---|---|
| Module | Module 6 |
| Paper type | Research ethics paper |
| Length | 1,260 words, about 5 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 4053 Module 6
Nobody Will Be Touched, So Why Ask Permission? Research Ethics, Consent and a Retrospective Review of 180 Fall Charts
Student Name
American College of Education
NUR4053: Research Methods and Evidence-Based Practice in Nursing
Module 6 Assignment
Instructor Name
August 3, 2026
The Plan and the Assumption Behind It
A night charge nurse on a 32-bed medical unit has noticed that several patients who fell over the past two years had bed alarms that were turned off at the time. She wants to know whether the pattern is real. Her plan is to pull the electronic records of every patient who fell on the unit over the past two years, about 180 falls, and record for each one the patient's age, diagnoses, medications, fall-risk score, whether a bed alarm was ordered and whether it was active when the fall occurred. If the pattern holds, she hopes to present the findings at a regional nursing conference and perhaps write them up for a journal. The nurse and her unit are composites described for this assignment.
When a colleague asked whether the project needed approval, she answered with an assumption many clinicians share: nobody will be touched, nobody will be asked anything and she already has access to these charts as part of her job, so there is no one to ask permission from. The assumption is understandable, and it is wrong in a way that matters, because the ethics of research is not only about what happens to a patient's body but about what happens to information patients never agreed to share for this purpose.
The Belmont Principles Applied to Records
The Belmont Report set out three principles that still anchor research ethics in the United States: respect for persons, beneficence and justice (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979). Respect for persons usually appears in the form of informed consent, and it applies to records because a medical record is a detailed account of a person's body, history and vulnerabilities. Patients gave their information to be cared for. Using it to answer a research question is a different purpose, and respect for persons means that someone other than the researcher should decide whether that new use is acceptable without asking them.
Beneficence asks researchers to minimize harm and maximize benefit. The risks in a chart review are not physical, but they are real: a breach of confidentiality, the exposure of diagnoses such as substance use or dementia, or findings that could be traced back to individual patients in a small unit's published data. The benefit, better understanding of bed alarm use and falls, is plausible and worthwhile. Justice asks whether the burdens and benefits of research fall fairly. Patients who fall are disproportionately older, cognitively impaired and dependent, the kinds of people least able to object to the use of their information, which is a reason for more care rather than less. Polit and Beck (2021) note that research using existing records can often proceed without individual consent, but only when an independent review has judged that the risk is minimal and that privacy is protected.
Who Decides Whether Consent Can Be Waived
Federal regulations for human subjects research, known as the Common Rule, define research as systematic investigation whose design aims to produce or add to knowledge that can be generalized, and they apply to studies that obtain, use or analyze identifiable private information about living individuals. The charge nurse's plan meets both parts of that definition. It is systematic, because it applies the same data collection to every fall over a defined period, and its stated purpose, a conference presentation and a journal article, is to produce knowledge that others can use. Her access to the charts as a clinician does not change their status as identifiable private information when they are used for research.
That does not mean every patient must be contacted. Under the regulations, an institutional review board can determine that a study of existing records qualifies for exemption or can waive the requirement for consent when the research involves no more than minimal risk, could not practicably be carried out without the waiver and would leave the patients' rights and welfare intact. Privacy rules for health information add a parallel requirement for a documented waiver of authorization. The central point is not that consent is always required, but that the researcher is not the person who decides whether it can be skipped.
Quality Improvement or Research?
The nurse might reasonably ask whether her project is quality improvement rather than research, since many hospitals do not send quality improvement projects to an institutional review board. The distinction is real but often misunderstood. Lynn et al. (2007), writing for a Hastings Center project on the ethics of quality improvement, describe quality improvement as systematic, data-guided activity designed to bring about immediate improvement in a particular setting. They argue that quality improvement carries its own ethical obligations, including respect for patients' privacy and oversight proportionate to risk, but that it should not be forced through research review when its purpose is local improvement.
By that standard, the nurse's project could be designed as quality improvement: a review of the unit's own falls, carried out through the hospital's quality department, aimed at changing the unit's alarm practices and reported back to the unit's staff. The plan to present and publish pushes it toward research, because it aims at knowledge for other settings. Publishing quality improvement work is possible, and reporting guidelines such as SQUIRE 2.0 exist for exactly that purpose (Ogrinc et al., 2016), but many journals now ask authors to state whether an institutional review board reviewed the project or judged it not to be human subjects research. Either way, the decision about how to classify the project belongs to the institution's designated reviewers, not to the nurse alone.
Before Opening the First Chart
The ethical path forward is straightforward and does not require abandoning the project. Before accessing any record for this purpose, the nurse would contact the hospital's institutional review board office and its quality department together, describe the project, its data points and its intended use, and ask for a determination of whether it is quality improvement, exempt research or research requiring review with a waiver of consent. She would complete the human subjects protection training the institution requires. She would design data collection to record only what the question needs, assign each case a study number and keep the key linking numbers to medical record numbers separate and secured. And she would plan to report results only in aggregate, suppressing any category small enough to identify a patient, such as the two falls involving patients under 40.
These steps would add perhaps four to six weeks before data collection begins. They would also protect the patients whose information she wants to use, protect the nurse from a professional or institutional violation and make her findings publishable, since a journal is unlikely to accept a chart review without documented ethical oversight.
Conclusion
A retrospective chart review can feel ethically weightless because no patient is contacted and the nurse already has access to the records. The Belmont principles, the federal definition of research and the ethics of quality improvement all point the other way. Patients' information carries their trust, and using it for a new purpose, especially one aimed at publication, calls for an independent judgment about risk and consent. The charge nurse's question about bed alarms is a good one, and the right way to answer it begins with asking permission from the people whose job it is to protect the patients in those 180 charts.
References
Lynn, J., Baily, M. A., Bottrell, M., Jennings, B., Levine, R. J., Davidoff, F., Casarett, D., Corrigan, J., Fox, E., Wynia, M. K., Agich, G. J., O'Kane, M., Speroff, T., Schyve, P., Batalden, P., Tunis, S., Berlinger, N., Cronenwett, L., Fitzmaurice, J. M., . . . James, B. (2007). The ethics of using quality improvement methods in health care. Annals of Internal Medicine, 146(9), 666-673. https://doi.org/10.7326/0003-4819-146-9-200705010-00155
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. U.S. Department of Health, Education, and Welfare.
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
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Reading the NUR 4053 Module 6 instructions
The last module of NUR 4053 often covers the ethics of research, including informed consent, privacy and the role of the institutional review board. Most prompts ask you to analyze a case or a proposal using the principles of the Belmont Report, explain what protections apply and who decides, and sometimes distinguish research from quality improvement or evidence-based practice projects. Some sections ask you to critique a historical case, while others want an analysis of a study you might do. Plan on three to five pages that cite the Belmont Report itself as well as the course text. Check the Canvas instructions for whether federal regulations must be cited directly and whether a historical case is required.
Inside the NUR 4053 Module 6 example
The paper begins with the plan in detail, including the chart count, the data points and the intention to publish, and states the nurse's assumption in her own reasoning so it can be answered fairly. The Belmont section applies each principle to records, noting that fall patients are often older and cognitively impaired, which raises the justice question. A regulatory section tests the plan against the definition of research element by element and describes the waiver criteria without predicting the board's decision. The quality improvement section takes that route seriously, using Lynn and colleagues and the SQUIRE guidelines by Ogrinc and colleagues, and shows how publication changes the answer. The final section lists the steps in order and estimates the time they add.
Reading the NUR 4053 Module 6 rubric
Ethics papers in this course are usually graded on accurate use of ethical principles, understanding of protections and oversight, application to the case and recommendations. Principle points require each Belmont principle applied to the facts, not defined in general. The oversight criterion rewards a correct account of who decides, the IRB rather than the investigator, and of what an exemption or waiver means. Application is often the heaviest row and rewards attention to details such as the vulnerability of the patients and the plan to publish. Recommendation marks go to concrete, ordered steps. Sources should include the Belmont Report itself, not a summary of it. Writing and APA 7 formatting complete the rubric.
Common NUR 4053 Module 6 mistakes, and how to avoid them
The commonest weakness is a list of Belmont definitions that never touches the chart review itself. A second common error is claiming a study is exempt; only the institution can make that determination. Students also treat quality improvement as a loophole that removes all ethical duties, which graders mark down. Do not confuse HIPAA privacy rules with research consent rules, though both apply to chart reviews. Avoid dramatic historical summaries unless the prompt asks for them. Keep recommendations practical, such as coding data and limiting variables to what the question needs. If your section assigns a historical case or a study you designed, the desk can write a Module 6 sample on it.
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 American College of Education 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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NUR 4053 Module 6 questions, answered
What does NUR4053 Module 6 usually cover?
NUR4053 Module 6 often ends the course with research ethics: informed consent, protection of human subjects, institutional review boards and the difference between research and quality improvement. Many sections ask students to analyze a case or their own proposed project. Your classroom's instructions decide the scenario, the sources required and the length of the paper.
Does a retrospective chart review need IRB approval?
Usually it needs at least an IRB determination, even if it ends up exempt or approved with a waiver of consent. A chart review aimed at generalizable knowledge, such as a publication, generally meets the federal definition of research. The institution's designated reviewers, not the investigator, decide whether consent can be waived and what privacy protections are required.
Where can I find a free NUR 4053 Module 6 sample paper?
This page publishes the complete research ethics paper on a 180-chart fall review, covering the Belmont principles, the federal rules, quality improvement versus research and the steps before data collection, with margin notes and four references.
Who decides whether a nursing study is exempt from IRB review?
The institution's IRB or a designated office decides, not the investigator. Even a study that looks exempt should be submitted for a determination, so there is a written record before any data are collected.
Does HIPAA apply to a chart review done for research?
Yes. Using identifiable health records for research requires either patient authorization or a waiver granted by an IRB or privacy board, alongside the research consent rules. Removing identifiers early and collecting only what the question needs reduces the risk.